Inflatable Device Research Articles

Experimental use of a novel single-port gasless laparoendoscopic operative field formation device.

IntroductionTraditional laparaendoscopic surgery using CO2 pneumoperitoneum is associated with complications and the existing gasless laparaendoscopic surgery has shortcomings such as poor visibility in the operation field. To overcome the disadvantages of the current lifting gasless laparaendoscopic operation platforms, we developed an inflatable device for gasless laparoscopic operation field formation (LOFF) that can be internally installed and applied in practice.MethodsWe initially designed operation platforms for gasless laparaendoscopic single-port (GLESP) surgery. Subsequently, a triangular prismatic LOFF device was selected and applied successfully to GLESP cholecystectomy of five pigs. Ultimately, using pigs as a model, three surgical approaches (LOFF-assisted laparaendoscopic single-site (LOFF-LESS), LESS surgery, and traditional lifting (GLESP) were compared, and the advantages and drawbacks of inflatable devices for gasless laparoscopic operation field assessed.ResultsThe use of the LOFF device in GLESP cholecystectomy was first evaluated. The time for surgical space formation (4.4 ± 1.2 and 4.8 ± 1.0), the operating time for gallbladder removal (25.2 ± 4.8 and 25.4 ± 2.7), and the loss of blood (9.4 ± 3.1and 9.2 ± 2.4) was similar between LESS and LOFF, respectively (Table 2). In contrast these parameters were higher in GLESP (6.6 ± 1.0, 30.3 ± 4.4 and 10.1 ± 2.0, respectively. The LOFF-LESS surgery exhibited a clearer exposure of the surgical field and shorter operating time than the GLESP surgery. LESS technology showed less postoperation pain, fast recovery, and extremely high cosmetic satisfaction.ConclusionThe LOFF device provides a safe, effective, and feasible operation platform that can be internally installed and inflated for GLESP surgery during cholescytectomy in animal models.

Towards development of a mobile RF Doppler sensor for continuous heart rate variability and blood pressure monitoring.

The standard in noninvasive blood pressure (BP) measurement is an inflatable cuff device based on the oscillometric method, which poses several practical challenges for continuous BP monitoring. Here, we present a novel ultra-wide band RF Doppler radar sensor for next-generation mobile interface for the purpose of characterizing fluid flow speeds, and for ultimately measuring cuffless blood flow in the human wrist. The system takes advantage of the 7.1~10.5 GHz ultra-wide band signals which can reduce transceiver complexity and power consumption overhead. Moreover, results obtained from hardware development, antenna design and human wrist modeling, and subsequent phantom development are reported. Our comprehensive lab bench system setup with a peristaltic pump was capable of characterizing various speed flow components during a linear velocity sweep of 5~62 cm/s. The sensor holds potential for providing estimates of heart rate and blood pressure.

Liver mobilization and liver hanging for totally laparoscopic right hepatectomy: an easy way to do it.

The purpose of this study is to describe a technical modification that facilitates right liver mobilization in laparoscopic right hepatectomy (LRH). In the supine position, an inflatable device is placed under the patient's right chest. For right hemiliver mobilization, the table is placed in 30° anti-Trendelenburg and full-left tilt. Balloon inflation offers an additional 30° left inclination that places the patient in an almost left lateral position. Foot and lateral supports are placed to prevent patient slippage during changes in the patient positioning. From December 2013 to October 2015, this technique has been used in 10 consecutive LRH. The indications for these procedures were as follows: four donor hepatectomies for living donor liver transplant, three hepatocellular carcinomas and one peripheral cholangiocarcinoma in cirrhotic patients, one hepatocellular carcinoma in a non-cirrhotic patient, and one case of colorectal cancer metastases. In this period, it has also been used to facilitate mobilization and resection in the posterior segments of the liver in seven patients. In every case, right hemiliver mobilization was easily performed in a maximum time of 15min and placement of a tape or plastic tube for liver hanging was prepared. We have not observed any complication directly attributable to the technique herein described (i.e. right brachialgia; arms, back or left flank pain) in the early or late postoperative follow-up. The additional left inclination obtained with the inflation of a balloon under the right chest facilitates right hemiliver mobilization. Its use may help in the performance and adoption of LRH.

