めぐみ Types of Penile Implants
Penile prosthesis implants provide a viable therapeutic option to obtain a satisfactory erection for sexual intercourse in patients where the pharmacological approach fails. The satisfaction rate is high for both partners.
They are also used to treat Peyronie’s disease, a curvature of the penis. The surgery is done in an outpatient setting and people go home the same day.
Inflatable penile prosthesis (IPP)
Inflatable penile prosthesis (IPP) is a medical device used to treat patients with erectile dysfunction. It consists of an implanted fluid reservoir with inflatable cylinders that are activated by the patient’s desire to achieve an erection. When the patient presses a pump in his scrotum, fluid is transferred to the cylinders, and the penis becomes erect. Pressing the pump again returns the fluid to the reservoir, deflates the cylinders, and restores the penis to its soft state. It has high satisfaction rates for both the patient and his partner. It is also easy to use and does not interfere with sensation, ejaculation, spontaneity, or orgasm.
Although IPPs have low failure rates, surgical complications can occur if the implant is not properly aligned or placed. Proper training in penile implant surgery can reduce these complications and improve patient outcomes. Anatomy-specific IPP surgery training is critical because several anatomical structures are at risk of injury during implantation.
Despite the many benefits of IPPs, their usage remains limited by inadequate coverage by Medicaid and Medicare. In addition, the implantation of these devices can be complex for neurologically impaired patients. This course will review the contraindications of IPP insertion and describe the technique for IPP implantation. It will also highlight the role of the interprofessional team in evaluating patients who require a penile implant.
Malleable penile prosthesis (MPP)
Infection remains a significant concern of penile prosthesis surgery, despite the development of antibiotic-coated devices. The most recent data indicate that infections occur in 2-3% of first-time implants. Infection is usually confined to the scrotal sac and often manifests within the first 3 months after implantation, although delayed infection beyond 1 year has been reported. Fortunately, infection rates have been reduced to the range of 0.6-0.88% after the introduction of antibiotic-coated protheses.
Surgical management of Peyronie’s disease involves manual modeling and, in some cases, distal wand vibration massager corporoplasty to correct lateral extrusion. A recurrent deformity is common, and most patients experience a loss of the ability to achieve full erections. The malleable penile prosthesis (MPP) offers a definitive treatment for ED and has excellent patient satisfaction rates, but it requires careful counseling of patients before insertion.
Men who suffer from organic ED and are not amenable to more conservative strategies, such as phosphodiesterase inhibitors, should be evaluated for candidacy for a prosthesis. While prosthesis insertion should be considered for reversible forms of ED, patients must understand that this is a permanent treatment and will not reverse the disease process. Those who are appropriately counseled will find that the MPP is as effective as IPP in restoring erectile function and has a similar rate of satisfaction. The authors report no conflicts of interest.
Semi-rigid penile prosthesis (SRP)
A semi-rigid penile prosthesis, also known as a rigid implant, is a solution for men who have erectile dysfunction or Peyronie’s disease. These implants are designed to give men a full, natural-looking appearance while they’re Stick Vibration Massager Manufacturer wearing them. They’re the most popular choice for men who want to regain their sexual vitality.
A cylinder-shaped rigid implant is inserted into the body of your penis, and tubes connect it to a reservoir under your lower abdomen (stomach). When you’re ready for sex, you use a pump to fill the reservoir with fluid, which creates a firm erection. When you’re done, you drain the fluid back into the reservoir and the penis returns to a flaccid state.
There are many different designs for inflatable penile prosthetics. Your health care provider will choose the design that’s right for you based on your body type and medical history. Be sure to tell them about any prescription or over-the-counter medications you take, especially aspirin, anti-inflammatory drugs and herbal supplements. These can increase your risk of bleeding during the procedure.
Penile implant surgery is a life-changing treatment for erectile dysfunction. Most patients and their partners report high levels of satisfaction with these devices. But it’s important to talk with your urologist about your expectations and goals before having this operation. Your doctor will explain all of your options and help you decide what’s best for you.
Non-rigid penile prosthesis (NRP)
This is the simplest type of penile implant and consists of two malleable rods that bend together. The rods can be easily inserted into the urethra during surgery, and they can then be flexed to form a rigid erection for intercourse. These implants do not require lubrication or battery power to work, and they are more discreet than semi-rigid prostheses. However, they do not produce a strong erection, and some patients may experience pain during sexual intercourse.
Before undergoing the procedure, the healthcare provider will take your temperature, pulse and blood pressure, and check to make sure you can empty your bladder without difficulty. The doctor will also talk to you about which type of penile implant is best suited for your needs. You should tell the doctor about any prescription and over-the-counter medications you are taking, including herbal supplements. This will help the doctor avoid any complications caused by the medications.
The first IPP was introduced by Brantley Scott at the AUA meeting in 1973. It used a hydraulic system to transfer fluid into expandable cylinders in the corpora cavernosa, and it allowed urologists to restore an erectile posture during sexual intercourse. It was a huge step forward in the treatment of ED, and it became a popular treatment option for many men with erectile dysfunction.