Fracture at the input tube-cylinder junction of AMS 700 inflatable penile prostheses as a complication of a modified implantation technique in a series of 99 patients

Objectives. To compare the incidence of a specific failure mode of the peni le implant, fracture at the input tube-cylinder junction, with respect to t wo methods of managing the input tube, Methods. AMS 700 series three-piece inflatable penile prostheses were impla nted in the first 26 patients using an ordinary technique in which the inpu t tubing runs alongside the cylinder within the corpus and exits through th e corporotomy (method A). In the subsequent 73 men, the input tube exited t hrough a separate stab wound in the proximal corpus using a modification of the basic surgical technique (method C). The mean follow-up period was 136 .4 months for method A and 69.0 months for method C. The incidence of fract ure at the junction of the input tube and cylinder was compared according t o the variables of input tube management, prosthesis type, and width of the proximal corpora. Results. The overall incidence of mechanical failure was 12.1%. Fractures a t the input tube-cylinder junction with leaking occurred in 7 patients. The cylinders in these patients were all implanted using method C. The inciden ce of fracture at the junction was significantly higher (P < 0.05) in men w ith narrow corpora (17.1%) than in the others (0%), regardless of the type of prosthesis implanted. The average functional duration of the failed pros theses was 66.1 months. Conclusions. The modified surgical procedure (method C) should be avoided i n patients with a narrow-width penis because of an increased likelihood of damage to the input tube-cylinder junction. UROLOGY 54: 148-151, 1999. (C) 1999, Elsevier Science Inc.