The Three Classes of Penile Implant Revision Surgery
The first class of revisions is men who have used their implant with no complaints, but it is simply broken. These men will have a very easy and straightforward revision surgery, and often it is simply a broken tubing, pump, or simple leak in the system that can be easily fixed. This patient is nearly always happy he did the implant in the first place, despite that setback of having that breakage. This patient often got his fair use out of the first device, and the breakages are simple to find and easy to fix.
The second class of revisions are men who have issues with their first (or subsequent) implant and want a revision. These issues are often more complex, detailed, and may or may not be easy to fix. These are not men who had an implant and it simply stopped working. These are more complex cases and are viewed in a case by case basis. Of course, some men are “peno-centric” and have broad and far-reaching issues that many implant attempts have not fixed. This second class of revisions, however, are based solely on issues with penile implant size (or simply….penis size), or with pump placement. I can nearly always add implant size, stretch the penis maximally, and get these men happy. Similarly, pumps are fairly simple enough to modify and I can usually make these men happy as well. I can lower the pump, reposition it, rotate it, or fix pump tubing to get it optimally situated.
There is then a third class of revision patients that most implant surgeons have the hardest time making happy with their implants. These issues have, in my experience, ranged from:
- Aches/pains that persist despite my ability to objectively see anything wrong
- The sensation of the cylinders being out of axis
- Bulges or bends/kinks that persist
- Reservoir tubing being too close to the penis itself
Throughout time, this third class of implant revision patients will continue to exist, and, in many cases, they are in a spectrum of legitimate complaints. These implant revisions are by no means the majority of my practice, but they do exist.
Says Dr. Kramer, “The term “penile implant revision” is a broad one; it is not a homogenous group. And while I do perform a high volume of revisions, the vast majority of patients who get implants are happy and satisfied, and the simple classes (one and two above) of implant revision patients are still by and large “happy” patients.”
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