Failure of the Jonas prosthesis.

A total of 27 patients received the standard Jonas silicone-silver penile prosthesis. The procedure was done at 3 separate hospitals by 2 surgical teams. Four patients who were reported on previously presented consecutively to our clinic with failed penile rigidity and complete multiple wire fractures were found at reoperation. Therefore, the remaining 23 patients were reviewed and 7 had positive findings suggesting fracture, including decreased penile rigidity, crackling that was audible or palpable and/or evidence of fracture on an x-ray. Seven patients had completely negative evaluations and 9 were lost to followup. Two patients with suspicious x-ray findings and 1 with negative x-ray findings but who reported less rigidity have since had the prostheses removed, and all had multiple wire fractures. Radiographs of fractured prostheses, both in the penis and explanted, attest to the limited reliability of x-ray in the diagnosis of wire fracture.