Every year, Baltimore, Maryland penile implant surgeon Dr. Andrew Kramer urology specialist, treats countless patients suffering from erectile dysfunction. While this problem is most common in the elderly, it can affect any man regardless of age. This explains the continued popularity of penile prostheses as a solution to male impotence.
One of the most popular penile prostheses today is Boston Scientific’s AMS 700 LGX implant, an inflatable prosthesis that comes in a variety of sizes and feature combinations. It is well-known for its ability to expand in both girth and length and give erections a natural look and rigidity.
As reliable as the LGX is, however, it is prone to wear like every other device. Penile implants can typically function as designed for 8 to 12 years before they need to be replaced. 5% of implants also malfunction within 5 years after treatment, necessitating repair or replacement.
Another issue often brought up is how implants can result in a reduction in the length of an erect penis.
In this article,Dr. Andrew Kramer helps a patient complaining about both issues.
A close examination
Around 8 years ago, a patient sought out Dr. Andrew Kramer for treatment that involved the use of an LGX implant to address the problem of erectile dysfunction. In 2020, this same patient returned to the surgeon to have the implant repaired because it no longer allowed him to maintain an erection.
The patient also wanted the implant to give his penis additional length during an erection.
The first order of business was to determine what was wrong with the implant. In most cases, a flat or umbilicated pump and/or faulty cylinders are behind malfunctioning implants. After opening up the patient and testing the device, however, Dr. Andrew Kramer discovered the pump and one cylinder undamaged.
The left cylinder had a break. He also checked the reservoir but found it in good condition.
Revision and upsizing
Revising the implant was a simple procedure that entailed removing the old cylinders and replacing them with new ones.
The original cylinders were 15 cm with 3 rear tips (15 + 3). To upsize the implant, Dr. Andrew Kramer used replacement cylinders that were longer and had fewer rear tips (18 + 1). Because the new cylinders were longer, Dr. Andrew Kramer used pump tubing of greater length during the operation.
Once the new cylinders were in place, Dr. Andrew Kramer also replaced the old pump with a new one. He then refilled the reservoir with fresh fluid.
Finally, Dr. Andrew Kramer tested the pump and cylinders to check for any other issues. Once he was confident the implant was working perfectly, he inserted all the structures into the penis and scrotum, then stitched the incision close.
It is to be noted that throughout the surgery, Dr. Andrew Kramer irrigated the wound using antibiotics to protect the patient from post-surgery complications such as bacterial infections.
As can be seen from this specific case, the revision and upsizing of a penile implant is a relatively quick, simple, and safe procedure. As technology advances, we can expect these devices to improve as a treatment for erectile dysfunction.
