Prosthetic Urology Trends: 12-year analysis of inflatable penile prosthesis Implantation using patient information forms data from a single manufacturer
Alzweri, L1; Gabrielson, A1; Hellstrom, W1; Yafi, F2
1: Tulane University, United States; 2: UC Irvine, Orange
Objective: To illustrate the global landscape on inflatable penile prosthesis (IPP) utilization from a single manufacturer’s patient information forms data from 2003-2015.
Materials and Methods: The Coloplast® Device Outcomes Database, which includes 69,260 IPP cases from 2003-2015, was retrospectively analyzed. Endpoints included incidence of IPP implantation, device model used, rear-tip extender (RTE) utilization, rate of revision/explantation and median time to revision/explantation.
Results: Of the 69,260 implantations, 45,813 cases had complete data for full analysis. IPP implantations per year increased from 1,836 in 2003 to 4,414 in 2015, a 2.4-fold increase. RTEs were used in 68% of all cases. In all, revision/explantation was required in 2.56% of cases and the median annual risk of revision was 1.96% +/- 0.68%. The overall revision/explantation rate increased from 1.1% of implants in 2003 to a peak of 3.2% of implants in 2012, followed by a decline back to 1.8% in 2015. For IPPs utilizing RTE, the median length added to a given cylinder in the form of RTEs was 2 +/- 0.96 cm. Subpopulation analysis of 364 patients with complete data found that the most common reasons for revision/explant was fractured tubing or tube leakage (34%), infection (14%), pump failure (13%), and corporal or urethral erosion (10%). There was no association between increased length of RTEs used and the rate of postoperative complications.
Conclusions: Placement of an IPP is a well-established treatment option for men with ED refractory to medical therapy. IPP implantations have increased by 2.4-fold from 2003-2015, with greater adoption of the Titan OTR model. The percentage of IPP utilizing RTE has also increased during that timeframe by 13.6-fold. Although the use of RTE was associated with 2-fold increase in rate of revision, the length added using RTE does not seem to impact the rate of postoperative complications significantly. Prosthetic urology has expanded significantly over the last two decades, and, with increased prevalence and awareness of the treatment options for ED, further growth is anticipated.
Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.Go Back