�UroToday.com - While cavernous dysfunction has been described since ancient times, enough treatment has only been available for the last three decades. Modern penial 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 retinal rod and mechanically skillful prostheses useable today are the successors of the devices intentional in the 1970s. These devices, while easier to implant, deliver few advantages over the newer inflatable devices because infection and mechanical malfunction rates ar similar. The semirigid devices consist of a central metal gist and a silicone elastomer rod while the mechanical Dura II implant is a serial publication of disks held in position by a fundamental cable. The latter intention 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 atomic number 14 or Bioflex . Options include girth enlargement and/or length elongation. Design modifications over the past times two decades have decreased mechanical malfunction rates from greater than 30% to less than 5% and antibiotic coating has rock-bottom 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 erecting in girth, length, and with satisfactory rigidity and excellent flabbiness for optimum 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 eating away in these highly difficult implantations.
Patients chosen for penile implantation therapy ar usually those that take failed PDE5 inhibitors and less encroaching therapy. Careful informed consent is critical in direction patients in front surgery. Post operatively patients should be counselled to cycle their devices day-by-day 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 oR were exploitation their implants an median of terzetto 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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