(484) Data-Driven PIIMP Chart Validates Inflatable Over Malleable Penile Implants for Optimising Penile Length and Girth

Introduction In developing countries, malleable penile implants or rods are performed more than three-piece inflatable implants (IPPs). Most government’s health insurance does not cover IPPs. Therefore, more rods are done. Rods have been shown to be better for patients with limited dexterity and are easier and faster to implant surgically. However, IPPs have consistently shown to have higher patient satisfaction rate and lower distal erosions. It was felt, but never shown that IPPs would simulate a better erection by filling out the penis better. Nevertheless, this has never been objectively proven in the literature to our knowledge. Objective In this study, a Penile Implant Intraoperative Measurements Planning (PIIMP) chart, where detailed penile measurements were documented, was used to find out whether inflatable penile prostheses (IPPs) were more likely to procure a longer penile length and a larger penile girth in comparison to rods or malleable implants. Methods 193 men were included in the study. 153 men had malleable implants and 40 men had three piece inflatable penile implants (IPPs). Penile length and circumference measurements were taken in both non-stretched and stretched states, and repeated after pharmacologically induced tumescence by means of a PGE1 intracorporal injection (ICI). Postoperative penile dimensions were retaken after the implantation. Results Penile lengthening was achieved in 1.96% of patients in the malleable implants group (n=3/153) compared to 12.5% (n=5/40) in the inflatable penile implants group. Fisher's exact test showed that patients having an IPP had 7.14 times higher odds of experiencing penile lengthening than those receiving a malleable implant (OR: 0.14; 95% CI: 0.03-0.61; p=0.010). Girth enhancement was noted in 11.1% of patients having a malleable implant (n=17/153) compared to 30% of patients receiving an inflatable penile implant (n=12/40). Fisher's exact test showed that patients receiving IPPs had 3.45 times higher odds of experiencing girth enhancement than those receiving malleable implants (OR: 0.29; 95% CI: 0.13-0.68; p=0.006). Conclusions The PIIMP Chart demonstrated that aggressive penile sizing was more attainable with inflatable rather than malleable implants. The chart might also serve as an objective postoperative counseling tool for patients, where their pre and postoperative penile dimensions would be documented and easily comparable. Disclosure No