(346) Long Term Experience with AMS-700 CXR™ Prosthesis in High-Risk Patients with Corporal Fibrosis

Abstract

Abstract Introduction Although commonly utilized for high-risk patients with corporal fibrosis, outcome data for narrow inflatable penile prosthesis (IPP) cylinders are relatively sparse. Objective The objective of this study is to assess the outcomes of a cohort of patients who underwent IPP placement with the AMS-700 CXR™ (CXR) cylinders at our tertiary referral center. Methods We retrospectively reviewed our institutional IPP database for patients who underwent CXR cylinder implantation between 2007 and 2021. Indications, clinical factors, and surgical outcomes were documented for all patients. Kaplan-Meier survival analysis was performed to illustrate implant survival. Patient satisfaction was assessed with a phone survey in which patients provided feedback on penile length, girth, rigidity, and overall satisfaction with the CXR implant. Results Among 1149 IPP surgeries reviewed during the study interval, 49 (4%) underwent CXR implantation with a mean (SD) age of 64 years (±11). Indications for CXR implantation included history of infected IPP (30/49, 62%), ischemic priapism 8/49 (16%), and idiopathic fibrosis (11/49, 22%). Postoperative complications occurred in 6/49 (12%) patients including infection 3/49 (6%), cylinder herniation 2/49 (4%), and glans necrosis 1/49 (2%). Discordant intraoperative corporal measurements were common (13/49, 27%), as were discordant rear tip extender lengths (16/49, 33%). The explantation and revision rates were 3/49 (6%) and 4/49 (8%), respectively. Forty percent (19/48) of patients were available for phone survey response (Figure). A total of 47% (9/19) of patients were dissatisfied with their implant, primarily due to perceived loss of penile length (12/19, 63%) and girth (10/19, 53%). Five (5/9, 55%) of these patients had a history of IPP explantation. Fifty-three percent (10/19) of those surveyed are still satisfied with their implant with 58% (11/19) pleased with the rigidity the CXR implant provides. Conclusions Narrow based inflatable penile implants have acceptable long-term survival. Cylinder lengths are often discordant in corporal fibrosis patients. Despite use in a high-risk group, patient satisfaction remains acceptable, although many complain of perceived loss of penile length and girth. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast.