Mechanical reliability, surgical complications, and patient and partner satisfaction of the modern three-piece inflatable penile prosthesis.

Objectives: The modern three-piece inflatable penile prosthesis (IPP) has undergone multiple revisions since its introduction in 1973. We reviewed devices placed since the last major revision by American Medical Systems (AMS) in 1987.

Methods: A retrospective chart review was refined with data from an independent patient and partner survey.

Back-pressure testing to prevent autoinflation of penile prosthetic devices.

Autoinflation of a penile prosthetic device can be a frustrating experience for the patient and surgeon alike. Although there are many causes of autoinflation, elevated reservoir pressure at the time of surgical placement is one of the more common etiologies. We describe a simple, quick technique to quantitate reservoir pressures and volume, preventing pressures that could lead to autoinflation.

Endocrine screening for sexual dysfunction using free testosterone determinations.

Purpose: Controversy exists concerning the need for routine endocrine screening in impotent men. Debate also continues as to what hormonal studies are necessary, the role of the free fraction of testosterone and whether a history of decreased libido or testicular atrophy can predict these endocrinopathies.

Materials And Methods: We reviewed 508 consecutive men who presented with sexual dysfunction within a 22-month period.

Oral terbutaline for the treatment of priapism.

The widespread use of penile injections in the management of erectile dysfunction has led to an increased incidence of priapism. It has been suggested that terbutaline, a beta-agonist, might be beneficial in treating priapism in this setting. We randomized 24 patients with prolonged erections to a prospective, double-blind, placebo-controlled trial.

Experience with triple-drug therapy in a pharmacological erection program.

A group of 170 impotent men achieved usable erections during a 26-month period with a combination of papaverine, phentolamine and prostaglandin E1 (triple-drug therapy) injected intracorporeally. Of the patients 146 elected to enter a pharmacological erection program using this combination. Patient age ranged from 24 to 85 years and the average duration on the program was 11.