Penile prosthesis implantation in men with neurogenic impotence

Abstract

Forty-seven men with neurogenic impotence had penile prosthesis implantation (25 non-traumatic neurological disorders, 12 spinal cord injury, and 10 peripheral nerve injuries). Infection occurred in 4%, erosion in 2%, and mechanical device failure in 4%. Forty-three of 47 patients (91%) have functioning prostheses. A review of the literature shows that spinal cord injury recipients of penile prostheses are at increased risk for periprosthetic infection and erosion. Men with spinal cord injury should be encouraged to consider alternative treatments for erectile dysfunction such as vacuum constrictive devices or intracavernous injection therapy. When men with spinal cord injury elect penile prosthesis implantation, they should be informed of these increased risks. To reduce the risk of erosion, hydraulic or inflatable devices should be chosen rather than semirigid rods; and to reduce the risk of infection preoperative urinary tract and genital infections should be treated.