Clinical reliability of three-piece inflatable implants for Peyronie's disease induced erectile dysfunction

This study was aimed at clarifying the clinical reliability of AMS 700 CX prostheses in the treatment of Peyronie's disease and associated erectile dysfunction. Sixteen patients were treated: additional plaque surgery was performed in 8 cases (50%). Mean (±S.E.) operative time was 145 ± 8 min. Mean (±S.E.) postoperative hospitalization was 2.9 ± 0.8 days. Mean (±S.E.) time for returning to preoperative activity was 9.2 ± 2.1 days. In the early postoperative followup, 2 patients (12%) developed a wound infection which was treated conservatively. At the six-week followup, complete penile straightening was achieved in 11 patients (70%). After full activation of the implant, rigidity was considered good by all patients. However the penis was considered short by 6 patients (38%). Three diabetic patients (19%) complained of severe scrotal and penile pain during full activation of the implant. One of these patients (6%) required removal of the implant due to unbearable pain. One patient (6%) required repositioning of the reservoir from the Retzius space to inside the peritoneum due to 'spontaneous' erections occurring after implant deactivations. Thirteen patients were assessed at the long-term followup (mean 17 months): 12 of them (92%) reported regular sexual activity. Five of 8 partners (62%) were definitely satisfied with postoperative sexual activity. Three-piece inflatable implants allow good rigidity to be achieved in parties with Peyronie's disease. Patients must be fully informed about possible surgical morbidity and actual postoperative penile length.