Penile Prosthesis Pump May Need Adjusting to Avoid Getting Stuck

Larry Hand

October 02, 2014

A penile prosthesis used for treating men with erectile dysfunction may need to have an adjustment at some point to "unstick" its inflate/deflate pump, but only in 7.8% of cases, according to an article published in the October issue of Urology.

Bruce B. Garber, MD, from the Department of Urology, Hahnemann University Hospital, Drexel University College of Medicine, Philadelphia, Pennsylvania, and colleagues reviewed the records of 550 consecutive patients with refractory organic erectile dysfunction who had been implanted with a Coloplast Titan Inflatable Penile Prosthesis with One-Touch Release (OTR) pump by the same surgeon during a 4-year period.

Twenty-nine (5.3%) patients returned to the surgeon complaining that their prosthesis would not inflate and that the pump felt "hard." In each case, the inflate/deflate valve disc had gotten stuck in the deflate position. After "very firm pressure" had been applied to the pump bulb, the device returned to normal inflate/deflate working order.

An additional 14 (2.5%) patients reported the same problem, but they were able to rectify it themselves. Some patients reported recurrent episodes they were able to correct themselves.

"We have recently identified a type of pseudo-malfunction of the OTR pump that has not been previously reported," the authors write.

"In all cases we have encountered, firm pressure on the pump bulb caused the valve to shift into the inflate position, and the device worked properly thereafter."

Timing of the "pseudo-malfunction" varied from early to late use.

"Patients with an OTR pump should be informed that approximately 8% might develop pseudo-malfunction in the postoperative period. The mechanism underlying this problem and the way to rectify it should be explained," the authors write.

Coloplast did not respond to requests for additional comment.

Thomas James Walsh, MD, professor of urology and director of the Men's Health Center at the University of Washington School of Medicine in Seattle, told Medscape Medical News that the prosthesis is one of two devices for this treatment that constitute "one of the most tried-and-true methods to restore a man's sexual function."

"What's interesting, and what I think all urologists who are specialized in this area would agree on, is that, given the high degree of success and satisfaction that goes along with these devices, we believe that they're probably underutilized," he continued. That results probably from lack of awareness on the part of patients and clinicians, he added.

"If you look at all the different treatments that we have at our disposal for the treatment of erectile dysfunction, it's really clear that this particular treatment offers some of the highest degree of satisfaction and some of the lowest complication rates compared to other treatments. It's probably one of the only treatments that really offers incredible return of spontaneity, incredible reliability, and the ability for men to actually have a sustained erection."

He continued, "I think what the authors are trying to show is the importance of expertise, that individuals who are having challenges with a penile prosthesis need to understand that there are some problems that have really simple solutions and they don't require surgery to explore this device, take it out, and put in a new one. But they need somebody who understands the nuances of these devices and quick and simple solutions."

Two coauthors have disclosed that they are paid consultants to Coloplast and American Medical Systems. The other authors and Dr Walsh have disclosed no relevant financial relationships.

Urology. 2014;84:857-859. Abstract

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