Comparison of i-gel with LMA ProSeal for ease of insertion in adultanaesthetised paralysed patients: a prospective randomized trial

Background: i-gel,a recently developed non-inflatable supraglottic airway device, a suitable better alternative to cuffed inflatable suprglottic airway device like LMA ProSeal.Aim and objectives: This study aimed to compare the ease of insertion to achieve early successful airway between LMA ProSeal and i-gel. The secondary objectives were to compare hemodynamic parameters and any airway complications.Materials and methods: This prospective randomized study done in fifty (n=25, each group) ASA I and II adult patients, aged between 20 and 65 years of either sex scheduled for elective surgeries. Patients airway was secured with appropriate size eitherLMA ProSeal or i-gel. The time taken for successful insertion, number of attempts and ease ofgastric tube placement were recorded. Hemodynamic parameters at basal (pre operative), 1, 3 & 5 minutes after insertion were recorded. Blood stain of device and any postoperative airway complications were noted.Results: Time taken for successful insertion was significantly less in i-gel group [Group 1(LMA ProSeal) 20.56±2.00, Group 2 (i-gel) 12.08±1.53, p=0.001*]. Time taken for gastric tube placement was significantly less in i-gel group [Group 1(LMA ProSeal) 31.96±4.58, Group 2 (i-gel) 21.48±2.55, p=0.001*]. Among hemodynamic parameters, heart rate immediately after insertion of device was stable in i-gel group. The numbers of insertion attempts were also less with i-gel group.Conclusion: In our study, ease ofinsertion with less number of attempts was observed with i-gel group.So i-gel found to be the better alternative to LMA ProSeal.

Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine.

Penile prosthesis implantation has emerged as a definitive treatment to restore sexual function to the motivated man with erectile dysfunction. Substantial improvements in the design of inflatable devices have been made since they first became available more than four decades ago. To review the history of the penile prosthesis, the indications, preoperative evaluation, and patient and partner satisfaction. The current approaches to addressing intra- and postoperative complications, provide an understanding of prosthesis infection, and placement of these devices will be reviewed. A committee of worldwide experts in this field was assembled during the 2015 International Consultation on Sexual Medicine (ICSM) and performed a systematic review of the peer-reviewed published medical literature pertaining to penile prosthesis. Particular attention was given to higher level trials when available. Recommendations are based upon the Oxford Criteria. Unfortunately there is limited level 1 and 2 evidence, and where expert opinion was utilized, the decision was unanimous within the committee with a goal of presenting a clinically relevant guideline pertaining to penile prostheses. Penile prosthesis has undergone an evolution over the past 40 years resulting in a more effective and reliable treatment for advanced erectile dysfunction not responding to less invasive methods including oral treatment with PDE5 inhibitors, vacuum erection device, and intracorporal injection therapy. It should be considered an appropriate treatment option for the man who wishes to restore erectile function and who understands the potential risk of mechanical failure and infection, both of which are less common now as a result of improvements made in device design as well as surgical protocols adhered to in the operating room. Patients must be clearly informed of the risks associated with penile prosthesis including mechanical failure, infection, shortening of the penis, change in sensation and configuration of the penis, as well as injury to local structures. Intraoperative complications are unusual but do occur and can usually be addressed intraoperatively to allow placement of the device at the time of initial surgery. Postoperative complications may also be addressed when they occur but may require more advanced reconstructive surgical techniques. Men with Peyronie's disease, corporal fibrosis due to infection, trauma, prior prosthesis explantation, priapism, and men who have undergone construction of a neophallus may require additional advanced maneuvers to obtain optimum results with a penile prosthesis. Penile prosthesis remains as an important, viable, and effective treatment for male erectile dysfunction that does not respond to other less invasive approaches or when these approaches are contraindicated or not acceptable to the patient. These devices provide the patient with the ability to engage in penetrative sexual activity without interfering with urination, ejaculation, sensation, or orgasm. Although mechanical failure can occur, the current devices are more reliable as a result of design modifications. Infection remains the most dreaded complication but since the introduction of antibiotic and hydrophilic coatings, infection is less common. Overall, patient and partner satisfaction appear to be reasonably high when a penile prosthesis is used to restore erectile function.

V70 Bilateral impending distal erosion of soft penile implant treated by device removal, bilateral distal re-tunneling upon penile MRI guidance, and inflatable device insertion

V70 Bilateral impending distal erosion of soft penile implant treated by device removal, bilateral distal re-tunneling upon penile MRI guidance, and inflatable device insertion

An Inflatable and Wearable Wireless System for Making 32-Channel Electroencephalogram Measurements.

