- Semi-rigid
- Inflatable
- Implantation of semi-rigid or inflatable penile prostheses associated with penile enlargement techniques
- Penile prosthesis reimplantation
Penile prostheses are silicone-made structures that aim to replace the corpora cavernosa (penile tissue, responsible for erection), preparing the man to perform a sexual act. For this reason, they are considered the definitive treatment for erectile dysfunction.
They are indicated in the following circumstances:
- Erectile dysfunction unresponsive to oral drugs and/or who have not adapted to intracavernous injectable drugs (medication injected into the penis)
- Men diagnosed with penile curvature (Peyronie’s disease) associated with erectile dysfunction
- Patients with severe penile deformities or severe penile shortening caused by Peyronie’s disease.
- Men who have a desire to increase penis size
Semi-rigid
Penile prostheses are considered the definitive treatment for erectile dysfunction. Patients with erectile dysfunction, regardless of the cause, who are unresponsive to oral drugs and/or who have not adapted to intracavernous injectable drugs (medication injected into the penis), are candidates for penile prosthesis implantation.
One type of penile prosthesis is the semi-rigid one, made of silicone and featuring a central axis consisting of a silver rod (bendable). Because it is bendable, even with an erection maintained, the patient is able to place the penis in a variety of positions.
To learn more, contact the office of Dr. Luiz Augusto Westin, a physician specializing in reconstructive urology in Rio de Janeiro.
Inflatable
The three-component inflatable penile prosthesis consists of two inflatable cylinders connected to a reservoir filled with saline solution and a small “pump” implanted in the scrotum. The patient himself pumps all the saline from the reservoir into the two cylinders, thus producing an erection.
After sexual intercourse, a maneuver is used to squeeze the device implanted in the scrotum to return the fluid to the reservoir, returning the penis to a flaccid state. The hydraulic system is modern, safe, aesthetic and provides an excellent degree of penile rigidity. This type of prosthesis is the most accepted by most patients, as it simulates a more physiological erection (penis in an erect state only during sexual intercourse).
Dr. Luiz Augusto Westin, a physician specializing in reconstructive urology in Rio de Janeiro and who works in Rio de Janeiro, performs this and other procedures related to men’s health.
Implantation of semi-rigid or inflatable penile prostheses associated with penile enlargement techniques
Prosthetic implants can be associated with penile lengthening procedures in selected cases:
- Large penile shortening caused by Peyronie’s disease;
- Severe penile deformities caused by Peyronie’s disease;
- Small shortenings in patients with below average penis;
- Patients who have the desire for penile enlargement.
The standard and best-known procedure for penile lengthening associated with prosthesis implantation is the Sliding Technique, first described in 2012.
After dissection of the neurovascular bundle and the urethra, 4 incisions are made in the corpora cavernosa and then the prostheses are implanted. This technique allows penile elongations of up to 3.5 cm.
After the description of this technique and the high degree of patient satisfaction due to the penile enlargement caused by the procedure, several modifications were proposed, however, always with the same concept: Lengthening the corpora cavernosa to the limit of the vascular-nervous bundle, causing a real penile enlargement, thus improving the surgical results related to patient satisfaction.
The important thing for the surgeon and the patient is to understand the concept of the technique. The excessive use of eponyms for small variations of the original technique only hinders general understanding, providing benefits only to the “creator” of the small modification.
Penile prosthesis reimplantation
The reimplantation of a penile prosthesis is one of the most challenging procedures in reconstructive urology, as the penis that has lost the prosthesis is a fibrosed penis, with a significant distortion of its anatomy and which often does not allow the implantation of a new penile prosthesis in the conventional way.
Within this scenario, we may come across some situations:
- Possibility of implanting just one of the penile prosthesis rods;
- Possibility of implanting 2 rods, but with different sizes and/or calibers;
- Possibility of implanting 2 rods, but with a smaller and thinner size and/or caliber than the previous prosthesis;
- Possibility of reimplantation of penile prosthesis with 2 rods that are the same and/or larger and thicker than those of the previous prosthesis.
Without a doubt, this last possibility would be the one that would bring the greatest degree of satisfaction to the urologist and especially to the patient.
For this last scenario to be viable, it is essential that the reconstructive urologist responsible for the procedure has mastery of multiple genital reconstruction techniques, with the use of grafts and meshes for the complete reconstruction of the fibrosed penis, thus restoring the man’s complete satisfaction and self-esteem.
