Table 2. Patient factors impact on device selection.
Patient factors | Preoperative considerations | Device selection |
---|---|---|
Limited manual dexterity (28,35) | (I) Difficulty with device inflation/deflation | (I) Malleable: (i) AMS Spectra; (ii) Coloplast Genesis (II) Pump: (i) AMS Momentary Squeeze; (ii) Coloplast Titan |
Spinal cord injured (12,37) | (I) Limited upper extremity movement (II) Higher incidence of CIC/condom cath use (III) Higher risk of prosthesis complication (infection/erosion/malfunction) |
Malleable: (i) AMS Spectra; (ii) Coloplast Genesis |
Peyronie’s disease (28,30) | (I) Curvature exacerbated by length expansion (II) Benefit from modeling after device implantation |
Three-piece IPP: (i) AMS 700 CX; (ii) Coloplast Titan |
Prior pelvic surgery (35,46,47) | (I) Obliteration of the space of Retzius from robotic prostatectomy, laparoscopic hernia, or renal transplant (II) Consider ectopic reservoir placement |
(I) Two-piece IPP: AMS Ambicor (II) Reservoirs: (i) AMS Conceal; (ii) Coloplast Cloverleaf |
Corporal fibrosis (1,35,46) | (I) Increased risk of infection, corporal perforation, and urethral injury (II) Difficulty with corporal dilation |
Narrow cylinder three-piece IPP: (i) AMS 700 CXR; (ii) Coloplast Titan Narrow |
Prior explant or salvage (35,47) | (I) Increased risk of infection (II) If explanted, risk of fibrosis and penile shortening |
(I) Malleable: (i) AMS Spectra; (ii) Coloplast Genesis (II) Coated implants: (i) AMS Inhibizone available on 700 series only; (ii) Coloplast hydrophilic coating available on Titan and Genesis |