Dr. J. Francois Eid has
performed more internal penile implant surgeries than anyone in the
world and has built a reputation for excellence in the treatment of
erectile dysfunction (ED). After examining the latest generation of
Inflatable Penile Prosthesis (IPP) and Artificial Urinary Sphincter
(AUS) technologies from American Medical Systems (AMS) and Coloplast
Corporation, reviewing pertinent studies, and drawing on his 20 years
of experience performing penile prosthesis surgery and overseeing his
patients’ recuperation and subsequent training in operating the
devices, Dr. Eid has high praise for the recent improvements. Updates
have been made to the IPP pumps offered by both AMS and Coloplast, as
well as to the CX and LGX cylinders offered by AMS. Also, AMS has
added an antibiotic coating to its AUS.

Momentary Squeeze (MS) Pump - AMS

AMS’s Momentary Squeeze (MS) Pump was first introduced nearly two
years ago, and Dr. Eid has implanted it with great success in patients
suited to the CX-cylinder and LGX-cylinder versions. (The LGX model
offers the potential for increased penile length in patients
complaining of penile shortening after radical prostatectomy.) Both
cylinders now feature redesigned proximal ends. At only 9.5mm in
diameter, the ends allow for significantly easier insertion for
patients with fibrotic proximal corporal bodies.

The MS Pump’s advantages include a smaller profile (which enables a
more discreet placement) and one-touch deflation. However, this
quality can result in operational difficulties with inflation (more
difficult to get a hold of within the scrotum) and deflation (small
button can initially be difficult to find). In addition, its new
lockout valve has the advantage of preventing auto-inflation
(potentially embarrassing and/or painful), but can at times make it
difficult to initiate inflation. For these reasons, Dr. Eid
recommends this pump for the younger patient with an average-sized
penis.

Tactile Pump (700 CX Series) - AMS

“The AMS 700 CX Series with the Tactile Pump remains my prosthesis of
choice for the older patient where pump concealment is not an issue,”
says Dr. Eid. “This pump is large, easily palpable, remains the
softest to inflate and has a very large deflation footprint, which is
quickly recognized by the patient.” The Tactile pump is not available
with the LGX cylinders.

Titan Pump - Coloplast

The FDA approved the improvements to the pump component of the
Coloplast Titan prosthesis in July 2008. Although the cylinders and
reservoir remain the same as the previous model, the pump now
features a one-touch-release (OTR) deflation valve — easy for
patients to locate and operable with one hand. In addition, the pump
offers a non-bulky, low-profile size; enhanced silicone for higher
threshold “tear strength” (likely to result in increased product
durability, an issue with previous versions); and an overall
simplicity likely to decrease repeat office visits, phone calls, and
repeat training time. From a hospital standpoint, intraoperative
prep of the device provides for easier priming of the implant system
(the removal of excess air prior to filling) and may reduce slightly
the overall intraoperative time.

“This remains a great device for the patient with a larger penis,”
says Dr. Eid, “as these are the only cylinders that will expand to
22mm girth.” In addition, only Titan cylinders are available in
lengths of 24cm, 26cm and 28cm.

Although the pump is easily identified and operated by patients, the
small size of the deflation valve sometimes requires a longer learning
curve.

In a recent study (”Evaluation of Three Penile Prosthesis Pump
Designs in a Blinded Survey of Practitioners,” Urologic Nursing,
2008), 32 medical professionals, all familiar in teaching the
operation of penile implants to patients, reviewed currently
available penile pumps. The blindfolded reviewers, examining the
pumps under time constraints through mock scrotal sacs, were asked to
rate device:

— ease of location of deflation valve
— ease of inflation
— ease of deflation, and
— anticipated ability to train patients in clinical setting.

The Titan OTR pump design performed very well and “consistently
demonstrated a significant advantage in subject preference.”
(Quallich, Ohl & Dunn, 2008, p. 5).

Artificial Urinary Sphincter - AMS

AMS has improved the AUS by coating the device surface with
inhibizone. This is the same antibiotic coating (Rifampin and Minocin)
currently available on the IPP that has dramatically reduced infection
rates since its introduction in 2001. In combination with Dr. Eid’s
self-developed “no-touch” surgical technique, which eliminates direct
and indirect contact between the prosthesis and the patient’s skin
(the origin of most infections), he believes the new coating will
offer additional protection against the most common pathogens
responsible for sphincter infections.

Dedicated to Patient Education

Dr. Eid has developed a website http://www.urologicalcare.com
dispelling common misconceptions about penile implant surgery. Having
performed over 3,000 penile implant surgeries (the most worldwide),
Dr. Eid knows what a remarkable and positive difference the treatment
can make in a man’s life. Between retaining a normal penis look and
feel, employment of multiple techniques for preventing infection, and
steady diminishment of pain until it is completely gone within 2-4
weeks, penile implant surgery has proven to be an effective treatment
for many men, resulting in normal, healthy and productive lives.

About J. Francois Eid, M.D, and urologicalcare.com

Dr. Eid is the director and founder of Advanced Urological Care in
New York City. He is also a Clinical Associate Professor of Urology
at Cornell University. Dr. Eid is one of the foremost specialists in
urological prosthetic reconstruction and performs over 300 internal
penile implants per year. Dr. Eid leads workshops on penile
prosthesis surgeries worldwide. More information about Dr. Eid and
his expertise with erectile dysfunction treatment, penile prosthesis
implantations and artificial urinary sphincters can be found on his
website, http://www.urologicalcare.com.

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