Approximately 30
million men in the United States are impotent. Implantation of a penile
prosthesis is one of several treatment options. Other options include
medications, intraurethral inserts (Muse), vacuum tumescence/constriction
devices and self-injection of the erectile tissues with a medication that
improves penile blood flow, such as Prostaglandin E-1 (Caverject). In the
occasional patient, penile revascularization is appropriate. Sex therapy
or psychotherapy is appropriate for patients with psychogenic impotence.
PENILE IMPLANT: an internal device that is permanent and makes
the penis hard enough for penetration. There are several types with
different features. With the currently available state-of-the-art
implants, a success rate of almost 95% may be expected.
PENILE IMPLANT SURGERY: this requires the placement of two
implants in the penis; one in the left erectile chamber and one in the
right. The implants and the pump which fills the implants are totally
concealed inside the body and give excellent cosmetic and functional
results in most patients.
The success rate is from 80 to 90% in terms of patient and partner
acceptance, and almost 95% in terms of patient satisfaction. The implants
are FDA approved.
There are two categories of implants: - the non-inflatable rods which
are bendable and can be manipulated to give an erection, and inflatable
implants which contain fluid to give a more natural erection. This fluid
is transferred within or to cylinders in the penis to give hardness.
While less than 5% of patients choose this form of treatment initially,
the final choice of treatment is a penile implant in 10% of patients. In
the U.S.A., approximately 14,000 implants are performed each year.
