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Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18

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Abstract

The use of semirigid rod penile prosthesis for the management of erectile dysfunction was first described over 85 years ago. Since then, there have been numerous design advancements leading to improved overall durability, concealability, rigidity, and natural feel. However, the inflatable penile prosthesis (IPP) still has a higher patient satisfaction rate and is currently the most commonly inserted prostheses in the United States. There are still certain situations and conditions where the simplicity of a rod may be preferred over an IPP. A pair of semirigid rods has been shown to have less risk of malfunction and need for revision surgery. In addition, patients with poor manual dexterity, those undergoing a salvage for infection prosthesis and those with a prolonged (> 48 h) priapic episode may be better served with a rod than an IPP. Finally, in patients compromised by infection or priapism, the rods can later successfully be exchanged for an IPP with potentially longer, wider cylinders with resultant greater patient satisfaction.

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Fig. 1: Silicone semirigid penile prostheses.
Fig. 2: Vintage silicone rod prostheses.
Fig. 3: Semirigid mechanical prosthesis.
Fig. 4: AMS purchase of Dacomed produces spectra.
Fig. 5: Jonas malleable prosthesis.
Fig. 6: Previous generation of malleables in US.
Fig. 7: Semirigid rod implants available in US today.
Fig. 8: Corpora cavernosa after priapism.

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Authors and Affiliations

  1. Department of Urology, Baylor University, Houston, TX, USA

    Mohit Khera

  2. Department of Urology, University of Alabama, Birmingham, AL, UK

    John Mulcahy

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

    Lexiaochuan Wen

  4. Department of Urology, Institute for Urologic Excellence, La Quinta, CA, USA

    Steven K. Wilson

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  1. Mohit Khera
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  2. John Mulcahy
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  3. Lexiaochuan Wen
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  4. Steven K. Wilson
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Correspondence to Lexiaochuan Wen.

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Conflict of interest

MK: Consultant Boston Scientific. JM: Consultant Boston Scientific, Coloplast. LW: none. SW: Consultant Coloplast, International Medical Devices. Lecturer Boston Scientific Stockholder NeoTract

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Khera, M., Mulcahy, J., Wen, L. et al. Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18. Int J Impot Res 35, 82–89 (2023). https://doi.org/10.1038/s41443-020-00376-6

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