EXPERIENCE WITH THE ULTREX AND ULTREX PLUS INFLATABLE PENILE PROSTHESIS - NEW IMPLANTATION TECHNIQUES AND SURGICAL OUTCOME

The Ultrex and Ultrex Plus penile prosthesis incorporate sequential de sign modifications that afford important functional advantages that re duce the potential for mechanical failure. This retrospective study re views our experience with these models emphasizing innovations in surg ical technique and postoperative results. Implantation of Ultrex (31%) and Ultrex Plus (69%) penile prosthesis was performed in 90 impotent men with organic erectile dysfunction following comprehensive multi-di sciplinary evaluation. During a follow-up interval of 7-50 months, pos toperative outcome was assessed. Of this group, 10% underwent simultan eous explant of another malfunctioning inflatable device or conversion from a semi-rigid prosthesis due to patient preference. Of the remain der, 20% selected implant surgery as their primary therapy while 73% w ere initially treated with various nonsurgical options prior to implan tation. In all patients rye employed a single peno-scrotal incision an d applied the concept of controlled radial dilatation of all compartme nts. In our last 32 consecutive patients including eight with previous radical pelvic surgery, we utilized the preperitoneal distention ball oon (PDB) facilitating safe and non-traumatic creation of the prevesic al space for reservoir insertion. Post operative complications occurre d in 8% of patients including pump infection and corporal deformity re quiring reimplantation with AMS 700 CX cylinders, or self-contained un itarian prosthesis as a salvage procedure. Satisfactory, functional an d anatomic outcome was reported in 95% of patients. Interim advances i ncorporated into the Ultrex and Ultrex Plus prosthesis have markedly r educed mechanical failure during our follow-up interval of up to 50 mo nths. Importantly, controlled, non-traumatic radial dilatation of the prevesical space by the PDB may encourage broader use of the multicomp onent inflatable models, particularly in a setting of pelvic fibrosis due to previous pelvic surgery or radiation.