Potable electroencephalography (EEG) devices have become critical for important research. They have various applications, such as in brain-computer interfaces (BCI). Numerous recent investigations have focused on the development of dry sensors, but few concern the simultaneous attachment of high-density dry sensors to different regions of the scalp to receive qualified EEG signals from hairy sites. An inflatable and wearable wireless 32-channel EEG device was designed, prototyped, and experimentally validated for making EEG signal measurements; it incorporates spring-loaded dry sensors and a novel gasbag design to solve the problem of interference by hair. The cap is ventilated and incorporates a circuit board and battery with a high-tolerance wireless (Bluetooth) protocol and low power consumption characteristics. The proposed system provides a 500/250 Hz sampling rate, and 24 bit EEG data to meet the BCI system data requirement. Experimental results prove that the proposed EEG system is effective in measuring audio event-related potential, measuring visual event-related potential, and rapid serial visual presentation. Results of this work demonstrate that the proposed EEG cap system performs well in making EEG measurements and is feasible for practical applications.

Elastomeric Polymer Multilayer Thin Film with Sustainable Gas Barrier at High Strain.

Most gas barrier thin films suffer from cracking or plastic deformation when stretched, leading to significant loss of barrier. In an effort to make a stretchable gas barrier, which maintains low permeability when exposed to cyclic strain, we prepared layer-by-layer assemblies of tannic acid (TA) and poly(ethylene oxide) (PEO). A 40-bilayer (344 nm-thick) TA/PEO assembly maintained its oxygen transmission rate (6X lower than the 1.6 mm-thick rubber substrate) after being stretched 100%. This submicron coating maintains a barrier 4X lower than the thick rubber substrate even after being strained 20X at 100%. These highly elastomeric assemblies are potentially useful for light-weighting inflatable devices.

Surgical Treatment of Erectile Dysfunction.

Currently, oral pharmacotherapy is the dominant treatment for erectile dysfunction. The aim of this article is to give an up-to-date summary of the possibilities of surgical therapy. A search of the literature over the last decade was performed. Relevant papers and guidelines on the topic were reviewed and included. We evaluate therapy options, such as penile vein surgery, arterial revascularization, and penile prosthetics. Vein surgery has faded into total insignificance due to the efficiency of oral and intracavernous therapeutics, and because of the known pathophysiology of corporal veno-occlusive dysfunction and the disappointing long-term results published in the literature. Penile revascularization surgery is performed today only in very limited number of patients with strict selection criteria such as age and exclusion of vascular risk factors. Penile prosthetics is the only surgical therapy option maintaining its significance as a cure for erectile dysfunction. There are convincing long-term results with a high degree of patient and partner satisfaction, high patient acceptance, and a good functional durability of the mostly three-piece inflatable devices. Bertero EB and Antunes DL. Surgical treatment of erectile dysfunction.

Penile prosthesis – a viable solution for erectile dysfunction refractory to conservative therapy

Introduction: Erectile dysfunction(ED) is a serious condition which can affect men of all ages, with an important impact over the quality of life. When conservative therapy fails, a viable solution is the penile prosthesis implantation (PPI). Objective: The purpose of this paper is to present data from recent literature regarding the satisfaction rates of men who have undergone penile PPI and as well as the partners satisfaction rates, ease of use, informations regarding long term survival of these prosthesis, postoperative complications and long distance complications, the effectiveness and the way that penile prosthesis have influenced the quality of life of the men who have opted for this solution. Material and methods: We have analyzed recent long term studies concerning the outcomes of the PPI, studies which were made retrospectively, over a period of time of 10 to 15 years. Results: Compared with the conservative treatment for ED, the satisfaction rates achieved after penile prosthesis implantation are higher. According to these studies, the overall patient’s satisfaction is 70-90%. The difference between patient and their partners’ satisfaction rate is negligible, this difference ranging between 2 to 8%. The satisfaction rate regarding the adequate erection for sexual intercourse is 80-90%. The overall satisfaction rates for the malleable prostheses are lower compared with inflatable devices, 30-75%, respectively 75-90% for the inflatable prosthesis. The mechanical and overall survival rates for the malleable prosthesis range between 65-80% at 10 years, and 58-75% for the inflatable devices. Overall ease of use is rated as 78%. Complications after implantation can be encountered in less than 5% of cases and infections in less than 2%. The likelihood of continued use is higher in the group of the patients with the inflatable prosthesis compared with the malleable ones 70-80%, respectively 50-60%. Up to 85- 90% of patients with inflatable prosthesis would recommend them. Conclusions: PPI is a high effective treatment for erectile dysfunction, refractory to pharmacological treatment. The inflatable penile prosthesis (IPP) provides more overall satisfaction than the malleable ones. The patients with IPP are more likely to continue using their devices than those with the malleable prosthesis. PPI improves significantly the quality of life for patients with erectile dysfunction.

