{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:29:49Z","timestamp":1788380989865,"version":"build-2803163510"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Reoperations are necessary in approximately 30% of penile prostheses over 15 years following original implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To determine the most common indications for initial penile prosthesis reoperation at our institution and to describe technical alterations that have improved postoperative outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective review of all patients who underwent penile prosthesis reoperation surgery at a single, high-volume Canadian center between 2006 and 2018 was performed. Patient demographic information, prosthetic device factors, and surgical complications were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure<\/jats:title>\n                  <jats:p>The primary outcomes were the indications for and variables associated with initial penile prosthesis reoperation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the study period, 99 first-time penile prosthesis reoperations were performed out of 1,161 penile prosthesis procedures (Figure 1). This included 14 (14.1%) explants, 32 (32.3%) revisions, and 53 (53.5%) explant and reimplants. Indications for reoperation included 49 (49.5%) mechanical failures, 28 (28.3%) technical causes (such as correction of malposition or device herniation), and 12 (12.1%) procedures to treat chronic postoperative pain. Median follow-up was 78.5 months, and median time to reoperation was 46 months. Mechanical failures commonly occurred in the tubing (n = 13, 26.5%) and cylinders (n = 13, 26.5%). The most frequently repositioned component was the valve pump (n = 11, 39.3%). Infection-related indications for reoperation were uncommon (n = 10, 10.1%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>More than a quarter of penile prosthesis reoperations may have been preventable with alterations in surgical technique, device positioning, and postoperative care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>This study evaluates a range of indications for initial penile prosthesis reoperation performed by a high-volume single surgeon over a 12-year period. Limitations include the retrospective nature of the study, loss of patients to follow-up, and lack of etiological determinants of prosthesis failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Reoperation for device repositioning and herniation was required for more than a quarter of the initial penile prosthesis implants. Modifications in surgical technique and perioperative care can help reduce the incidence of these technical causes for reoperation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.06.003","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T22:09:16Z","timestamp":1562882956000},"page":"1444-1450","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["Indications for Penile Prosthesis Revision: Lessons Learned to Limit Technical Causes of Reoperation"],"prefix":"10.1093","volume":"16","author":[{"given":"Ernest Pang","family":"Chan","sequence":"first","affiliation":[{"name":"Schulich School of Medicine and Dentistry , London, Ontario , Canada"},{"name":"Western University , London, Ontario , Canada"},{"name":"Division of Urology , London, Ontario , Canada"},{"name":"Department of Surgery , London, Ontario , Canada"},{"name":"St. Joseph\u2019s Hospital , London, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Punjani","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry , London, Ontario , Canada"},{"name":"Western University , London, Ontario , Canada"},{"name":"Division of Urology , London, Ontario , Canada"},{"name":"Department of Surgery , London, Ontario , Canada"},{"name":"St. Joseph\u2019s Hospital , London, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Douglas","family":"Campbell","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry , London, Ontario , Canada"},{"name":"Western University , London, Ontario , Canada"},{"name":"Division of Urology , London, Ontario , Canada"},{"name":"Department of Surgery , London, Ontario , Canada"},{"name":"St. Joseph\u2019s Hospital , London, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haider","family":"Abed","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry , London, Ontario , Canada"},{"name":"Western University , London, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Brock","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine and Dentistry , London, Ontario , Canada"},{"name":"Western University , London, Ontario , Canada"},{"name":"Division of Urology , London, Ontario , Canada"},{"name":"Department of Surgery , London, Ontario , Canada"},{"name":"St. Joseph\u2019s Hospital , London, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"issue":"Suppl 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