Objective: Implant surgery is the most acceptable curative choice for patients with erectile dysfunction and their partners, since the results are excellent with regard to the couple’s pleasure and the materials used are extremely manageable Materials and Methods: We performed 46 prosthesis implantations in patients with erectile dysfunction: in 22 patients we implanted soft prostheses; in 20 malleable prostheses; in 1 a mono-component prosthesis, and in 3 patients a tri-component model. All patients and partners were evaluated using a questionnaire. Results: We obtained a degree of satisfaction equal to 82% against 18% dissatisfaction due to a sensation of ‘unnaturalness’ report by the partner, with low perioperative and postoperative complications. Conclusion: In our opinion the degree of satisfaction of the patient is currently the only legitimate indicator to establish the effectiveness of therapy.

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The etiology and evolution of Peyronie’s disease are not well known, and this certainly affects patient management. If spontaneous regression or stabilization of the disease is lacking, actually all therapies, except surgery, seem to be only partially successful. We attended 88 patients affected by Peyronie’s disease, and 21 patients (23.6%) were referred for surgery and penile implantation; plaque excision was necessary in 8 patients (38.1%). We implanted 10 malleable prostheses and 11 soft prostheses. So far, potency has been the only parameter for evaluating the results of surgery, but in our view both the patient and his partner should be satisfied aesthetically and functionally.

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Neoplastic diffusion can occur due to dissemination, continuity, through lymphatic or haematic vessels, or, more rarely originate from surgical instruments. We report a particular case of prostate cancer spread. A 64-year-old man was diagnosed with undifferentiated prostate cancer through prostate biopsy. The patient was treated with a total androgenic block allowing a decrease in PSA blood level. The patient, wishing to regain his sexual activity compromised by hormonal therapy, interrupted the treatment spontaneously and unchecked. 19 months later he contacted us again: we had to hospitalize him due to a 12-hour anuresis. A urgent right transcutaneous nephrostomy was carried out, yielding an improvement in the patient's condition. A descending pyelography carried out by means of nephrostomy revealed a completely reduced urethral lumen. During the following surgery for transcutaneous urinary derivation we observed the two ureters entangled in whitish tissue, spreading bilaterally up to the renal pelvis. The histological examination of tissue samples showed the presence of neoplastic metastasis of prostatic origin. We assume that this neoplastic diffusion has occurred due to permeability through the lymphatic vessels of the urethral wall, producing a subsequent neoplasm growth: this has been limited by the urethral connective sheath, thus preventing its wide diffusion to the surrounding tissues, but fostering its spreading upwards along the ureter pathway.