Penile prosthesis implantation for end-stage erectile dysfunction after radical prostatectomy

Abstract

When erectile dysfunction occurs after radical prostatectomy and phosphodiesterase-5 inhibitor therapy fails, second-line therapies such as vacuum constriction devices, intraurethral prostaglandins, and penile injection therapy should be offered. When second-line therapies are not effective or acceptable to the man and his partner, penile prosthesis implantation becomes the treatment of choice. Today's 3-piece inflatable devices offer flaccidity and erection that approach the natural state. Design improvements have resulted in devices that have freedom from mechanical failure ranging from 92% to 94%. Antibiotic and hydrophilic coatings have reduced infection rates.

Figure 1

Mentor Alpha I® inflatable penile prosthesis. Courtesy of Mentor Corporation, Santa Barbara, CA.

Figure 2

American Medical Systems 700 Ultrex™ inflatable penile prosthesis. Courtesy of American Medical Systems, Minnetonka, MN.