A study on the male sexual impotence. II. Treatment of organic impotence by implantation of a penile prosthesis

Abstract

Except for the publications of Heller, Loefer et al., Pearman and Lash, we are unable to find any references in the literature relating to the treatment of organic impotence.We implant silicone implants to the patients who are incapable of erection because of true organic diseases. The purpose of this study is to design a prosthesis which conforms with the anatomical architecture of the penis.The shape of the silicone penile implant is a half circle rod, flat on the bottom and curved on top, 10-12mm. in diameter and 10cm. in length. Under general or lumbar anesthesia, a 3cm incision is made in the mid-dorsal shaft and subcutaneous tissue. Care is taken to minimize the disturbance to the veins and nerves by retracting them laterally. Colles' fascia is identified and incised. Below this, Buck's fascia is identified and incised. Further below this, the tunica albuginea is identified. With the aid of a vein retractor and with meniscus scissors a pocket is made between Buck's fascia and the tunica albuginea of corpora cavernosa proximally as far as the suspensory ligament of the penis and distally to just under the corona of the glans penis. The silastic rod is inserted into the pocket. Buck's fascia is closed with 5-0 chromic atraumatic catgut or 5-0 nylon. Colles' fascia is closed in a like manner. The skin is sutured with 5-0 nylon. Sexual intercourse is discouraged for at least 4 weeks.This operation is recommended as a treatment for organic impotence.