Evolution of penile prosthetic devices

Le, Brian; Burnett, Arthur L.

doi:10.4111/kju.2015.56.3.179

Cited by 47 publications

(43 citation statements)

References 29 publications

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“…[41] Malleable prostheses tend to function more effectively as in some cases, due to fibrosis of tissues, inflatable prostheses are not able to overcome corporeal rigidity. [42] However, satisfaction rates have been found to be higher in inflatable prostheses than in malleable ones, most likely because inflatable prostheses give the patient the option of choosing when the penis is erect and are more aesthetically pleasing.…”

mentioning

confidence: 99%

Ischaemic priapism: A clinical review

Ridgley

Raison

Sheikh

et al. 2017

Turkish Journal of Urology

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Objective: Ischaemic priapism is a rare condition characterised by little or no cavernosal blood flow, pain and rigidity of the penis. Immediate intervention is required to restore blood flow, prevent necrosis and erectile dysfunction. This review was conducted to determine the best course of treatment and identify areas in current guidelines to which improvements could be made. PubMed, Ovid, MEDLINE (1946-December 2016 and the Cochrane Library were searched as sources for literature. Key studies in each of the areas of management were identified and analysed. Material and methods:Results: A total of 45 articles were reviewed. The first step in treatment should be aspiration of corporeal blood. Further studies are needed to make firm recommendations as to whether irrigation should follow, as currently literature is inconclusive. If this fails to cause detumescence, sympathomimetics should be injected. The sympathomimetic of choice is phenylephrine as it is effective, specific and causes minimal cardiovascular side effects. It should be injected at a concentration of 100-500 μg/mL, with 1 mL being injected every 3-5 minutes for up to an hour (maximum 1mg in an hour). Surgical shunting is the next step, except in the cases of delayed priapism (48-72 hours duration) where immediate penile prosthesis insertion may be considered more appropriate. Distal shunts should be performed first, followed by proximal ones to minimise damage leading to erectile dysfunction. There exists little evidence recommending one shunting procedure over another. The final intervention is insertion of a penile prosthesis. Literature suggests that an inflatable prosthesis inserted immediately will yield the greatest patient satisfaction. Conclusion:A review of the literature has highlighted areas in which further research needs to be done to make conclusive recommendations, including whether irrigation should accompany aspiration and efficacy of shunting procedures. Further studies are required to ensure that patients receive the treatment most likely to cause detumescence and maintain erectile function.

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mentioning

confidence: 99%

Ischaemic priapism: A clinical review

Ridgley

Raison

Sheikh

et al. 2017

Turkish Journal of Urology

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“…The implant of penile prosthetics has become a common procedure over the last decades, with an annual implant rate of 25.000 in North America alone. 1 Improvements in prosthesis technology and surgery reduced the complication rate to less than 2% within 5 years. Erosion, infection and device malfunction however, are potential, severe complications which may require removal of the device.…”

Section: Discussionmentioning

confidence: 99%

Stretch due to Penile Prosthesis Reservoir Migration

Baten

Vandewalle

Renterghem

2016

Urology Case Reports

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A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

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“…Small modifications have been made including hydrophilic coating and more blunted tips, but the design remains very similar to that implant created by Drs. Small and Carrion in the 1970s [20].…”

Section: The Modern‐day Malleablementioning

confidence: 99%

The Evolution and Utility of the Small-Carrion Prosthesis, Its Impact, and Progression to the Modern-Day Malleable Penile Prosthesis

Martinez

Terlecki²,

Brant

2015

The Journal of Sexual Medicine

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Introduction Erectile dysfunction has plagued humanity for millennia. For years, treatment had been in the hands of mental health professionals. It was not until the 1970s that urologists created a modality that was marketable, reproducible, and consistently successful at treating impotence, the Small-Carrion Penile Prosthesis. Aim We present the evolution of the malleable/semi-rigid penile prosthesis, concentrating our efforts reviewing and critiquing the pivotal article published by Drs. Michael P. Small, Hernan M. Carrion, and Julian A. Gordon. We then discuss its continued advancement, current-day utilization, and the future of the malleable prosthesis. Methods From the early 1900s, surgeons have been toying with the idea of creating a penile implant. These initial attempts utilized rib cartilage, and eventually synthetic materials, including acrylic, silicone, and polyethylene. Results In 1975, Drs. Carrion and Small presented their initial experience of 31 patients utilizing their silicone implant. In their manuscript titled, “The Small-Carrion Penile Prosthesis: New Implant for the Management of Impotence,” they discuss their technique, perioperative management of complications, and results. Conclusions The malleable penile prosthesis continued to evolve throughout the years to the current day Genesis and Spectra. Although the current market is dominated by the inflatable penile prosthesis, there are specific situations where the malleable is ideally utilized. The pivotal article by Drs. Carrion and Small helped pave the way for the “New Era” of penile prosthetics and still remains one of the most impactful contributions to the management of erectile dysfunction.

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Evolution of penile prosthetic devices

Cited by 47 publications

References 29 publications

Ischaemic priapism: A clinical review

Ischaemic priapism: A clinical review

Stretch due to Penile Prosthesis Reservoir Migration

The Evolution and Utility of the Small-Carrion Prosthesis, Its Impact, and Progression to the Modern-Day Malleable Penile Prosthesis

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