What are penile prostheses?
Penile prostheses are devices that are implanted inside the corpora cavernosa of the penis. In this model you can see perfectly a penis. The penis, cut transversely see that it has two corpora cavernosa and inside these corpora cavernosos is where the penile prosthesis is implanted. These devices what they do is restore erectile function. That is, they allow the penis to achieve a good rigidity and allow an adequate sexual relationship before the problem that the individual has of impotence.
Is the prosthesis a good option for erectile dysfunction?
Really the penile prosthesis, in many occasions, is the best option and we will see that in many occasions, it is also the only option. It is the best option because when pharmacological treatments have really failed, physical treatments such as vacuum or intracavernous injections that have also been used for this pathology. There are patients, maybe 15% of individuals suffering from erectile dysfunction due to a major disease such as diabetes, such as hypertension, cardiorespiratory failure, etc.. For these individuals it is the only option, and it is the first, therefore, it is not the last. It is a really spectacular solution because erectile dysfunction is recovered.
What is the intervention and how does a penile prosthesis work?
The operation is a complex operation. In our center we have a lot of experience and therefore it is a routine surgery. It consists of previously making an incision in the peneoscrotal angle and, through a small incision of three centimeters (usually enough), it allows us to place a prosthetic system like the one in my hand, which is a state-of-the-art prosthesis.. It activates this small pumping system that is placed inside the individual's scrotum and when activated by pressing on the skin with a pressure of 200 grams, an erection of an optimal rigidity is achieved. Until the patient ends his sexual relationship and when he has finished, pressing on a system of deactivation for two seconds, as I am doing now, the penis by its same weight drops immediately and is completely flaccid.
The surgery lasts about 50 minutes, 60 minutes at most, with locoregional anesthesia of half a body down and usually only one night in the clinic, if we operate in the afternoon, or leave in the afternoon, if we operate in the morning. At four or five weeks after the operation, except for some complication that may exist, infection or not, but which are very low, the patient is able to have sexual relations.
How to know which prosthesis is the most appropriate?
To know which prosthesis is the most appropriate, no doubt, we must start from the complete clinical history of the patient, know the patient's typology, know their concomitant diseases ... Once all these details are known we can choose between malleable prostheses or hydraulic of last generation. What difference there are? The malleable are prostheses that are not activated but can only be bent or straightened like the one I am showing now and that would be indicated for an obese, diabetic person, who does not reach or can not handle the prosthesis at the level of the scrotum. Or that, for example, he has a disease such as osteoarthritis of the hands, fingers and could not handle a pumping system as I have taught before.
Once this is known, the prosthesis is chosen and it should be avoided whenever there are complications in the future. The most important are preoperative complications, that is, avoiding false expectations. What I can say, finally, is that the prosthesis is the best solution to an erectile dysfunction problem that is not solved by other methods and is highly rewarding for the patient himself, for his partner and for the doctor.