(324) EX-VIVO DEMONSTRATION OF A NOVEL METHOD FOR AUTO-INFLATION PREVENTION IN PATIENTS WITH INFLATABLE PENILE PROSTHESIS

Abstract Introduction Inflatable penile prosthesis (IPP) is a surgical treatment for refractory erectile dysfunction which has repeatedly demonstrated a high patient and partner satisfaction rate. Three-piece IPPs are associated with the highest satisfaction of different implants due to alternating excellent rigidity and flaccidity. Despite the high satisfaction rate enabled by the reservoir, mechanical dysfunction associated with this piece may conversely lead to poor satisfaction and re-intervention. One reported mechanical dysfunction is auto-inflation, in which there is propagation of fluid from the reservoir to the cylinders without manual action on the pump. Auto-inflation leads to annoyance and discomfort at best. At worst, significant morbidity has been reported including device erosion into the urethra. To overcome auto-inflation, Coloplast devices contain a lockout valve in the reservoir itself, while Boston Scientific devices have the lockout valve in the pump. Nevertheless, auto-inflation remains a source of dissatisfaction, with management potentially requiring revisional surgery in patients with significant bother. Objective We describe a simple technique for prevention of auto-inflation of inflatable penile prostheses (IPP) by using 1-2 pump squeezes and demonstrate this ex-vivo. Methods The pump/cylinder units of both Coloplast Titan and Boston Scientific AMS 700 devices were tested separately within the operating room. Auto-inflation Simulation: A 60 cc Luer lock syringe is used to inject normal saline solution into the pump/cylinders while the device is in deflation mode. A reasonable pressure is applied during injection. Cylinder inflation is observed only in the Titan device, suggesting potential auto-inflation. Prevention Maneuver: The Titan cylinders are manually deflated. Following this, the pump is squeezed once or twice. The Luer lock syringe is then used to attempt to inject normal saline, but in this case is unsuccessful using reasonable pressure application. Confirmatory Maneuver: The above procedure is repeated for the AMS 700 device. Normal saline is still unable to be propagated into the cylinder after 1-2 squeezes of the pump. Results Our findings demonstrate that the simple maneuver of one to two pump squeezes after deflation effectively prevents auto-inflation in the Coloplast Titan IPP. The efficacy of this technique has been further validated in a clinical setting. Five patients experiencing auto-inflation with the Titan device were treated using this maneuver, and it successfully resolved the issue in all cases. Conclusions The simple technique of one to two pump squeezes after IPP device deflation demonstrates a non-invasive method for prevention of IPP auto-inflation. Disclosure No.