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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请注明名称（个人，公司，学会等等）: Boston and Coloplast

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Objectives: Radical prostatectomy (RP) for prostate cancer treatment, although effective, can lead to severe erectile dysfunction.
We will present a new treatment consisting in a novel penile reinnervation technique between the femoral and cavernous corpus and dorsal penile nerves via sural nerve grafts and end-to-side neurorraphies.
The ten first cases, prostatectomized, present 60% positive response with normal penetration.
Currently the number of cases is 74, the majority submitted to prostatectomy but 3 cases due diabetes, 1 due hip fracture and 1 due elderly.

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Objectives: Since 2005, we started the use of PLGA scaffolds, to reconstruct postoperative abnormalities, with great success. Since 2006, we use them combined with tissue culture or rich plasma, for Augmentation phalloplasty. Since 2014, we use micro fat devices for fat rich in adipose mesenchymal stem cells, combined wth V-Y incision and ligamentolysis or circumcision and PLGA scaffold 


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