Penile Prosthesis: Difference between revisions
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* '''Designed to approximate normal function more closely by permitting girth and length expansion during erection and penile flaccidity when not in use''' | * '''Designed to approximate normal function more closely by permitting girth and length expansion during erection and penile flaccidity when not in use''' | ||
* Consist of 2 hollow intracorporeal cylinders, each of which fills a corpus cavernosum; the cylinders are inflated with saline solution to produce penile rigidity during sexual activity and are deflated after intercourse. | * Consist of 2 hollow intracorporeal cylinders, each of which fills a corpus cavernosum; the cylinders are inflated with saline solution to produce penile rigidity during sexual activity and are deflated after intercourse. | ||
* '''Subdivided into 2-piece vs. 3-piece devices''' | * '''<span style="color:#ff0000">Subdivided into 2-piece vs. 3-piece devices</span>''' | ||
** '''2-piece device''' | ** '''<span style="color:#ff0000">2-piece device</span>''' | ||
***'''Consists of the two cylinders and a scrotal pump'''. | ***'''<span style="color:#ff0000">Consists of the two cylinders and a scrotal pump</span>'''. | ||
**** '''Reservoirs in the proximal portion of the cylinders are prefilled with saline''' '''and preconnected to the pump via silicone tubing'''. | **** '''Reservoirs in the proximal portion of the cylinders are prefilled with saline''' '''and preconnected to the pump via silicone tubing'''. | ||
**** '''Pressing a valve mechanism''' in the pump transfers the solution from the reservoirs into the distal, inflatable portion of each cylinder. | **** '''Pressing a valve mechanism''' in the pump transfers the solution from the reservoirs into the distal, inflatable portion of each cylinder. | ||
**** '''Bending the cylinders down for several seconds activates a release valve''' that deflates the device by allowing the fluid to flow back to the reservoirs. | **** '''Bending the cylinders down for several seconds activates a release valve''' that deflates the device by allowing the fluid to flow back to the reservoirs. | ||
** '''3-piece device''' | ** '''<span style="color:#ff0000">3-piece device</span>''' | ||
***'''Consists of the two hollow cylinders, a scrotal pump, and a saline-filled reservoir.''' | ***'''<span style="color:#ff0000">Consists of the two hollow cylinders, a scrotal pump, and a saline-filled reservoir.</span>''' | ||
**** Silicone tubing connects the cylinders to the pump and the pump to the reservoir. | **** Silicone tubing connects the cylinders to the pump and the pump to the reservoir. | ||
**** '''Repeatedly squeezing the pump''' transfers saline from the reservoir to the cylinders until adequate rigidity is achieved | **** '''Repeatedly squeezing the pump''' transfers saline from the reservoir to the cylinders until adequate rigidity is achieved | ||
**** '''Pressing a valve mechanism in the pump causes the fluid to flow back to the reservoir.''' | **** '''Pressing a valve mechanism in the pump causes the fluid to flow back to the reservoir.''' | ||
** Both devices are available in several widths and lengths and come with optional rear tip extensions to allow them to be tailored to each patient. | ** Both devices are available in several widths and lengths and come with optional rear tip extensions to allow them to be tailored to each patient. | ||
** '''Advantages of two-piece compared to three-piece (2)''' | ** '''<span style="color:#ff0000">Advantages of two-piece compared to three-piece (2):</span>''' | ||
**# '''No need to implant a separate reservoir''' | **# '''<span style="color:#ff0000">No need to implant a separate reservoir</span>''' | ||
**#* Facilitates surgery and may be useful with patients in whom placement of the reservoir is extremely difficult because of colostomy, ileostomy, kidney transplant, or extensive pelvic surgery | **#* Facilitates surgery and may be useful with patients in whom placement of the reservoir is extremely difficult because of colostomy, ileostomy, kidney transplant, or extensive pelvic surgery | ||
**# '''Reaches full inflation with fewer squeezes of the pump''' | **# '''<span style="color:#ff0000">Reaches full inflation with fewer squeezes of the pump</span>''' | ||
** '''Disadvantages of two-piece compared to three-piece (3):''' | ** '''<span style="color:#ff0000">Disadvantages of two-piece compared to three-piece (3):</span>''' | ||
**# '''Pump is very small and hard, making it difficult for patients to manipulate''' | **# '''<span style="color:#ff0000">Pump is very small and hard, making it difficult for patients to manipulate</span>''' | ||
**# '''Implantation requires a larger incision of the tunica albuginea''' | **# '''<span style="color:#ff0000">Implantation requires a larger incision of the tunica albuginea</span>''' | ||
**# '''Feels and acts less like a natural erection''' | **# '''<span style="color:#ff0000">Feels and acts less like a natural erection</span>''' | ||
== Pre-operative evaluation == | == Pre-operative evaluation == | ||