Recent advancements in penile prosthetics.

Mathew Q Fakhoury,Joshua Halpern,Nelson Bennett

doi:10.12688/f1000research.17407.1

Mathew Q Fakhoury, Joshua Halpern + Show 1 more

Open Access

https://doi.org/10.12688/f1000research.17407.1

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Abstract

Since the original inflatable penile prosthesis in the 1970s, several enhancements to penile prosthesis implant design, implant surgical technique, and post-operative care have been developed to increase overall patient (and partner) satisfaction rates. We, in this communication, seek to discuss these advancements and the overall impact in combating erectile dysfunction. As we continue to pursue avenues of effective and definitive treatment modalities for erectile dysfunction refractory to medical therapy, rates of infection and mechanical failure will hopefully continue to decline in the perioperative setting.

Highlights

Since its initial description by Scott et al in 1973, the penile prosthesis has remained a mainstay of treatment of erectile dysfunction (ED)[1]
Reinstatker et al performed a retrospective analysis of intra-operative dorsal penile nerve block using an extended-release bupivacaine liposomal suspension (Exparel®, Pacira Pharmaceuticals, Inc., Parsippany-Troy Hills, NJ, USA), which led to substantially lower utilization of narcotic pills in the experimental versus control group (8.2 versus 24.1 tablets, P
Though limited by its retrospective nature and small sample size, this study suggests a growing role for an multi-modal analgesic (MMA) approach in penile prosthetics

Summary

Introduction

Since its initial description by Scott et al in 1973, the penile prosthesis has remained a mainstay of treatment of erectile dysfunction (ED)[1]. A number of studies have reported the use of novel, intraoperative local anesthetic regimens to improve post-operative pain management and reduce narcotic utilization following penile prosthesis placement. Current guidelines recommend removal of the prosthesis followed by irrigation of the penis and scrotum and a lengthy the course of antibiotics If another device is not immediately placed, the patient develops corporal fibrosis and penile shortening. Carrion recently developed a synthetic plaster-like vancomycin/tobramycin cast which is inserted into the infected corporal space to facilitate clearance of offending bacteria[37] This calcium sulfate internal cast has been shown to prevent penile shortening while preserving the intracorporal space for future implantation of a prosthesis[37]. Le et al were able to demonstrate that this prosthesis can produce the mechanical forces necessary for producing a penetration-quality erection comparable to that produced by hydraulic-based devices[38]

Conclusions

Mulcahy JJ

Findings

37. Carrion RE