Evaluating the physical demands when using sled-type stair descent devices to evacuate mobility-limited occupants from high-rise buildings

The physical demands on evacuators were investigated when using different types of sled-type stair descent devices designed for the emergency evacuation of high rise buildings. Twelve firefighters used six sled-type stair descent devices during simulated evacuations. The devices were evaluated under two staircase width conditions (1.12, and 1.32 m). Dependent measures included electromyographic (EMG) data, heart rates, Borg Scale ratings, and descent velocities. All stair descent speeds were below those reported during pedestrian egress trials. With the exception of the inflatable device, the devices operated by two evacuators had higher descent speeds than those operated by a single evacuator. High friction materials under the sleds facilitated control and reduced the muscle demands on stairs but increased physical demands on the landings. Usability assessments found devices with shorter overall lengths had fewer wall contacts on the landing, and handles integrated in the straps were preferred by the evacuators.

Development and application of a multifunctional thoracolumbar fixation rescue vest

Objective To develop an all-in-one multifunctional thoracolumbar fixation rescue vest for land and water rescue of thoracolumbar injury and investigate its application effect. Methods According to the thoracolumbar physiological curve, type Ⅰ thoracolumbar fixation rescue vest with keel and inflatable airbag and type Ⅱ thoracolumbar fixation rescue vest with additional lifesaving balloon and inflatable cylinder were developed using thermoplastic polyurethane (TPU)-nylon composites and polycarbonate (PC) as the main materials. Clinical application of type Ⅰ thoracolumbar fixation rescue vest in 532 cases of thoracolumbar injury was discussed. Type Ⅱ thoracolumbar fixation rescue vest were tested at marine rescue and related parameters measured were automatic inflation time, buoyancy force, floating time, floating condition and victims' face orientation. Clinical outcome was quantified by the MacNab standard, and VAS for pain was recorded. Results According to the MacNab standard, excellent outcome was achieved for all cases. VAS improved from 8.2 points to 2 points after the bracing was applied, showing 100% improvements. The brace into the water showed automatic inflation time of 3-5 seconds and maximum buoyancy force of 100 kg, and ensured a 90 kg dummy of floating over 96 hours. At marine rescue, the wounded in braced condition showed face upward with 24-hour buoyancy loss ≤5% and freedom of movement. Conclusions The multifunctional thoracolumbar fixation rescue vest provides dual immobilization and ensures marine rescue for its automatic inflation device. This invention provides the feasibility to remove, transport and evacuate the thoracolumbar fracture patients in cabin. Key words: Spinal injuries; Thoracic vertebrae; Lumbar vertebrae; Emergency medical services

Pointwise characterization of the elastic properties of planar soft tissues: application to ascending thoracic aneurysms.

In this manuscript, we present a combined experimental and computational technique that can identify the heterogeneous elastic properties of planar soft tissues. By combining inverse membrane analysis, digital image correlation, and bulge inflation tests, we are able to identify a tissue's mechanical properties locally. To show how the proposed method could be implemented, we quantified the heterogeneous material properties of a human ascending thoracic aortic aneurysm (ATAA). The ATAA was inflated at a constant rate using a bulge inflation device until it ruptured. Every 3kPa images were taken using a stereo digital image correlation system. From the images, the three-dimensional displacement of the sample surface was determined. A deforming NURBS mesh was derived from the displacement data, and the local strains were computed. The wall stresses at each pressure increment were determined using inverse membrane analysis. The local material properties of the ATAA were then identified using the pointwise stress and strain data. To show that it is necessary to consider the heterogeneous distribution of the mechanical properties in the ATAA, three different forward finite element simulations using pointwise, elementwise, and homogeneous material properties were compared. The forward finite element predictions revealed that heterogeneous nature of the ATAA must be accounted for to accurately reproduce the stress-strain response.

Repairing Fetal Membranes with a Self-adhesive Ultrathin Polymeric Film: Evaluation in Mid-gestational Rabbit Model.

