Mp47-17 Malleable Penile Prosthesis Fractures—lessons Learned From 15 Years in a Tertiary Hospital in Brazil

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I (MP47)1 May 2024MP47-17 MALLEABLE PENILE PROSTHESIS FRACTURES—LESSONS LEARNED FROM 15 YEARS IN A TERTIARY HOSPITAL IN BRAZIL Manuela Horta, Danilo C. Nagato, Carlos V. Neto, Gabriel P. O. Lima, Jose Bessa, Plinio M. Goes, Eduardo Z. S. Pato, William C. Nahas, Jorge Hallak, and Bruno C. G. Nascimento Manuela HortaManuela Horta , Danilo C. NagatoDanilo C. Nagato , Carlos V. NetoCarlos V. Neto , Gabriel P. O. LimaGabriel P. O. Lima , Jose BessaJose Bessa , Plinio M. GoesPlinio M. Goes , Eduardo Z. S. PatoEduardo Z. S. Pato , William C. NahasWilliam C. Nahas , Jorge HallakJorge Hallak , and Bruno C. G. NascimentoBruno C. G. Nascimento View All Author Informationhttps://doi.org/10.1097/01.JU.0001008880.11564.10.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Malleable penile prosthesis (MPP) are widely used for the treatment of refractory erectile dysfunction (ED) in Brazil. Mechanical failures (fractures), however, are seldom reported. The aim of this study is to report and describe the characteristics of MPP fractures (MPPF) managed in the largest tertiary hospital in Latin America in the last 15 years. METHODS: Retrospective review of the medical records from patients who underwent MPP Revision Surgery due to MPPF in our service from 2008 to 2023. Medical records were systematically analyzed to evaluate both clinical and intraoperative data from the first prosthesis placement. The signs and symptoms reported that ultimately led to the diagnosis of MPPF were also evaluated. Diagnostic imaging tools and their effectiveness in indicating the presence of a fracture. All patients had the diagnosis of MPPF confirmed during revision surgery. RESULTS: Out of the 683 patients undergoing MPP Surgery in the last 15 years, 36 patients (5,2%) required at least one revision surgery due to fracture, with 10 of these requiring more than one revision procedure. The median age of these patients at the first implant was 59 (27 - 72y). ED etiology included metabolic syndrome in 15 (41,6%), oncologic in 14 (38%), Peyronie disease in 5 (13%), priapism in 1 (2,7%) and neurologic in 2 (5%) of the patients. Complaints that motivated the investigation started after a median of 5 years (3 - 168 months) after the first MPP, with instability being the most reported complaint (89%), while pain was reported in only 10 patients (21%) of the cohort. Thirty-two (68%) cases reported difficulty of penetration, while 6 (12.7%) reported complete incapacity to penetrate and 10 (21%) reported no impact on penetration ability. In regards to diagnostic tools, physical exam was abnormal in 86% (40) of the cases, while the X-Ray revealed fracture in 80% (25) of the 31 cases it was requested. MRI was performed in 9 cases, demonstrating fracture in only 2 (22%), reinforcing the importance of a good history, physical exam and some limitations of imaging. CONCLUSIONS: MPP fractures are underreported complications that may occur both early and late after the prosthesis placement. MPPF should be suspected when a patient complains of instability and difficulty with penetration after a period of adequate function. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e769 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Manuela Horta More articles by this author Danilo C. Nagato More articles by this author Carlos V. Neto More articles by this author Gabriel P. O. Lima More articles by this author Jose Bessa More articles by this author Plinio M. Goes More articles by this author Eduardo Z. S. Pato More articles by this author William C. Nahas More articles by this author Jorge Hallak More articles by this author Bruno C. G. Nascimento More articles by this author Expand All Advertisement PDF downloadLoading ...