Penile prostheses are used to achieve and maintain rigidity of the penis, enabling a normal sexual intercourse. The main indication for implanting penile prostheses is a permanent loss of erection, says Prof. Dr. Miroslav Djordjevic – urologist and pediatric surgeon urologist.
90% of the operated patients have normal sexual intercourse
The operation of inserting prostheses is performed under general and spinal anesthesia, as a one-day surgery. The average time for inserting the prostheses depends on the causes for erectile dysfunction and the type of prostheses, ranging from 40 to 100 minutes. The patient takes the necessary antibiotics in order to prevent infections, and 4-6 weeks after the surgery can start the sexual intercourse. The frequency of complications following the insertion of penile prostheses is lower than 7 percent, and most commonly occur infections, tissue erosion or displacing of some prosthesis components. In some complications, the prosthesis should be removed while others can be treated conservatively. According to the conducted trials after the insertion more than 90 percent of patients and their partners are satisfied with the surgery and have a normal sexual intercourse. The inserting of penile prostheses allows complete solution of all, even the most severe forms of erectile dysfunction, which enables a life-long normal sexual activity.
The most common causes leading to loss of erectile function are: diabetes mellitus (diabetic vasculopathy and neuropathy), neurological disorders (cerebral vascular disorders, peripheral neuropathies, nerve compression in the intervertebral disc prolapse), Peyronie’s disease (resulting in damage to the vein occlusion mechanism for achieving an erection), priapism (permanent fibrous damage to the erectile tissue), traffic and professional trauma, injuries during surgeries in the lower pelvis (ex. surgery of prostate, bladder, urethra, rectum). Certain conditions can accelerate the occurrence of permanent erectile dysfunction, such as: hypertension, hyperlipidemia, smoking, depression, hormonal imbalance. If the erectile function can not be corrected by oral and injection therapy, the only option to completely restore rigidity of the penis is an insertion of penile prostheses.
In principle, there are two types of penile prostheses: semirigid and inflatable prostheses. Semirigid penile prostheses are inserted into erectile bodies and thus the patient gets permanent penile strength sufficient for a sexual intercourse. The patient simply manually shapes the penis giving him a penetration position. On the other hand, inserting inflatable prostheses involves insertion of cylinders in the cavernous bodies, pumps in the scrotum and reservoir in the bladder region. After the insertion of inflatable prostheses, the desired erection is achieved simply by pressing the pump located in the patient’s scrotum. The advantage of the semirigid prostheses is in the simplicity of insertion and more than once lower cost, while the advantage of the inflatable prostheses is achieving a natural erection by increasing the length and circumference of the penis.