E5345. Complications in Three-Piece Inflatable Penile Prosthesis
  1. Yashant Aswani; University of Iowa Hospitals and Clinics
  2. Amr Elmahdy; University of Iowa Hospitals and Clinics
  3. Mohammed Sabawi; University of Iowa Hospitals and Clinics
  4. Subramaniyan Ramanathan; Hamad Medical Corporation
Erectile dysfunction (ED) is the persistent inability to achieve or maintain a penile erection sufficient for successful vaginal intercourse. ED is on the rise with increasing prevalence of cardiovascular disease, diabetes, alcohol use, smoking, and a higher life expectancy. By 2025, the worldwide prevalence of ED is estimated to reach 322 million cases. It impacts the quality of life of both the patient and his partner. The 2018 American Urological Association (AUA) guidelines promote the concept of shared decision making for the management of ED wherein all the available treatment options are discussed. Although many men prefer the least invasive options initially, the AUA guidelines note that it is valid for them to begin with any treatment, regardless of invasiveness or reversibility. Examples of less invasive therapies include oral pharmacotherapy, intraurethral alprostadil, and intracavernous injections, whereas implantation of penile prosthesis for ED lies at the other end of spectrum. Nevertheless, each year upward of 25,000 American men choose penile implants. Also, it is estimated that 17.1% of the 10.3 million American men who sought care for ED in 2022 could benefit from penile implants. With such a rising number of penile implant surgeries, it is imperative to bridge the knowledge gap amongst the radiologists about the penile prosthesis.

Educational Goals / Teaching Points
• Discuss ED and penile prosthesis as an effective treatment. • Describe the role of radiology in assessment of a three-piece inflatable penile prosthesis (IPP). • Describe the normal appearance of a three-piece IPP on imaging. • Discuss imaging review of complications associated with three-piece IPP. • Illustrate a proposed template for reporting of the three-piece IPP in radiology reports.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1. The normal radiological appearance of a three-piece IPP. 2. The classifications of the common complications of each part of the IPP. 3. Imaging illustration of the common complications like infections, mechanical failure, corporal crossover, buckling, and migration.

IPPs offer a promising solution for the management of ED, yet their potential complications present significant challenges. Radiological imaging emerges as an indispensable tool in this landscape, leading to accurate diagnosis of the complications associated with IPP and effective management.