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      State-of-art review of current malleable penile prosthesis devices in the commercial market

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          Abstract

          The malleable penile implant is often considered an inferior device to the three-piece inflatable penile prosthesis implant. Nonetheless, the malleable prosthesis has its unique advantages such as lower cost, easier to perform and fewer mechanical complications than inflatable prostheses. Furthermore, its role can be extended to patients with issues relating to poor manual hand dexterity, those undergoing a salvage for infection prosthesis and as an emergency surgical measure in patients presenting with acute ischaemic priapism. Over the past few decades, there have been numerous design and technological advancements to improve overall clinical efficacy, mechanical durability, axial rigidity and device concealability of malleable penile prostheses. The following article provides a narrative review of the six major contemporary malleable penile prosthesis devices in the commercial market, namely, the Coloplast Genesis prosthesis, the Boston Scientific Tactra prosthesis, the Zephyr ZSI 100 and 100 (female-to-male) FTM devices, the Rigi10 prosthesis, the TUBE malleable prosthesis and the Shah prosthesis and evaluates the published outcomes. Appropriate patient selection and strict counselling regarding what to expect with malleable prostheses coupled with adherence to safe surgical principles are paramount to ensure excellent clinical success and patient satisfaction rates.

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          Most cited references22

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          Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine.

          Penile prosthesis implantation has emerged as a definitive treatment to restore sexual function to the motivated man with erectile dysfunction. Substantial improvements in the design of inflatable devices have been made since they first became available more than four decades ago.
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            Penile Prosthesis Complications: Planning, Prevention, and Decision Making

            Inflatable penile prosthesis (IPP) is an established treatment option for men with erectile dysfunction (ED) refractory to medical therapy. Standardization of surgical technique and improvements in device construction have reduced all-cause complication rates to less than 5% in recent reports. Nonetheless, complications do exist, and can strongly impact morbidity and the quality of life of patients. Prosthetic urologists must be aware of the constellation of complications that can arise during or after IPP placement.
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              The Malleable Implant Salvage Technique: Infection Outcomes after Mulcahy Salvage Procedure and Replacement of Infected Inflatable Penile Prosthesis with Malleable Prosthesis.

              Since its introduction in 1996 Mulcahy salvage has significantly improved outcomes for the removal and replacement of infected inflatable penile prostheses. Long-term followup data of Mulcahy salvage show an infection-free rate of 82%. A multicenter retrospective analysis of the malleable implant salvage technique was conducted to assess infection outcomes and the feasibility of conversion from malleable device back to inflatable penile prosthesis.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: ValidationRole: Writing – review & editing
                Journal
                Ther Adv Urol
                Ther Adv Urol
                TAU
                sptau
                Therapeutic Advances in Urology
                SAGE Publications (Sage UK: London, England )
                1756-2872
                1756-2880
                14 July 2023
                Jan-Dec 2023
                : 15
                : 17562872231179008
                Affiliations
                [1-17562872231179008]AndroUrology Centre, Suite 3, 530 Boundary Street, Brisbane, QLD 4000, Australia
                [2-17562872231179008]Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
                [3-17562872231179008]Macquarie University Hospital, Sydney, NSW, Australia
                [4-17562872231179008]AndroUrology Centre, Brisbane, QLD, Australia
                Author notes
                Author information
                https://orcid.org/0000-0003-3373-3668
                Article
                10.1177_17562872231179008
                10.1177/17562872231179008
                10350748
                37465318
                7c35e892-5c38-4f58-9f35-1ffafe9cdf24
                © The Author(s), 2023

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 19 December 2022
                : 12 May 2023
                Categories
                Review Article
                Advances in Prosthetic Urology
                Custom metadata
                January-December 2023
                ts1

                clinical outcomes,malleable device,mechanics,patient selection,penile prosthesis

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