The study aimed to assess the long-term device survival of a 3-piece inflatable penile prosthesis (PP) in patients with erectile dysfunction (ED). This retrospective observational longitudinal study involved patients with drug-refractory ED who underwent primary 3-piece inflatable PP implantation at a single center from 1992 to 2019. The outcomes included complications of various inflatable PP models, and Kaplan–Meier analysis was used to estimate the probability of PP survival. Of the total 426 patients, 140 (32.9%) were implanted in the period of 1992–2000, 128 (30.0%) in the period of 2001–2008, and 158 (37.1%) in the period of 2009–2019. The PP used in the study included AMS 700 CX (62.0%, n = 264), AMS 700 CXR (7.7%, n = 33), AMS Ultrex Plus (10.3%, n = 44), and Alpha I (20.0%, n = 85). The overall complication rate was 28.2% (120/426), and the majority happened after 6 months. The causes of device removal included mechanical failure (11.0%, n = 47), infection (3.9%, n = 17), cylinder extrusion (6.3%, n = 27), and unspecified (0.2%, n = 1). Of the total mechanical failures (n = 47), 18 (38.3%) occurred in the cylinders, 10 (21.3%) occurred in the pump, 7 (14.9%) occurred in the reservoir, 6 (12.8%) occurred in the connections, and 6 (12.8%) were nonspecific. Global average survival rates of the PP at 1 year, 5 years, 10 years, and 15 years were 96.2%, 86.7%, 77.5%, and 58.7%, respectively. The 3-piece inflatable PP has an excellent device survival rate at 5 years and 10 years.

Keywords: device survival; erectile dysfunction; infection; mechanical failure; penile prosthesis

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