prosthesis
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Reliable Treatment. Satisfied Patients. Proven Success. |
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Semi-Rigid or Malleable Prosthesis
- Less Expensive
- Less chance of wear-induced failure
- Easier placement
- More appropriate for men who are anticoagulated
- Better at holding condom catheter in place
- More difficult to conceal, as is always firm
- No change in penile girth
- No change in penile length
Self-Contained Inflatable Prosthesis
- Will not recreate length of patient's natural erection
- More pronounced gladular end provides support for condom catheter
- Preferred in SCI or men with neurologic disease, due to their decreased/lacking penile sensation
- Avoids the greater risk of erosion seen with semirigid prothesis
Three-Piece Inflatable Prosthesis
- Will not recreate length of patient's natural erection
- Allows most control over erection
- Provides most natural appearance when not in use
- Can add girth with inflation
- Higher chance of mechanical failure
- Patient needs good manual dexterity to work scrotal pump
Ideal Penile Prosthesis
- Cosmetically resembles natural erection
- Resembles natural flaccid state
- Is convenient and easy to use
- Allows for spontaneity
- Does not distort natural penile shape
- For the majority of men this ideal is a three-piece inflatable prosthesis
Contraindications to Surgery
- UTI
- Active infection anywhere on the body, but particularly on the groin and perineal area
- Elevated glycosolated hemoglobin in diabetic patients is not a contraindication, unless it is greater than 11.5%
Preoperative Evaluation
Manual Dexterity
- Less of an issue with malleable prosthesis
- Important that patient be able to manage scrotal pump
- Personal Hygiene
- Patient must have access to living conditions that support his need to keep incision clean
- Patient must be able to comprehend need to keep incision site clean
Preoperative Patient Counseling
- Any prosthesis creates erections that are approximately 1/2 to 1" shorter than patient's natural erection
- Effective preoperative education is also important in order to prevent unrealistic expectations after the surgery.
Postoperative Management
- Since the reasons for this surgery are usually kept quiet by patient, he may receive little support while in the hospital or during the initial post-operative perion
- Nursing staff will have important support role, especially with patient who is not involved in a relationship
- Provide opportunities for patient to discuss feelings regarding surgery itself and recovery
Immediate Postoperative Care
- Sexual activity should be avoided prior to initial postoperative visit
- Use of the prosthesis prior to proper healing of the incisions could cause damage to the incision, and potential damage to the prosthesis; it also increases the risk of infection
- Dr. Schoenfeld will advise when it is safe to resume sexual activity
Follow-Up
- Reported improvement in self-image
- Increased satisfaction with intercourse and orgasm
- Increased frequency of intercourse
- Rejection by partner (illustrates why it is vital to include patient and partner in decision making/ education)
- Carry
prosthesis identification card or MedicAlert bracelet at
all times
- Prevents misinterpretations of pelvic x-ray
- Prevent misdiagnosis of priaprism in the case of the semi-rigid prosthesis
Overall Satisfaction Rate
Overall satisfaction rate comparing Viagra with Penile Prosthesis.
- 82% overall satisfaction with Viagra
- 95-97% overall satisfaction with penile prosthesis
