Objectives: The best management of patients with Erectile Dysfunction non responsive or not applicable to medical treatment or external devices.
Introduction: Surgical implantation of a penile prosthesis is one of the most effective treatment for patients with erectile dysfunction due to an organic cause. It is indicated in male who failed to respond to medical treatment or external devices, or are unwilling or cannot continue with the other treatment [1]. In last years penile prosthesis implantation have resulted in excellent long-term functional outcomes and patient satisfaction. Since their introduction, different models of penile prosthesis have been developed and there is an increasing tendency to implant hydraulic inflatable prostheses rather
Materials / method: Despite excellent results, a small percentage of patients are dissatisfied after the procedure. Defining the satisfaction after surgery is very complex. It involves the self perception of surgery outcome, the cosmetic appearance and the functional outcome related to partner satisfaction [3]. Certain patients, indeed, are more likely than others to have inadequate coping techniques, or have behavioral characteristics that make them at risk for having poor outcomes and decreased satisfaction [4]. Furthermore, technical aspects related to surgical procedures may be involved to contribute to patie
Results: Penile prosthesis currently available include one-piece malleable and two- and three-piece inflatable versions. Each type of penile prosthesis has its own advantages and disadvantages of its utilization. Malleable prosthesis are easier to use for some kind of patient, less expensive, and less likely to fail mechanically compared to inflatable prostheses. However, complete penile detumescence cannot be achieved with malleable versions: it is very important to discuss previously with the patient of these aspects, because it could roughly impact on patient satisfaction. Three-piece inflatable pen
Conclusion: The choice of penile prosthesis, its surgical implantation and consequently the patient satisfaction may be a challenge for the surgeon. There are no evidence of what the best prosthesis needs and there is no prosthesis which may be implanted in all patient with good outcomes. However, it is clear that different aspects have to combined, based on patient habit and status, to make the treatment tailored on each patient traits. This is the reason why patient consultation is essential before surgical implantation.
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