Dissatisfaction with penile prosthesis implantation is multifactorial.
Patients commonly report penile shortening as a major issue; it may be perceived or real. Candidates for penile prosthesis commonly have chronic and advanced ED and therefore are predisposed or already have penile shortening. To reduce dissatisfaction with the procedure and medical/legal liability, proper preoperative counseling is invaluable.
Drs. Montague and Angermeier recently studied the utility of preoperative stretched penile length (SPL) as a predictor of post-implant functional length. Forty-nine patients received either an AMS 700 CX or CXM, or AMS 700 Ultrex depending on the presence or absence of fibrosis (tunica or corporal smooth muscle), respectively. Preoperative stretch, post-operative inflated and deflated lengths were compared.
In the fibrosis patients who received the AMS 700 CX/M, preoperative SPL was predictive in 38% and within 1-cm in 88%. In the non-fibrotic group who received the girth and length expanders (AMS Ultrex), preoperative SPL was predictive in 27% and within 1-cm in 70%. Moreover, with the expanders inflated, the Ultrex group reported penile lengthening of at least 1-cm and up to 3-cm in 15% of patients.
The authors concluded that preoperative SPL was useful for counseling patients on expected penile lengths post-implant. Those patients without fibrosis who undergo the AMS Ultrex implant should expect to gain anywhere from 1 to 3-cm of additional length. Girth was not measured.
By Raymond Pak, MD
Reference:
J Sex Med 2006; 3(Suppl 1) Abstract 102.
Montague DK, Angermeier KW.
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