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MALLEABLE PENILE PROSTHESIS FRACTURES - LESSONS LEARNED FROM 15 YEARS IN A TERTIARY HOSPITAL IN BRAZIL

Journal of Urology 2024 May 1
https://doi.org/10.1097/01.JU.0001008880.11564.10.17

INTRODUCTION AND OBJECTIVE:
Malleable penile prosthesis (MPP) are widely used for the treatment of refractory erectile dysfunction (ED) in Brazil. Mechanical failures (fractures), however, are seldom reported. The aim of this study is to report and describe the characteristics of MPP fractures (MPPF) managed in the largest tertiary hospital in Latin America in the last 15 years.

METHODS:
Retrospective review of the medical records from patients who underwent MPP Revision Surgery due to MPPF in our service from 2008 to 2023. Medical records were systematically analyzed to evaluate both clinical and intraoperative data from the first prosthesis placement. The signs and symptoms reported that ultimately led to the diagnosis of MPPF were also evaluated. Diagnostic imaging tools and their effectiveness in indicating the presence of a fracture. All patients had the diagnosis of MPPF confirmed during revision surgery.

RESULTS:
Out of the 683 patients undergoing MPP Surgery in the last 15 years, 36 patients (5.2%) required at least one revision surgery due to fracture, with 10 of these requiring more than one revision procedure. The median age of these patients at the first implant was 59 (27- 72y). ED etiology included metabolic syndrome in 15 (41.6%), oncologic in 14 (38%), Peyronie disease in 5 (13%), priapism in 1 (2.7%) and neurologic in 2 (5%) of the patients. Complaints that motivated the investigation started after a median of 5 years (3-168 months) after the first MPP, with instability being the most reported complaint (89%), while pain was reported in only 10 patients (21%) of the cohort. Thirty-two (68%) cases reported difficulty of penetration, while 6 (12.7%) reported complete incapacity to penetrate and 10 (21%) reported no impact on penetration ability. In regards to diagnostic tools, physical exam was abnormal in 86% (40) of the cases, while the X-Ray revealed fracture in 80% (25) of the 31 cases it was requested. MRI was performed in 9 cases, demonstrating fracture in only 2 (22%), reinforcing the importance of a good history, physical exam and some limitations of imaging.

CONCLUSIONS:
MPP fractures are underreported complications that may occur both early and late after the prosthesis placement. MPPF should be suspected when a patient complains of instability and difficulty with penetration after a period of adequate function.

Interesting ..nothing is fool proof but fools themselves .. lol

easymoney wrote:Interesting ..nothing is fool proof but fools themselves .. lol

That's very zen! A revision rate of 5.2% in 15 years, that translates to a 94.8% survival rate over 15 years! Sounds like a good deal for the price of carrying a silicone toy 24/7.

That is just crazy dependability, jeeze and I was thinking at the pace my nympho wife has been attacking it, I would be happy with 5 years.

Thedriver ..you and your wife could become the poster children for the maker of your implant .. give a blow by blow description of how you guys are using it ... might even pay you ..lol

easymoney wrote:Thedriver ..you and your wife could become the poster children for the maker of your implant .. give a blow by blow description of how you guys are using it ... might even pay you ..lol

LOL,,,, I could tell you how she is dressed in something sexy every morning with a short skirt and some slutty heels as she go's thru the house each day, eventually ending up either on the couch or in the king sized bed watching some sort of wild kinky porn on the 75 inch with her legs spread wide showing off her baby smooth legs and freshly shaved pussy that is always dripping wet and tasty, she has toys in every room, toys in the RV, toys in the side x side, toys in the ice house, toys in the vehicles, 2 different types of remote controlled fucking machines, more lube thru the house than that fucking p-diddy guy, and that is not even counting all the devices like nipple clamps, ropes, chains, blindfolds, vibrators, and the list go's on and on.
I don't know how many times in the past year after we got done with a heavy duty play session, I thought to myself
(ohhh that session would have broken another one of those IPP's for sure)
I could tell you all some stories that you just wouldn't believe, and show you some pictures that would make a porn star blush, but there is a few members that don't mind a dick pic showing up on there screen as they are on here, but don't want to see a picture of a beautiful woman popping up on the screen so I can't do that.
I don't know,,, maybe we are just a couple of freaks,,, but as long as I found my unicorn in life I might as well enjoy it.

thedriver wrote:

easymoney wrote:Thedriver ..you and your wife could become the poster children for the maker of your implant .. give a blow by blow description of how you guys are using it ... might even pay you ..lol

LOL,,,, I could tell you how she is dressed in something sexy every morning with a short skirt and some slutty heels as she go's thru the house each day, eventually ending up either on the couch or in the king sized bed watching some sort of wild kinky porn on the 75 inch with her legs spread wide showing off her baby smooth legs and freshly shaved pussy that is always dripping wet and tasty, she has toys in every room, toys in the RV, toys in the side x side, toys in the ice house, toys in the vehicles, 2 different types of remote controlled fucking machines, more lube thru the house than that fucking p-diddy guy, and that is not even counting all the devices like nipple clamps, ropes, chains, blindfolds, vibrators, and the list go's on and on.
I don't know how many times in the past year after we got done with a heavy duty play session, I thought to myself
(ohhh that session would have broken another one of those IPP's for sure)
I could tell you all some stories that you just wouldn't believe, and show you some pictures that would make a porn star blush, but there is a few members that don't mind a dick pic showing up on there screen as they are on here, but don't want to see a picture of a beautiful woman popping up on the screen so I can't do that.
I don't know,,, maybe we are just a couple of freaks,,, but as long as I found my unicorn in life I might as well enjoy it.

you can't do this to us thedriver, now you have to show them to us , if you don't want to post them to us you have to send them to us in pm

Yes pm for sure don't be shy .. we'll show you "ours" you show us "yours" .. Hers" .. whatever you need to call it ..lol

easymoney wrote:Yes pm for sure don't be shy .. we'll show you "ours" you show us "yours" .. Hers" .. whatever you need to call it ..lol

YES thedrive pls Pm all of us pls pls pls

thedriver wrote:

easymoney wrote:Thedriver ..you and your wife could become the poster children for the maker of your implant .. give a blow by blow description of how you guys are using it ... might even pay you ..lol

LOL,,,, I could tell you how she is dressed in something sexy every morning with a short skirt and some slutty heels as she go's thru the house each day, eventually ending up either on the couch or in the king sized bed watching some sort of wild kinky porn on the 75 inch with her legs spread wide showing off her baby smooth legs and freshly shaved pussy that is always dripping wet and tasty, she has toys in every room, toys in the RV, toys in the side x side, toys in the ice house, toys in the vehicles, 2 different types of remote controlled fucking machines, more lube thru the house than that fucking p-diddy guy, and that is not even counting all the devices like nipple clamps, ropes, chains, blindfolds, vibrators, and the list go's on and on.
I don't know how many times in the past year after we got done with a heavy duty play session, I thought to myself
(ohhh that session would have broken another one of those IPP's for sure)
I could tell you all some stories that you just wouldn't believe, and show you some pictures that would make a porn star blush, but there is a few members that don't mind a dick pic showing up on there screen as they are on here, but don't want to see a picture of a beautiful woman popping up on the screen so I can't do that.
I don't know,,, maybe we are just a couple of freaks,,, but as long as I found my unicorn in life I might as well enjoy it.

hmmm , maybe you should clone her .