Penile Prostheses

Penile Prostheses

 

Definition

Penile prostheses are semirigid or inflatable devices that are implanted into penises to alleviate impotence.

Purpose

The penis is composed of one channel for urine and semen and three compartments with tough, fibrous walls containing "erectile tissue." With appropriate stimulation, the blood vessels that lead out of these compartments constrict, trapping blood. Blood pressure fills and hardens the compartments producing an erection of sufficient firmness to perform sexual intercourse. Additional stimulation leads to ejaculation, where semen is pumped out of the urethra. When this system fails, impotence (failure to create and maintain an erection) occurs.
Impotence can be caused by a number of conditions, including diabetes, spinal cord injury, prolonged drug abuse, and removal of a prostate gland. If the medical condition is irreversible, a penile prosthesis may be considered. Patients whose impotence is caused by psychological problems are not recommended for implant surgery.

Description

Penile implant surgery is conducted on patients who have exhausted all other areas of treatment. The semirigid device consists of two rods that are easier and less expensive to implant than the inflatable cylinders. Once implanted, the semirigid device needs no follow-up adjustments, however it produces a penis which constantly remains semi-erect. The inflatable
The inflatable implant is a common penile prosthesis. This device connects through a tube to a flexible fluid reservoir and a pump. The pump is shaped like a testicle and inserted in the scrotum. When the pump is squeezed, the fluid is forced into the inflatable cylinders implanted inside the penis, producing an erection.
The inflatable implant is a common penile prosthesis. This device connects through a tube to a flexible fluid reservoir and a pump. The pump is shaped like a testicle and inserted in the scrotum. When the pump is squeezed, the fluid is forced into the inflatable cylinders implanted inside the penis, producing an erection.
(Illustration by Electronic Illustrators Group.)
cylinders produce a more natural effect. The patient is able to simulate an erection by using a pump located in the scrotum.
With the patient asleep under general anesthesia, the device is inserted into the erectile tissue of the penis through an incision in the fibrous wall. In order to implant the pump for the inflatable implant, incisions are made in the abdomen and the perineum (area between the anus and the genitals). A fluid reservoir is inserted into the groin and the pump is placed in the scrotum. The cylinders, reservoir, and pump are connected by tubes and tested before the incisions are closed.

Preparation

Surgery always requires an adequately informed patient, both as to risks and benefits. In this case, the sexual partner should also be involved in the discussion. Prior to surgery, antibacterial cleansing occurs and the surrounding areas are shaved.

Aftercare

To minimize swelling, ice packs are applied to the penis for the first 24 hours following surgery. The incision sites are cleansed daily to prevent infection. Pain relievers may be taken.

Risks

With any implant, there is a slightly greater risk of infection. The implant may irritate the penis and cause continuous pain. The inflatable prosthesis may need follow-up surgery to repair leaks in the reservoir or to reconnect the tubing.

Resources

Books

Jordan, Gerald H., et al. "Surgery of the Penis and Urethra." In Campbell's Urology, edited by Patrick C. Walsh, et al. Philadelphia: W. B. Saunders Co., 1998.

Key terms

General anesthesia — Deep sleep induced by a combination of medicines that allows surgery to be performed.
Genital — Sexual organ.
Perineum — Area between the anus and genitals.
Scrotum — The external pouch containing the male reproductive glands (testes) and part of the spermatic cord.
References in periodicals archive ?
Valenzuela specializes in the following areas: general urology, prosthetic urology, sexual dysfunction, urinary incontinence, benign prostatic hypertrophy (BPH), treatment of Peyronie's disease, medical education, public speaking and more He is one of the most prolific implanters of penile prostheses, artificial urinary sphincters and male slings in the Northeast region.
Penile prostheses, testicular, breast, expanders, and hand gel antiaderenziale.
Largest Prospective, Multi-Year, Penile Prosthetic Registry Advances Understanding of Real-World Satisfaction with Penile Prostheses For Erectile Dysfunction Patients
Second-line self-injection with vasoactive agents, vacuum erection devices, and surgical approaches with inflatable penile prostheses offer ED management with high potential for patient and partner treatment satisfaction.
Objective: To evaluate the changing cavernosal length of patients with diabetes mellitus (DM) and organic erectile dysfunction (ED) who were treated with inflatable, three-piece penile prostheses, a current surgical treatment option in our clinic, over the course of 12 years.
This is termed the "learned-intermediary" doctrine, and it is also applicable to medical devices such as dialysis equipment, breast implants, blood products, penile prostheses, and even contact lenses, although the situation is less clear where an optometrist does the prescribing (Products Liability 63A Am.
Experience with penile prostheses in the treatment of impotence with diabetic men.
Thus, polyurethane elastomers have been extensively evaluated for use as artificial heart diaphragms, heart valves, joint prostheses, vascular grafts, urethral catheters, mammary prostheses, penile prostheses and many other devices intended for long-term implant.
The Spectra prosthesis combines the power of the company's DURA II[R], 650[TM] and 600M[TM] malleable lines with the Rear Tip Extenders (RTEs) of the AMS 700[R] Inflatable Penile Prostheses (IPP) to create a surgical solution for erectile dysfunction.
Question of the supply of testicular and penile prostheses.
Two chapters follow which cover the current state of surgery, penile prostheses, self-injection therapy, and vacuum pump therapy.