Use of penile prostheses to maintain external condom catheter drainage in spinal cord injury patients.
This is a retrospective analysis of 79 spinal cord injury patients who have had penile implants from one to 14 years. The primary indication for implants was the loss of condom catheter with a small retractile penis. Mean period after injury to when the implants were placed was 8.24 years (range 1-21 years). Mean total length of time the implants have been followed was 7.08 years (1-14 years). Sixty patients responded to our detailed questionnaire and they have been subjected to further analysis: prior to the implant 46 patients (77%) frequently lost their condoms. Fourteen of the patients (23%) had indwelling catheters, and 3 (5%) had a suprapubic cystostomy since they could not retain an external condom for urinary drainage because of retraction of a small penis. Post implant, 81% of patients had no accidents involving condom loss, while 19% still lost condoms. All indwelling catheters could be removed except for one patient who continued with a suprapubic catheter following transurethral sphincterotomy (TURS) and a penile implant. Sixty-eight percent used the implant for sex and felt their wives were satisfied. Patient satisfaction survey showed a markedly increased self esteem, increased mobility without fear of condom loss, and an improved sex life. Overall, the long term prosthesis failure rate was 8%. The specific infection complication rate was less than 2%. The Flexirod semirigid, hinged prosthesis proved ideal in meeting the requirements for these patients.
Perkash
I
I
Department of Urology, Stanford University, California.
Kabalin
J N
JN
Lennon
S
S
Wolfe
V
V
D000328:Adult; D000368:Aged; D003075:Coitus; D003275:Contraceptive Devices, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015917:Penile Prosthesis / Q000009:adverse effects; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000628:therapy*; D011795:Surveys and Questionnaires; D014546:Urinary Catheterization