1. No. 100
Comparison between AMS700TM CX and ColoplastTM Titan inflatable penile prostheses for Peyronie’s disease treatment and remodelling: Clinical outcomes and patient satisfaction.
Eric Chung1,2 , Matthew Solomon1,2, Ling De Young2 and Gerald B Brock2
1 Department of Urology, Princess Alexandra Hospital, Brisbane, QLD Australia
2 Division of Urology, St Joseph Health Care, London, ON Canada
Introduction
Inflatable penile prosthesis (IPP) is indicated in men with Peyronie’s disease (PD) and medically-refractory erectile dysfunction (ED).
The implantation of penile prosthesis with simultaneous manual penile remodelling allows for men with PD and ED to undergo a single procedure aimed at correcting both the penile deformity/curvature and ED.
To date, there is no published literature comparing AMS700TM CX and ColoplastTM Titan IPP in patient group.
Results
A total of 138 patients with an average age of 57.7 (32 to 80) underwent either AMS 700TM CX (88 patients) or ColoplastTM Titans (50 patients) IPP implantation during the 5-year period.
The majority of patients (91%) required only one IPP implantation.
The IPP clinical outcomes include 8 (6%) revision surgery for device malfunction and 3 (2%) device explantation for prosthesis infection.
While there was no statistically significance in device survival and infection between the 2 devices, the trend favoured AMS700 CX over Titan (5-year Kaplan-Meier estimates of mechanical survival were 91% vs. 87%, p<0.05) (Figure 1) and both IPPs provided similar penile straightening without the need for revision surgery.
Most men (79%) reported great satisfaction following IPP implantation with greater than two thirds of men reported greater self-confidence and 82% of patients would undergo the same operation again (Table 1).
Aim
To evaluate the clinical outcomes and patient satisfaction following AMS700TM CX and Titan IPPs implantation.
Methods
A retrospective review of clinical database and prospective independent telephone survey were undertaken in all men who underwent IPP implantation for PD between January 2006 and December 2010.
Patient demographics, International Index of Erectile Function (IIEF-5) scores, preoperative PD characteristics, previous PD therapies and types of IPP implanted were reviewed.
Follow-up assessments included surgical outcomes and overall patient satisfactions such as ease and frequency of use, patient and partner satisfaction, and self esteem.
Figure 1: Kaplan-Meier estimates of survival from mechanical failure showed trend toward enhanced AMS 700 CX over Titan IPP that did not reach statistical significance at 5 years (p>0.05).
Table 1: Selected characteristics of survey responders
Demographic variables
AMS 700 CX (%)
Titan (%)
Total number of IPP implanted
88 (64)
50 (36)
Overall satisfaction (out of 5)
Rating 1-3
12 (14)
5 (10)
Rating 4-5
76 (86)
45 (90)
Would undergo surgery again
Yes
72 (82)
44 (88) No
18 (18)
6 (12)
Primary reason for dissatisfaction
1. Decreased penile length
2. Problems with prosthesis
2 (2)
1 (2)
3. Personal health concerns
3 (6)
4. Loss of regular sexual partners
3 (3)
0 (0)
Frequency of sexual intercourse
1. At least once a week
25 (28)
17 (34)
2. Fortnightly
30 (34)
22 (44)
3. At least once a month
22 (25)
4. Other
11 (13)
Conclusions
IPP implantation and remodelling appears to provide permanent penile straightening without an increase risk in revision surgery.
AMS 700TM CX and Titan IPPs were similar in device survival and patient satisfaction.
Poster presentation sponsor