Penile Prostheses For The Treatment Of Erectile
Dysfunction
10 Aug 2008
UroToday.com - While erectile dysfunction has been described since
ancient times, adequate treatment has only been available for the
last three decades. Modern penile prosthetic devices were first
developed in the early 1970s when Small et al. along with Scott et
al. reported the implantation of penile prosthetic devices into
the corpora cavernosa to fill the corpora cavernosa and provide a
physiologically functional erection with good cosmetic results.
Semirigid rod and mechanical prostheses available today are the
successors of the devices designed in the 1970s. These devices,
while easier to implant, have few advantages over the newer
inflatable devices because infection and mechanical malfunction
rates are similar. The semirigid devices consist of a central
metal core and a silicone elastomer rod while the mechanical Dura
II implant is a series of disks held in position by a central
cable. The latter design facilitates positioning of the implant
between uses.
The three-piece inflatable penile prostheses vary in construction
from three-layer silicon/Dacron/Lycra to a single layer of silicon
or Bioflex . Options include girth expansion and/or length
elongation. Design modifications over the past two decades have
decreased mechanical malfunction rates from greater than 30% to
less than 5% and antibiotic coating has reduced the infection
rates from over 4% to fewer than 1%.
The three-piece inflatable penile prostheses continue to be the
most satisfactory prostheses. These prosthetic devices produce the
most natural appearing erection in girth, length, and with
satisfactory rigidity and excellent flaccidity for optimal
concealment. They also have advantages for many patients with
complex penile implantations because the flaccid position removes
pressure from the corporal cavernosa and decreases the possibility
of erosion in these highly difficult implantations.
Patients chosen for penile implantation therapy are usually those
that have failed PDE5 inhibitors and less invasive therapy.
Careful informed consent is critical in counselling patients
before surgery. Post operatively patients should be counselled to
cycle their devices daily and that satisfaction increases over 3
to 6 months after implantation. Multicenter studies have
documented the long term satisfaction and normal mechanical
function of penile implants and their satisfaction rates. Patients
queried 5 years after surgery were using their implants an average
of three times monthly.
Presented by: Culley C. Carson, MD, at the Masters in Urology
Meeting - July 31, 2008 - August 2, 2008, Elbow Beach Resort,
Bermuda
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Article URL: http://www.medicalnewstoday.com/articles/117606.php
Main News Category: Erectile Dysfunction / Premature
Ejaculation
Also Appears In: Men's health, Urology / Nephrology, |