Preterm premature rupture of membranes causes 40% of all preterm births, affecting 150000 women each year in the United States. Prenatal diagnostic procedures and surgical interventions increase incidence of adverse events, leading to iatrogenic membrane rupture after a fetoscopic procedure in 45% of cases. We propose an ultrathin, self-adherent, poly-L-lactic acid patch ("nanofilm") as a reparative wound closure after endoscopic/fetoscopic procedures. These nanofilms are compatible with application in wet conditions and with minimally invasive instrumentation. Ex vivo studies to evaluate the nanofilm were conducted using human chorion-amnion (CA) membranes. A custom-built inflation device was used for mechanical characterization of CA membranes and for assessment of nanofilm adhesion and sealing of membrane defects up to 3 mm in size. These ex vivo tests demonstrated the ability of the nanofilm to seal human CA defects ranging in size from 1 to 3 mm in diameter. In vivo survival studies were conducted in 25 mid-gestational rabbits, defects were created by perforating the uterus and the CA membranes and subsequently using the nanofilm to seal these wounds. These in vivo studies confirmed the successful sealing of defects smaller than 3 mm observed ex vivo. Histological analysis of whole harvested uteri 7 days after surgery showed intact uterine walls in 59% of the nanofilm repaired fetuses, along with increased uterine size and intrauterine development in 63% of the cases. In summary, we have developed an ultrathin, self-adhesive nanofilm for repair of uterine membrane defects.

Penile prostheses and the litigious patient: a legal database review.

Erectile dysfunction (ED) is a common problem with significant impact on patient quality of life. Penile prosthesis implantation provides an effective treatment for ED but as an invasive procedure carries with it an increased risk of medicolegal liability. To investigate factors associated with malpractice litigation surrounding penile prosthesis implantation. The Westlaw legal database was used to perform an advanced search for case reports using the term "medical malpractice" in combination with "penile" or "penis" and "prosthesis" or "implant" with dates between the January 1990 and December 2013. Each report was examined for trial information including patient demographics, device model and indications, alleged breach of duty, alleged damages, progression to trial, case outcome, and plaintiff award(s). The initial search yielded 76 cases that were narrowed to 40 after exclusions. There were 23 (57.5%) cases that were found in favor of the defendant, while 17 (42.5%) cases led to indemnity payment to the plaintiff including two cases (5.0%) that were settled out of court and 15 (37.5%) favoring the plaintiff in front of a jury. The mean settlement received was $335,500 compared with the mean indemnity award of $831,050 for verdicts decided in favor of the plaintiff (P = 0.68). The most common breach of duty was error in surgical decision making, present in 20 cases (48.8%). Informed consent was an issue in 13 filings (31.7%), and postoperative infection was seen in 13 cases (31.7%). In cases that identified the type of implant used, 58.3% were malleable implants, and 41.7% were inflatable devices. The main issues involved in malpractice litigation for penile prosthesis implants included surgical performance, informed consent, and postoperative management. Urologists must be aware of these potential issues in order to minimize their malpractice liability.

Modelling and experimental validation of Textile Pockets based active inflatable device

This paper aims with the mathematical modelling of an active inflatable device. This device is composed of a compressor, an Electro-pneumatic Pressure Converter (EPC) and an Inflatable Textile fabric Pocket (ITP). The later has interesting mechanical properties and is fabricated using Jacquard knitting technique which allows automatic production of unlimited varieties of pattern weaving without any mould. Thanks to these features, these ITPs have provided a better alternative to the classical airbags made by stretchable polymer material. The proposed mathematical model is obtained by combining sub-models of two main parts of the whole system. In this way, a generalised and flexible model is obtained which can easily take into consideration the ITPs of different shapes. The pressure dynamics inside the ITP are considered by taking into account the air flow rate, variation of the volume of ITP and the length of pneumatic lines joining ITP with compressed air source. The parameters of the whole mathematical model are obtained via identification techniques. The effectiveness of the model is assessed through several experimental tests with the help of a servo hydraulic fatigue testing machine.

Study of Firemen Respirator Fixed Inflatable Device Rapid Inflation Methods Optimization

The use of air pressure pump for local pressurization in pressure air system is an important application of energy saving technology of pneumatic. The firemen respirator fixed inflatable this basic principle device utilization system design. Due to the different inflation affects firefighters respirator fixed inflatable device energy consumption and filling speed, in this paper, the energy consumption by comparing different charging mode , and the charging mode is optimized to achieve rapid fire breathing bottle inflated and improve firefighter respirator fixed inflatable device efficiency.

