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Commentary on posteroperative vaccuum therapy following AMS LGX 700 inflatable penile prosthesis placement: penile dimension outcomes and overall satisfaction

Is there a benefit to adjunctive vacuum therapy after penile prosthesis placement?

International Journal of Impotence Research volume 32, pages 142–143 (2020)Cite this article

The Original Article was published on 11 February 2019

Advancements over the past four decades have improved inflatable penile prosthesis (IPP) reliability while minimizing the inherent risk of complications such as device infection [1]. The result has been consistently high patient and partner satisfaction rates in excess of 80–90% [2, 3]. Why are those 10–20% of patients dissatisfied? The reasons vary, but there is no doubt that the chief among these is concerns regarding penile morphometric changes such as length loss, which is reported by a significant proportion regardless of the type of prosthesis that is placed [4, 5]. To date, an approach to reliably restore a man’s penile length to the “glory days” before ED-onset remains elusive. This is not for lack of want, and a variety of pre-, intra-, and post-operative protocols have been described to optimize outcomes with varying results. In this month’s issue of International Journal of Impotence Research, Antonini et al. describe their outcomes with a protocol for length and girth preservation utilizing twice daily device cycling with vacuum erection device (VED) application after American Medical Systems (Boston Scientific, Marlborough, MA, USA; AMSTM); LGX700® IPP placement [6].

The protocol, as described, included prosthesis activation within 1–2 weeks followed by twice daily IPP inflation/deflation for 10–15 minutes. The novel aspect of the protocol by Antonini et al. lies in the application of the VED postoperatively after IPP placement in order to supplement daily IPP cycling [6]. Starting at 3 weeks, patients were instructed to utilize a VED for 5 min twice per day with the device fully inflated for a period of 12 weeks. Patients followed up at 12, 24, and 48 weeks for subsequent evaluation. Not surprisingly, average penile length was shorter immediately after surgery, but with each subsequent time-point the average penile length increased such that at 1 year after surgery the authors found that both penile length and girth were similar to the “erect” penis measurements obtained preoperatively.

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References

  1. Pastuszak AW, Lentz AC, Farooq A, Jones L, Bella AJ. Technological improvements in three-piece inflatable penile prosthesis design over the past 40 years. J Sex Med. 2015;12:415–21.

    Article  Google Scholar 

  2. Levine LA, Becher EF, Bella AJ, Brant WO, Kohler TS, Martinez-Salamanca JI, et al. Penile prosthesis surgery: current recommendations from the international consultation on sexual medicine. J Sex Med. 2016;13:489–518.

    Article  Google Scholar 

  3. Barton GJ, Carlos EC, Lentz AC. Sexual quality of life and satisfaction with penile prostheses. Sex Med Rev. 2019;7:178–88.

    Article  Google Scholar 

  4. Osterberg EC, Maganty A, Ramasamy R, Eid JF. Pharmacologically induced erect penile length and stretched penile length are both good predictors of post-inflatable prosthesis penile length. Int J Impot Res. 2014;26:128–31.

    Article  CAS  Google Scholar 

  5. Deveci S, Martin D, Parker M, Mulhall JP. Penile length alterations following penile prosthesis surgery. Eur Urol. 2007;51:1128–31.

    Article  Google Scholar 

  6. Antonini G, De Berardinis E, Busetto GM, Del Giudice F, Chung BI, Conti SL et al. Postoperative vacuum therapy following AMS LGX 700(R) inflatable penile prosthesis placement: penile dimension outcomes and overall satisfaction. Int J Impot Res. 2019. https://doi.org/10.1038/s41443-019-0125-z. [Epub ahead of print]

  7. Tsambarlis PN, Chaus F, Levine LA. Successful placement of penile prostheses in men with severe corporal fibrosis following vacuum therapy protocol. J Sex Med. 2017;14:44–6.

    Article  Google Scholar 

  8. Qin F, Wang S, Li J, Wu C, Yuan J. The early use of vacuum therapy for penile rehabilitation after radical prostatectomy: systematic review and meta-analysis. Am J Mens Health. 2018;12:2136–43.

    Article  Google Scholar 

  9. Pryor MB, Carrion R, Wang R, Henry G. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after coloplast Titan prosthesis. Asian J Androl. 2016;18:754–8.

    Article  Google Scholar 

  10. Wallen JJ, Barrera EV, Ge L, Pastuszak AW, Carrion RE, Perito PE, et al. Biomechanical comparison of inflatable penile implants: a cadaveric pilot study. J Sex Med. 2018;15:1034–40.

    Article  Google Scholar 

  11. Barboglio Romo P, Chikkatur HP, Beldona S, Yi Y, Bruns TM, Malaeb BS. Comparative evaluation of physical characteristics of different inflatable penile prostheses. Scand J Urol. 2017;51:420–5.

    Article  CAS  Google Scholar 

  12. Negro CL, Paradiso M, Rocca A, Bardari F. Implantation of AMS 700 LGX penile prosthesis preserves penile length without the need for penile lengthening procedures. Asian J Androl. 2016;18:114–7.

    Article  CAS  Google Scholar 

  13. Kim KS, Bae WJ, Kim SW, Lee MY. Experience with AMS 700 LGX penile prostheses for preserving penile length in Korea. BMC Urol. 2019;19:6.

    Article  Google Scholar 

  14. Wallen JJ, Madiraju SK, Wang R, Henry GD. Implementation of length expanding inflatable penile prosthesis is not sufficient to prevent postsurgical penile shortening. Asian J Androl. 2018. https://doi.org/10.4103/aja.aja_77_18. [Epub ahead of print]

    Article  Google Scholar 

  15. Chung PH, Siegel JA, Tausch TJ, Klein AK, Scott JM, Morey AF. Inflatable penile prosthesis as tissue expander: what is the evidence? Int Braz J Urol. 2017;43:911–6.

    Article  Google Scholar 

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  1. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Matthew Ziegelmann

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Correspondence to Matthew Ziegelmann.

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Ziegelmann, M. Commentary on posteroperative vaccuum therapy following AMS LGX 700 inflatable penile prosthesis placement: penile dimension outcomes and overall satisfaction. Int J Impot Res 32, 142–143 (2020). https://doi.org/10.1038/s41443-019-0191-2

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