Penile Prosthesis
Penile prostheses are divided into 3 general types: malleable (semirigid), mechanical, and inflatable devices. The malleable devices are made of silicone rubber and several models contain a central intertwined metallic core. The mechanical device is also made of silicone rubber but contains polytetrafluoroethylene-coated interlocking polysulfone rings in a rod column, which provides rigidity when the rings are lined up in a straight line and flaccidity when the penis is bent.
Inflatable (hydraulic) devices are further divided into 2-piece and 3-piece devices. Two-piece inflatable prostheses consist of a pair of cylinders attached to a scrotal pump-reservoir. Three-piece inflatable penile prostheses consist of paired the penile cylinders, a scrotal pump, and a suprapubic fluid reservoir (Table 37-6).
In general, the malleable devices last longer than the inflatable ones. Patients should be informed that a 5-15% failure rate is expected in the first 5 years and most of the devices will fail in 10-15 years and will need a replacement. Potential complications include mechanical failures, cylinder leaks, tubing leaks, infection, perforation, persistent pain, and autoinflation (Mulcahy, 2000; Montague et al, 2001; Anastasiadis et al, 2001).
- Introduction
- Physiology of Penile Erection
- Male Sexual Dysfunction
- Male Sexual Dysfunction Epidemiology
- Diagnosis & Treatment
- Nonsurgical Treatment of Erectile Dysfunction
- Lifestyle Changes
- Changing Medications
- Psychosexual Therapy
- Hormonal Therapy
- Phosphodiesterase (PDE) Inhibitors
- Yohimbine
- Trazodone
- Apomorphine
- Transurethral Therapy
- Intracavernous Injection
- Vacuum Constriction Device
- Lifestyle Changes
- Penile Vascular Surgery
- Penile Prosthesis
- Male Sexual Dysfunction Involving Emission, Ejaculation, & Orgasm
Revision date: December 5, 2007
Last revised: by Levon Ter-Petrosyan, D.M.D.
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