A practical overview of considerations for penile prosthesis placement

Trost, Landon; Wanzek, Philip; Bailey, George C.

doi:10.1038/nrurol.2015.270

Cited by 38 publications

(20 citation statements)

References 119 publications

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“…Penile prostheses, which first began to be used in the 1970s, were modernized with the development of new prostheses with a silicon inner side and metal support in 1989. Then, with the production of inflatable and multiple-piece and even antibiotic-coated prostheses, devices that led to less complications and were more suitable for social life were developed (22,23). An ideal penile prosthesis should be able to be implanted without leading to a serious complication during the operation, have an adequate length and rigidity for penetration, and provide the highest patient and partner satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Penile Prosthesis Implantation for Treating Organic Erectile Dysfunction

Kadıhasanoğlu¹,

Erkan²,

Yücetaş³

et al. 2016

Istanbul Med J

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Erectile dysfunction (ED) is the second most common sexual dysfunction in men after premature ejaculation (1) and is defined as "the inability of a man to have and/or maintain adequate penile erection for sexual intercourse for at least 6 months" (2). In a community-based study conducted by the Turkish Society of Andrology on the prevalence of ED, its prevalence was found to be 69.2% (33.2% as mild, 27.5% as moderate, and 8.5% as advanced ED) (3). According to the findings of the Massachusetts Male Aging Study (MMAS), which is accepted to be a reference as one of the most important international epidemiological studies, of male patients between the ages of 40 and 70 years, 17% had mild ED, 25% had moderate ED, and 10% had severe ED (4). Based on these findings, it is estimated that the number of ED patients will increase to approximately 322 million worldwide in 2015 (5). It has been demonstrated that frequent ED can seriously affect the quality of life of the spouse as well as the patient (4).In basic scientific and clinical studies conducted on the physiology and pathophysiology of erection, it has been revealed that ED is a vascular pathology associated with risk factors, such as cardiovascular diseases, hypertension, atherosclerosis, lipid disorders, smoking, diabetes mellitus, obesity, metabolic syndrome, and a sedentary lifestyle (2, 6). Apart from the abovementioned medical problems, iatrogenic factors, such as pelvic surgeries, particularly radical prostatectomy where even bilateral neuroprotective is applied, are also among the important factors that play a role in the occurrence of ED (7).Currently, lifestyle changes and primary and secondary care conservative therapies, including medical treatment choices applied orally or through intracavernous injection, are the first techniques performed for patients with ED. Phosphodiesterase type-5 inhibitors, intracavernous injections, intraurethral alprostadil, and vacuum devices can fail in approximately 80% of patients because they discontinue the treatment (8, 9). In such a situation or in ED patients, particularly in the case of ED with an organic origin, with no adequate response to the treatment, despite invasive and costly intervention, flexible or inflatable penile prosthesis implantation, which has been The Clinical Results of Penile Prosthesis Implantation for the Treatment of Organic Erectile DysfunctionIntroduction: The aim of this study is to evaluate the clinical results of penile prosthesis implantation for the treatment of the patients with organic erectile dysfunction (ED).Methods: Medical records of penile prosthesis implantation for the treatments of 36 patients with organic ED between January 2006 and December 2014 were retrospectively reviewed. The demographic data of the patients, the causes and duration of ED, operative time, hospitalization time, types of prosthesis, and intraoperative and postoperative complications were evaluated. Results:The mean age of patients was 53.94±9.66 years and the mean body mass index of the patients was 27....

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Section: Discussionmentioning

confidence: 99%

Clinical Results of Penile Prosthesis Implantation for Treating Organic Erectile Dysfunction

Kadıhasanoğlu¹,

Erkan²,

Yücetaş³

et al. 2016

Istanbul Med J

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“…The three-piece inflatable implant is composed of a pair of cylinders within the corpora cavernosa, a scrotal pump, and a reservoir, which may be placed in the traditional perivesical space or in other alternative locations such as submuscular in the anterior abdominal wall deep to the rectus abdominis but superficial to the transversalis fascia and peritoneum (73). Two other locations for the penile implant reservoir include (a) just lateral to the rectus abdominis, either cephalad or caudad in the periumbilical region, or (b) even more lateral in location and deep to any of the following: external oblique, internal oblique, transversus abdominis, or transversalis fascia (73).…”

