madman
Super Moderator
ABSTRACT
Introduction: Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of erectile dysfunction refractory to medical management. Technological advancements in the design of 3-piece IPPs have been improved to optimize concealability and surgical placement since the 1980s. Recent advancements over the past 10 years include pump, reservoir, tubing, and cylinder updates.
Objectives: This review examines the latest updates in IPP technology, reviews recent relevant research, and is based on over 32 years of experience performing IPP surgery in addition to concurrent postoperative management.
Methods: A literature review was conducted for studies published over the last 10 years through March 2020 with an emphasis on technical updates of IPP, specifically the pump, reservoir, tubing, and cylinder, and their functional outcomes. Anti-infective coating and transgender innovations, in addition to postoperative management, are also reviewed.
Results: Technological advancements include a flat reservoir designed for improved discreteness and a prosthesis with optimized tubing length, a one-touch deflatable 3-piece system, narrow-base cylinders, a 0° angle design between the cylinders and tubing to aid in cylinder placement, a soft molding cylinder tip redesign that better mimics human anatomy, and a 3-piece IPP specifically designed for neophallus use. Furthermore, the Food and Drug Administration approved the submuscular reservoir placement.
Conclusion: Penile prosthesis has evolved over time to improve functional outcomes, ease of use, and minimize postoperative complications and pain. Penile prosthesis implantation continues to be a life-changing procedure for patients and it is imperative for surgeons to be up-to-date on the latest developments and research in order to provide the best functional outcomes for those they take care of.
INTRODUCTION
Over 18 million men in the United States suffer from erectile dysfunction (ED).1 Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of ED refractory to medical management and is under constant improvement by medical professionals and industry collaborations.2This review examines the latest updates in IPP technology reviews recent relevant research and is based on over 32 years of experience performing IPP surgery in addition to concurrent postoperative management. A 3-piece IPP is composed of a scrotal pump, dual intracorporeal inflatable cylinders, and a separate intra-abdominal fluid reservoir. These 3-piece IPPs will be the focus of this review as they provide the best rigidity and flaccidity in addition to holding the largest market share and having vast popularity in comparison to 2-piece IPP and malleable penile prosthesis.3,4 IPP devices developed by the major manufacturers, American Medical Systems (AMS) (Minnetonka, MN, USA, a subsidiary of Boston Scientific), and Coloplast (Minneapolis, MN, USA), formerly Mentor, has been updated. Other manufacturers, including Zephyr Surgical Implants (ZSI) (Geneva, Switzerland) and Rigicon (Ronkonkoma, NY, USA), have also made changes in their products in the last decade. Innovations regarding transgender neophallus and the anti-infective coating will also be discussed.
*INFLATABLE PROSTHESIS MECHANICS INNOVATIONS
*PUMP AND RESERVOIR INNOVATIONS
*CYLINDER AND TUBING INNOVATIONS
*ANTI-INFECTIVE COATING INNOVATIONS
*TRANSGENDER
*OPERATIVE ADVANCES
CONCLUSIONS
The penile prosthesis has evolved over time to improve functional outcomes, ease of use and minimize postoperative complications and pain. Teaching patients how to inflate and deflate remains a challenging portion of the penile implant journey and has been facilitated by preoperatively providing models of the pump in order for patients to familiarize themselves with the different anatomical attributes of the inflation and deflation footprint of the devices. The rise in acceptance and practice of transgender surgery will continue to expand the role of penile prosthesis in patients undergoing female to male gender affirmation procedures. Penile prosthesis implantation continues to be a lifechanging procedure for patients and it is imperative for surgeons to be up-to-date on the latest developments and research in order to provide the best functional outcomes for those they take care of.
Introduction: Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of erectile dysfunction refractory to medical management. Technological advancements in the design of 3-piece IPPs have been improved to optimize concealability and surgical placement since the 1980s. Recent advancements over the past 10 years include pump, reservoir, tubing, and cylinder updates.
Objectives: This review examines the latest updates in IPP technology, reviews recent relevant research, and is based on over 32 years of experience performing IPP surgery in addition to concurrent postoperative management.
Methods: A literature review was conducted for studies published over the last 10 years through March 2020 with an emphasis on technical updates of IPP, specifically the pump, reservoir, tubing, and cylinder, and their functional outcomes. Anti-infective coating and transgender innovations, in addition to postoperative management, are also reviewed.
Results: Technological advancements include a flat reservoir designed for improved discreteness and a prosthesis with optimized tubing length, a one-touch deflatable 3-piece system, narrow-base cylinders, a 0° angle design between the cylinders and tubing to aid in cylinder placement, a soft molding cylinder tip redesign that better mimics human anatomy, and a 3-piece IPP specifically designed for neophallus use. Furthermore, the Food and Drug Administration approved the submuscular reservoir placement.
Conclusion: Penile prosthesis has evolved over time to improve functional outcomes, ease of use, and minimize postoperative complications and pain. Penile prosthesis implantation continues to be a life-changing procedure for patients and it is imperative for surgeons to be up-to-date on the latest developments and research in order to provide the best functional outcomes for those they take care of.
INTRODUCTION
Over 18 million men in the United States suffer from erectile dysfunction (ED).1 Inflatable penile prosthesis (IPP) technology is a mainstay in the treatment of ED refractory to medical management and is under constant improvement by medical professionals and industry collaborations.2This review examines the latest updates in IPP technology reviews recent relevant research and is based on over 32 years of experience performing IPP surgery in addition to concurrent postoperative management. A 3-piece IPP is composed of a scrotal pump, dual intracorporeal inflatable cylinders, and a separate intra-abdominal fluid reservoir. These 3-piece IPPs will be the focus of this review as they provide the best rigidity and flaccidity in addition to holding the largest market share and having vast popularity in comparison to 2-piece IPP and malleable penile prosthesis.3,4 IPP devices developed by the major manufacturers, American Medical Systems (AMS) (Minnetonka, MN, USA, a subsidiary of Boston Scientific), and Coloplast (Minneapolis, MN, USA), formerly Mentor, has been updated. Other manufacturers, including Zephyr Surgical Implants (ZSI) (Geneva, Switzerland) and Rigicon (Ronkonkoma, NY, USA), have also made changes in their products in the last decade. Innovations regarding transgender neophallus and the anti-infective coating will also be discussed.
*INFLATABLE PROSTHESIS MECHANICS INNOVATIONS
*PUMP AND RESERVOIR INNOVATIONS
*CYLINDER AND TUBING INNOVATIONS
*ANTI-INFECTIVE COATING INNOVATIONS
*TRANSGENDER
*OPERATIVE ADVANCES
CONCLUSIONS
The penile prosthesis has evolved over time to improve functional outcomes, ease of use and minimize postoperative complications and pain. Teaching patients how to inflate and deflate remains a challenging portion of the penile implant journey and has been facilitated by preoperatively providing models of the pump in order for patients to familiarize themselves with the different anatomical attributes of the inflation and deflation footprint of the devices. The rise in acceptance and practice of transgender surgery will continue to expand the role of penile prosthesis in patients undergoing female to male gender affirmation procedures. Penile prosthesis implantation continues to be a lifechanging procedure for patients and it is imperative for surgeons to be up-to-date on the latest developments and research in order to provide the best functional outcomes for those they take care of.
