The implantation process for the AMS DURA IITM involves pre-operative preparation, surgery and post-operative care, with the length of the hospital stay depending on the condition of the patient.
The DURA II surgical procedure follows these steps.
Caution: This information is for general educational purposes only. Refer to the Instructions For Use and procedure videos for more detailed instructions on this surgical procedure.
Step 1: External Measurement
Gently stretch the penis to the approximate length of an erection. Using the sizer, measure the stretched penis from the penile base to the mid-glans area. (Measurements are commonly in the 8 cm to 13 cm range). Do not press the sizer into the skin or fat pad. Record this measurement in the Patient Information Form supplied.
Step 2: Incision & Corporotomy
Make a skin incision at the selected surgical approach site and dissect to expose the tunica albuginea. A subcoronal approach is recommended, although other approaches such as the penoscrotal may also be used. Perform the standard longitudinal corporotomies of 2-3 cm in length. When a non-subcoronal approach is used, it may be necessary to extend the corporotomies to 5-7 cm to allow the prosthesis to be inserted. However, extension of the corporotomies should be made after dilation.
Step 3: Dilate & Measure the Diameter
Dilate both corpora proximally and distally to accommodate prosthesis diameter. If possible, dilate to 14 R to accommodate a 12 mm body. Simultaneously insert two same diameter dilators to verify the penis can accommodate two similarly sized prostheses cylinders.
Step 4: Measure the Intracorporal Length
For intracorporal measurement, gently stretch the penis to approximate an erection. Using the prosthesis sizer, measure the stretched corporal length in centimeters in both the proximal and distal directions to determine the total intracorporal length. Length must be measured for each corpus. Record these measurements on the Patient Information Form supplied.
Step 5: Select the Prosthesis Size
Using the measurements for penile base to mid-glans length and total intracorporal length, refer to the sizing chart provided in the Instructions For Use to select the appropriate distal and proximal tips to be used. If the total intracorporal length varies for the right and left corpora, size each corpus for its measured length per the sizing chart.
Step 6: Assemble the Prosthesis
The body cylinder is bi-directional. Proximal and distal tips may be applied to either end. To assemble the tips to the body cylinders, use the hex wrench supplied with each pair of body cylinders to tighten screws securely.
Step 7: Insert the Prosthesis
When using the subcoronal approach, first insert the proximal end of the prosthesis into the proximal corpora. Then insert the distal tip of the prosthesis under the glans by lifting and retracting the corpus distally with a vein retractor. At the same time, press the distal tip of the prosthesis into the corpus under the glans.
Step 8: Close
Prior to closure, always bend prosthesis in all directions to confirm that there is no springback and to confirm the proper placement of the bend point. Optimally, the device should bend at the body plane. If a subcoronal approach is used, a circumcision must be performed. Complete the circumcision, close the incision and apply the wound dressing.
Post-Operative Care
The patient should change the outside dressing daily, but leave the Vaseline® gauze on the suture line for three days. The patient may resume sexual activity four to six weeks after surgery. |