Tubing erosion of an inflatable penile prosthesis long after implantation.

IntroductionErosion through skin of connecting tubing of an inflatable penile prosthesis (IPP) has not been previously reported.AimThe aim of this study was to present a case of tubing erosion, review the pertinent literature, and discuss the possible causes and management options, including preservation of the device and its components.MethodsA 42-year-old male failing to respond to medical treatment for erectile dysfunction underwent insertion of an AMS 700 IPP in 1986. Six years later, a revision was necessary because of a leak in the right cylinder and 4 years after, the pump was replaced. Fourteen years after the original implant, he presented with a portion of the tube connecting the pump to the right cylinder eroding through the skin. There was no infection. The skin area involved was resected and the original pump and tubing were buried in a new scrotal pocket after thorough irrigation.ResultsThe IPP remained in place, allowing vaginal penetration and without infection for another 11 years. Three years later, it was de-functionalized, converted into a fixed volume device. It eventually was replaced 25 years after originally implanted with a semirigid prosthesis because it did not provide sufficient rigidity and because of concerns about the presence of “screws” detected during pelvic imaging.ConclusionsMechanical failures in the early IPP models, as illustrated in this case, were expected. However, the long survival of the device is remarkable. Erosion of the connecting tubing through the skin is unique and, under exceptional circumstances, may be managed conservatively without replacing components of the IPP. Clinicians unfamiliar with procedures involving inflatable devices need to be aware of “foreign bodies” visible in radiological examinations in men who have had revisions of an IPP. Morales A. Tubing erosion of an inflatable penile prosthesis long after implantation. Sex Med 2014;2:103–106.

Post-prostatectomy erectile dysfunction: contemporary approaches from a US perspective.

Success of cancer surgery often leads to life-changing side effects, and surgical treatment for malignant urologic disease often results in erectile dysfunction (ED). Patients that undergo surgical prostatectomy or cystoprostatectomy will often experience impairment of erections due to disruption of blood and nerve supply. Surgical technique, nerve sparing status, patient age, comorbid conditions, and pretreatment potency status all have an effect on post-surgical ED. Regardless of surgical technique, prostatectomy results in disruption of normal anatomy and nerve supply to the penis, which governs the functional aspects of erection. A variety of different treatment options are available for men who develop ED after prostatectomy, including vacuum erection device, oral phosphodiesterase 5 inhibitors (PDE5I), intracorporal injections, and penile prosthesis. The vacuum erection device creates an artificial erection by forming a vacuum via suction of air to draw blood into the penis. The majority of men using the vacuum erection device daily after prostatectomy, regardless of nerve-sparing status, have erections sufficient for intercourse. Phosphodiesterase 5 inhibitors remain a common treatment option for post-surgical ED and are the mainstay of therapy. They work through cyclic adenosine monophosphate and cyclic guanine monophosphate pathways and are recommended in all forms of ED. Intracorporal injections or intraurethral use of vasoactive substances may be a good second-line therapy in men who do not experience improvement with oral medications. Surgical placement of a penile prosthesis is typically the treatment strategy of choice after other options have failed. Semi-rigid and inflatable devices are available with high satisfaction rates. With careful patient counseling and proper treatment selection, patient satisfaction and improved erectile function can be achieved. We advise that patients use a vacuum erection device daily in the early postoperative period in combination with an oral PDE5I. For patients who do not respond to a vacuum erection device or PDE5I, consideration should be given to intraurethral alprostadil, intracorporal injections, or a penile prosthesis.

The Evolution of the Inflatable Penile Prosthetic Device and Surgical Innovations with Anatomical Considerations

Historically, early surgical treatment for erectile dysfunction involved the placement of rigid devices outside of the corpora cavernosa. This practice resulted in high rates of erosion and infection. Today, most urologists in the United States place an inflatable penile prosthesis (IPP) with an infection-retardant coating inside the corpora cavernosa. In addition to changes in the type of implant used, surgical techniques have evolved greatly in recent years, resulting in reduced operating times, lower infection rates, and improved outcomes. However, anatomical considerations have directed the prosthetic surgeon to improve patient outcomes and satisfaction rates by employing both new surgical techniques and postoperative maneuvers.