Section: Penile Prosthesesmentioning

confidence: 99%

Adventures and Misadventures in Plastic Surgery and Soft-Tissue Implants

et al. 2017

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Soft-tissue augmentation and implants are increasingly seen by the radiologist as more techniques emerge for a variety of indications and locations. Some surgical and implant procedures are performed for purely cosmetic reasons in otherwise healthy patients seeking to improve their body image, and some are performed for reconstruction after cancer or other chronic illnesses. Abdominoplasty, liposuction, and autologous fat grafting can be performed for abdominal and gluteal contouring. Injection of liquid injectable silicone has historically been fraught with legal issues, although it continues to be used for augmentation in a variety of anatomic locations. Newer solid silicone implants have revolutionized cosmetic and reconstructive muscular contouring. Subdermal implants placed by nonmedical professionals are relatively new and unrecognized within the medical establishment, although such implants have been described in the popular culture. Perhaps the most rapidly increasing segment of cosmetic procedures, however, is minimally invasive cosmesis in the form of soft-tissue fillers in the hands and face. Finally, the major principles of breast augmentation and penile implants are also reviewed. Regardless of the location and the type of implant, complications of plastic surgery and soft-tissue implants can generally be classified into the following categories: seroma, hematoma, infection, migration, vascular or nerve compression, fibrosis, foreign-body reaction, and rupture or breakdown. Key concepts include knowing the appropriate anatomic location and the normal postoperative appearance so that complications can be properly detected. A broad range of approved, off-label, and illicit plastic surgical and implant procedures are described and their complications illustrated with cases with classic imaging findings. RSNA, 2017.

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“…The risk of infection with virgin implantation of the modern IPP has ranged from less than 1% and up to 4% ( 1 , 9 , 10 ). Though the risk is low, patients should be aware of factors that predispose them to higher rates of infection and how to minimize their risk.…”

Section: Preoperative Counselingmentioning

confidence: 99%

“…The modern prosthesis has been around for over 40 years and undergone numerous iterations. For patients refractory to medical therapies, including phosphodiesterase type 5 inhibitors, penile prosthesis placement is widely considered the gold standard surgical therapy ( 1 , 2 ). The IPP has evolved from the semi-rigid implant and two-piece inflatable prosthesis to the modern three-piece inflatable device, the “Cadillac” of available penile implants.…”

Section: Introductionmentioning

confidence: 99%

Preoperative counseling and expectation management for inflatable penile prosthesis implantation

Narang

Figler

Coward

2017

Transl. Androl. Urol.

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The inflatable penile prosthesis (IPP) is the gold standard surgical treatment for medical refractory erectile dysfunction (ED). While the modern IPP has enjoyed high satisfaction rates as a product of its continued innovation, reliability, and performance, patient dissatisfaction can still occur. IPP implantation restores physiologic function with cosmetic and psychological consequences, both of which place inherent emphasis on preoperative counseling and expectation management. This review aims to highlight the complex nature of such counseling and provide practitioners with a roadmap to navigate the landscape. Preoperative counseling begins with appropriate patient selection and identification of those patients who are at risk for dissatisfaction as a result of personality characteristics. The informed consent provides a natural framework to discuss the host of complications and risks that are associated with surgery, including infection, device malfunction, damage to nearby structures, and device erosion. Device selection is a nuanced process that merges patient preference with clinical factors and consideration. We address device selection through a description of cylinder construction, pump design, and reservoir placement in the context of preoperative counseling. Lastly, we draw attention to expectation management with a specific focus on possible post-operative changes to penile length and sensation as well as partner involvement. The modern IPP provides excellent results with high patient and partner satisfaction. Ultimately, satisfaction is dependent on multiple factors, but providing accurate, realistic counseling and expectation management prepares patients for the best possible outcomes.

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A practical overview of considerations for penile prosthesis placement

Cited by 38 publications

References 119 publications

Clinical Results of Penile Prosthesis Implantation for Treating Organic Erectile Dysfunction

Clinical Results of Penile Prosthesis Implantation for Treating Organic Erectile Dysfunction

Adventures and Misadventures in Plastic Surgery and Soft-Tissue Implants

Preoperative counseling and expectation management for inflatable penile prosthesis implantation

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