Name of the Procedure:

Prosthesis, Penile, Non-Inflatable (C2622)

Common Name: Penile Prosthesis Implantation
Technical Term: Penile Prosthesis, Non-Inflatable

Summary

The implantation of a non-inflatable penile prosthesis is a surgical procedure to insert a device into the penis to allow men with erectile dysfunction to achieve and maintain an erection. This type of implant is semi-rigid, giving the penis permanent firmness while being flexible enough to be positioned discreetly.

Purpose

This procedure addresses erectile dysfunction (ED) that has not responded to other treatment methods, such as medications or vacuum pumps. The main goal is to enable men to achieve an erection sufficient for sexual intercourse, improving sexual satisfaction and quality of life.

Indications

• Persistent erectile dysfunction that does not respond to conservative treatments.
• Conditions such as Peyronie's Disease, where scar tissue causes abnormal curvature of the penis.
• Post-surgical or post-traumatic erectile dysfunction.
• Patient preference after other treatments have been deemed ineffective or undesirable.

Preparation

• Pre-procedure evaluation includes a detailed medical history, physical examination, and possibly imaging studies such as ultrasound.
• Patients are usually advised to fast for at least 6-8 hours before the surgery.
• Medication adjustments may be necessary, especially if the patient is taking blood thinners.
• Antibiotics are often given preoperatively to prevent infection.

Procedure Description

1. The procedure is typically performed under general or spinal anesthesia.
2. A small incision is made either at the base of the penis or in the lower abdomen.
3. The prosthesis, composed of two semi-rigid rods, is inserted into the penile shaft.
4. The rods are positioned in such a way that they allow the penis to be manually adjusted for an erection or to lay flaccid.
5. The incision is then closed with sutures, and a catheter may be placed temporarily to aid in urination post-surgery.
6. The surgical field is cleaned, and dressings are applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

It is usually performed in a hospital or surgical center that has the necessary facilities for urological surgeries.

Personnel

• Urologist or specialized surgeon trained in prosthetic surgery
• Anesthesiologist or nurse anesthetist
• Surgical nurses and operating room technicians

Risks and Complications

• Infection: Can usually be managed with antibiotics but may require additional surgery in severe cases.
• Device malfunction or breakage: May necessitate repair or replacement surgery.
• Pain: Common in the immediate post-operative period, manageable with medications.
• Erosion or extrusion of the prosthesis: Rare but may require further surgical intervention.
• Scarring or fibrosis within the penis.

Benefits

• Reliable solution for erectile dysfunction
• Enables penetrative sexual activity
• Improvement in sexual and overall quality of life
• Permanent and discrete once implanted

Recovery

• Patients can typically go home the same day or the day after surgery.
• Pain and discomfort are common and can be managed with prescribed painkillers.
• Avoid strenuous activities and sexual activity for approximately 4-6 weeks.
• Follow-up appointments are necessary to check on healing and prosthesis function.

Alternatives

• Oral medications (e.g., Viagra, Cialis): Non-surgical option, but not effective for all.
• Vacuum erection devices: Effective but less convenient, requires ongoing use.
• Inflatable penile prostheses: Another type of implant that can be deflated and inflated but is more complex.
• Injections or urethral suppositories: Less invasive but can be inconvenient and uncomfortable for some patients.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Post-procedure, patients may experience pain and swelling, which can be managed with medication. The sensation of having semi-rigid rods may feel unusual at first but generally becomes accepted over time. Effective positioning techniques can help manage daily activities and intimacy discreetly.