Fracture at the input tube-cylinder junction of AMS 700 inflatable penile prostheses as a complication of a modified implantation technique in a series of 99 patients.

OBJECTIVES To compare the incidence of a specific failure mode of the penile implant, fracture at the input tube-cylinder junction, with respect to two methods of managing the input tube. METHODS AMS 700 series three-piece inflatable penile prostheses were implanted in the first 26 patients using an ordinary technique in which the input tubing runs alongside the cylinder within the corpus and exits through the corporotomy (method A). In the subsequent 73 men, the input tube exited through a separate stab wound in the proximal corpus using a modification of the basic surgical technique (method C). The mean follow-up period was 136.4 months for method A and 69.0 months for method C. The incidence of fracture at the junction of the input tube and cylinder was compared according to the variables of input tube management, prosthesis type, and width of the proximal corpora. RESULTS The overall incidence of mechanical failure was 12.1%. Fractures at the input tube-cylinder junction with leaking occurred in 7 patients. The cylinders in these patients were all implanted using method C. The incidence of fracture at the junction was significantly higher (P <0.05) in men with narrow corpora (17.1%) than in the others (0%), regardless of the type of prosthesis implanted. The average functional duration of the failed prostheses was 66.1 months. CONCLUSIONS The modified surgical procedure (method C) should be avoided in patients with a narrow-width penis because of an increased likelihood of damage to the input tube-cylinder junction.