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HelloMD.com: UROLOGY (URINARY AND GENITAL SYSTEMS)

PENILE PROSTHESIS (IMPLANTS)

When are penile implants required?
These are usually required in older people suffering from diabetes or other vascular Problems like atherosclerosis involving the corpus cavernosum (This is the main tissue involved with the mechanism of creation. It is a spongy cylindrical tissue which gets engorged with blood during erection. There are two such tube like tissues in a penis on each side).

What are the things a potential prosthetic patient need to know?
1. Any other possible conservative treatment options.
2. What the prosthesis will do for him, and what change in body status will result.
3. Explanation in lay terms where the device is to be placed
4. Expected functional and cosmetic result.
5. Possible involvement of others who will be involved with the patent in prothetic care and/ or use.
6. Explanation of possible complications.

What are the types of penile prosthesis available?
Penile prosthesis are basically of two broad categories:-
1. Malleable or semirigid
2. Inflatable devices.

MALLEABLE OR NON INFLATABLE DEVICES:
These are of pure silicon rubber or contain an intertwined central or spiral metallic core. The advantages of semiriged device are easier placement, less chances of failure due to wear and tear and lower cost. The drawback of semi rigid devices include less concealability (one has to wear a special underwear) and inability of change in girth. Two such cylinder like devices are placed in penis by giving small incision at the base of the penis on each side.

INFLATABLE DEVICES:
These are of two types :-
1. Two piece - with a cylinder and a reservoir.
2. Three piece - with a cylinder, reservoir and a pump.

An advantage of two piece device includes easier surgical placement but because less fluid is transferred in and out of the cylinders with the erect and flaccid states, the degree of rigidity and change in girth and length is not as good as with the three piece inflatable device. The three piece devices provide a flaccid and erect state that more closely mimics natural erection, but one mandatory caution to be made to the prospective recipient is that no penile prosthesis will restore the full length previously achieved by the patent with his natural erection.

In three piece devices the cylinders are placed in the shaft of the penis, the reservoir is placed in the scrotum and the pump is placed in the pubic area beneath the rectus muscle. Complications include infection, leakage of fluid and mechanical failure of device. A common dissatisfaction expressed is inadequate length which may be one or two centimeter lesser than before. In general, patient and partner satisfaction ranges from 75% to 85 %.

 

 

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