(156) Real World Penile Measurements Comparison Between Malleable and Three-Piece Inflatable Implants: An Objective Comparative Study
Authors: Zaazaa A , Elnabarawy R , Elbitar M , Mostafa T , D Henry G 
Published: March 2024

Abstract

Introduction
Despite the fact that malleable penile implants are easier and faster to implant surgically, yet inflatable penile implants (IPPs) have usually shown to have higher patient satisfaction rate and lower rates of distal erosion. It was felt, but never shown that IPPs simulated better erections that filled out the penis better. Nevertheless, this had never been objectively proven in the literature to our knowledge.

Objective
In this study, to achieve objective comparisons, we introduced the Penile Implant Intraoperative Measurements Planning (PIIMP) chart to find out whether IPPs were more likely to procure greater penile dimensions in comparison to malleable implants.

Methods
193 men undergoing penile prosthesis implantation were included in the study. 153 had malleable implants, while 40 had an IPP. Penile length and circumference were measured both in a stretched and unstretched state, both before and after a PGE1 intracorporal injection (ICI). Postoperative penile dimensions were re-taken after implantation and documented together with cylinders/rods dimensions.

Results
In malleable implants, postoperative penile length ranged between pre and post ICI stretched length in 71.4% of times (n=110/153), fell below pre-ICI stretched length in 26.2% of cases (n=40/153) and reached beyond post-ICI stretched length in 1.96% of cases (n=3/153). In IPPs, postoperative penile length ranged between pre and post ICI stretched length in 60% of times (n= 24/40), fell below pre-ICI stretched length in 27.5% of cases (n=11/40) and reached beyond post-ICI stretched length in 12.5% of cases (n= 5/40). Using Fisher's exact test, it was found that postoperative penile length was 6.37 times more likely to rise above preoperative post-ICI stretched length in inflatable penile implants compared to malleable implant cases (12.5% vs 1.96%) (P value=0.0105) As for penile circumference, malleable implants showed a postoperative penile circumference ranging between pre and post-ICI relaxed girth in 69.9% of cases (n=10), reaching above post-ICI relaxed girth in 10.9% of cases (n=17), and falling below pre-ICI relaxed girth in 19.2% of cases (n=30). On the other hand, IPPs cases had a postoperative penile circumference ranging between pre and post ICI relaxed girth in 57.1% of cases (n=24), reaching above post-ICI relaxed girth in 27.2% of cases (n= 12), and falling below pre-ICI relaxed girth in only 9.1% (n= 4) of cases. (P &lt;0.05) Thus IPPs were 2.5 times more likely to increase the girth of the penis (27.2% vs 10.9%) (P value &lt;0.05) and 2.1 times less likely to cause a decrease in circumference in comparison to malleable implants (9.1% vs 19.2%) (P value &lt;0.05)

Conclusions
Our study demonstrated that IPPs were superior to malleable implants in attaining greater postoperative penile lengths and girths. We introduced the PIIMP chart as an objective standardized and easily reproducible instrument for intraoperative documentation of penile dimensions.

Disclosure
No.