Treatment Options
Third-line therapy
Penile prosthesis
The surgical implantation of a penile prosthesis may be considered in patients who fail pharmacotherapy or who prefer a permanent solution to their problem. Two types of prosthesis exist: malleable (semi-rigid) and inflatable (two- or three-piece).
Most patients prefer the three-piece inflatable devices due to the more ‘natural’ erections obtained.
However, the two-piece inflatable prosthesis can be a reliable option with less mechanical complications and a simpler implantation technique. A semi-rigid prosthesis provides a constantly rigid penis and can be a choice in older patients with infrequent sexual intercourse1. Prosthesis implantation has one of the highest satisfaction rates (70-87%) among treatment options for ED based on appropriate consultation2,3.
References:
1. Montague DK, Angermeier KW. Penile prosthesis implantation. Urol Clin North Am 2001;28:355-361, x. http:/anti-infectives/Paris-Event/Live-Webcast.cfmwww.ncbi.nlm.nih.gov/entrez/query
2. Holloway FB, Farah RN. Intermediate term assessment of the reliability, function and patient satisfaction with the AMS700 Ultrex penile prosthesis. J Urol 1997;157:1687-1691. http:/anti-infectives/Paris-Event/Live-Webcast.cfmwww.ncbi.nlm.nih.gov/entrez/query
3. Tefilli MV, Dubocq F, Rajpurkar A, Gheiler EL, Tiguert R, Barton C, Li H, Dhabuwala CB. Assessment of psychosexual adjustment after insertion of inflatable penile prosthesis. Urology 1998;52:1106-1112. http:/anti-infectives/Paris-Event/Live-Webcast.cfmwww.ncbi.nlm.nih.gov/entrez/query
