Penile Prostheses Health Article

Definition

Penile prostheses are semi-rigid or inflatable devices that are implanted into penises to alleviate impotence.

Purpose

The penis is composed of one channel for urine and semen, and three compartments with tough, fibrous walls containing erectile tissue. With appropriate stimulation, the blood vessels that lead out of these compartments constrict, trapping blood. Blood pressure fills and hardens the compartments producing an erection of sufficient firmness to perform sexual intercourse. Additional stimulation leads to ejaculation, where semen is pumped out of the urethra. When this system fails, erectile dysfunction or impotence (failure to create and maintain an erection) occurs.

Impotence can be caused by a number of conditions, including diabetes, spinal cord injury, prolonged drug abuse, and removal of the prostate gland. If the medical condition is irreversible, a penile prosthesis may be considered. Men whose impotence is caused by psychological problems are not recommended for implant surgery.

Demographics

Recently, it has been reported that surgeons insert approximately 20,000 penile implants into American men yearly. The most common device is a multi-component inflatable implant (approximately 45% of all implants). Semi-rigid rods account for about 35% of the implants. Self-contained devices comprise approximately 20% of implants.

Description

Penile implant surgery is conducted on persons who have exhausted all other areas of treatment. Semi-rigid devices consist of two rods that are easier and less expensive to implant than the inflatable cylinders. Once implanted, the semi-rigid device needs no follow-up adjustments; however, it produces a penis that constantly remains semi-erect. Inflatable cylinders produce a more natural effect. Men using them are able to simulate an erection via a pump located in the scrotum.

With a surgical patient under general anesthesia, the device is inserted into the erectile tissue of the penis through an incision in the fibrous wall. In order to insert the pump for the inflatable implant, incisions are made in the abdomen and the perineum (area between the anus and the genitals). A fluid reservoir is placed into the groin, and the pump is placed in the scrotum. The cylinders, reservoir, and pump are connected by tubes and tested before the incisions are closed.