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Myron I. Murdock, M.D., F.A.C.S.
Implantable Penile Prosthetic Devices Penile prostheses are implanted in those patients in whom all other therapies are ineffective or suboptimal or in which the patient is not willing to utilize other treatment modalities. Penile prostheses are the final way to resolve an impotence condition. It works, and patient satisfaction is greater than 99%. Partner satisfaction is approximately 98%. The negative press given to penile prostheses is unwarranted and for appropriate patients is an excellent way of resolving their erectile dysfunction. The different penile prostheses include semi-rigid malleable devices, self-contained inflatable devices, and multicomponent inflatable devices. In most cases the multi-component inflatable device should be utilized since it has the best quality erectile function with the best cosmetic flaccid state. The self-contained prostheses are used in those males who cannot have a reservoir within the abdomen due to extensive previous surgery, but these devices do not have the same flaccid and erect properties of the multi-component devices. The inflatable devices require some manual dexterity to use. Semi-rigid devices can be utilized in those men who are incapable of utilizing their hands and do not have partners able to manipulate their inflatable devices. The inflatable penile prostheses are manufactured by two companies; American Medical Systems in Minnetonka, Minnesota and Mentor Corporation in Santa Barbara, California. The devices manufactured by these companies are of the highest quality with an excellent long term success rate. Surgery is necessary for all penile implants. The procedure takes anywhere from 40 minutes to an hour and a half and is done under general, spinal or local anesthesia. The surgery can be done on an outpatient basis or as an overnight admission. Patients are placed on prophylactic antibiotics just prior to and after their surgery. Significant discomfort usually lasts less than two weeks in most patients, though it may persist, especially in diabetics. Most of the devices are functional after six weeks, at which time pain and swelling has disappeared, and the incisions are well healed The inflatable prostheses are mechanical devices and will wear out or break, especially if abused. Revisions are occasionally needed, 6-12% in 12 years. Infection can occur early or late, and usually requires removal of the device. On a rare occasion the device works its way out of the body and has to be removed. Diabetics, who are more liable to infection, have poorer blood supply, and less sensation have a higher complication rate. To decrease the incidence of infection AMS has coated their devices with "Inhibizone" a combination of the antibiotics rifampin and ... Mentor is using a hydrophilic substance that adsorbs antibiotics of the surgeons choice. The smoothness of this material prevents bacteria from adhering to the prosthesis. Lastly, infections can be decreased by using levofloxin for three days prior to and 2 weeks after implantation, and by taking betadine soap showers twice daily for 3 days prior to surgery. Rev: 04/03 [ Back] [Oral Meds] [Urethral Meds] [Injectable Meds] [External Devices] [Implants] [Future Therapy] |
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[Home] Werner - Francis Urology Associates llc - Mid Atlantic Urology Associates llc Greenbelt - Bowie - Laurel Maryland (301) 441-8900 Fax (301) 982 0453 7500 Hanover Parkway Suite 206 Greenbelt, MD 20770
Rev:03/08 |