An outcomes analysis of over 200 revision surgeries for penile prosthesis implantation: a multicenter study

J Sex Med. 2012 Jan;9(1):309-15. doi: 10.1111/j.1743-6109.2011.02524.x. Epub 2011 Nov 14.


Introduction: Inflatable penile prosthesis (IPP) implantation is a well-established treatment for medically refractory erectile dysfunction, with long-term reliability. Overall survival is 96% at 5 years and 60% at 15 years for primary (virgin) implantation.

Aim: The aim of this study was to explore factors associated with success and complications of IPP revision surgery in a multicenter study.

Main outcome measures: Reasons for revision including mechanical issues, patient dissatisfaction, corporal deformity, and supersonic transport (SST) deformity were recorded.

Methods: At four institutions, 214 clinically uninfected IPP revisions were performed between November 2000 and November 2007. Data were incomplete for 28 cases (14%). Failure-free survival was estimated using Kaplan-Meier's Meier product limit method.

Results: The majority of revisions were secondary to mechanical failure (N = 109; 65%) and combined erosion or infection (N = 17 + 15 = 32; 19%). Sixteen percent (N = 26) were carried out on functional uninfected prostheses secondary to patient dissatisfaction (N = 9), SST deformity (N = 10), scrotal hematoma (N = 2), or upsize revision because of corporal fibrosis (N = 5). Average age at revision was 66 years. Mean follow-up time was 55.7 months. In this study, 12 individuals required a secondary revision procedure or suffered a complication. Despite prior reports of high infection rates with revision surgery, only 5.7% of clinically uninfected and noneroded prostheses were complicated by infection or impending extrusion/erosion, following a revision washout protocol. Overall, 93% of cases were successfully revised, providing functioning IPPs.

Conclusions: For this study population, component exchange followed by revision washout showed a low incidence of infection and subsequent mechanical failure.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Erectile Dysfunction / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Patient Satisfaction
  • Penile Implantation / adverse effects
  • Penile Implantation / statistics & numerical data*
  • Penile Prosthesis / adverse effects
  • Prosthesis Failure / adverse effects
  • Prosthesis-Related Infections / epidemiology
  • Reoperation / adverse effects
  • Reoperation / statistics & numerical data
  • Time Factors
  • Treatment Outcome