Masculine

Kontakt

Praxis für Urologie
Dr. med. Aref El-Seweifi
Forum Zehlendorf
Teltower Dam 35
D-14169 Berlin
Deutschland

Tel.: +49 30 804 90 950
Fax: +49 30 804 90 951
info@masculine.de

Penis prosthesis

The use of the semiflexible and flexible hydraulic penis prosthesis is a big advance in the treatment of erectile dysfunction. The industrial advances in polymer and biochemical fields and hydraulics led to the development of the new prosthesis that is inert and hydraulically inflatable and deflatable and is also a those semiflexible prosthesis. They can be safely implanted so that they connot be noticed and in such a way as to function very similarly to the normal physiological state of the body.

The operation has been developed and advanced to the point of the well known hydraulic penile prosthesis that has been safely implanted in thousands of patients. The penis consists of three separate cylinders: the corpus spongiosum where the urethra runs, and two dorsal corpora cavernosae which include a specialised spongy tissue. They are able to expand according to the amount of blood included within. These structures are responsible for the erection of the penis. When they are engorged with blood they are rigid and erect and when blood escapes back into the body through the veins they become flaccid. This function is influenced by the psychological state and the health of the arteries, the veins and the nerves. The failure of the latter to be treated pharmacologically indicates the need for implanting a penis prosthesis.

Patients who do not respond to the pharmacological or physical treatment of impotence or those who refuse it, need the operation. Psychological causes of impotence are to be excluded in every case.

The patient lies on his back during the operation. A long incision is done in the middle between the penis and scrotum to reach the spongy caverneous tissue of the penis (erectile bodies). This structure is evacuated of tissues and blood. The maximal length of the space is determined. Adequate cylinders for the penis prosthesis with similar length are chosen and implanted in the space. The tissues of the septum of the scrotum are prepared to create a gap for the pump to be invisibly inserted between the two testicles. The pump is fixed in place by two sutures. An incision is done at the very lower side part of the abdomen to reach the peritoneum which is then opened. A tunnel is created between the penoscrotal incision and that of the abdomen. The tubes between the cylinders and the fluid reservoir are pulled through this tunnel and connected to the fluid filled reservoir. The reservoir is inserted in the cavity of the abdomen, that is to say the peritoneum or inside the pelvis behind the pubic bone. The incisions are closed. The penis is erected by filling the penile cylinders to compress the tissues to prevent bleeding.

I do use the modern method of tissue ingeneering to surround the shaft of the penis with a special material inclosing self cells of the patient (fibroblasts) to thicken the penis, give a normal consistency and let the prosthesis not to be felt.