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Penile Prosthesis Advances
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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Copyright © 2008 – UroToday
Article URL: http://www.medicalnewstoday.com/articles/117606.php Main
News Category: Erectile Dysfunction / Premature Ejaculation
Also Appears In: Men's health,
Urology / Nephrology,
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