Future considerations: advances in the surgical management of erectile dysfunction

Abstract

As treatment options for erectile dysfunction (ED) continue to expand, and with more attractive alternatives such as effective systemic treatment becoming available, the number of men presenting for treatment of ED is increasing exponentially. Since a subset of these men continue to require surgical therapy, there is a potential for the number of operations for the treatment of ED and related disorders to actually increase. Areas in the surgical treatment of ED where improvements are needed are identi®ed, including: measures to prevent penile prosthesis infections, better penile implants, improved penile augmentation procedures, better surgical procedures for the treatment of Peyronie's disease, improved penile revascularization procedures, and new motor and sensory penile nerve grafting procedures.

The impact of sildenafil citrate on sexual satisfaction profiles in men with a penile prosthesis in situ

“…Overall, the penile prosthesis still has the highest scores for patient and partner satisfaction, largely because it is reliable and easy to use [9]. One significant advantage, attractive to many patients, is that implants represent a longterm solution, obviating the need for tablets or injections.…”

Surgical Treatment of Erectile Dysfunction

“…Whereas the girth of the penis may be greater than natural erection particularly with three‐piece devices, it should be emphasized to the patient that the girth, not the length, is responsible for penile rigidity, which produces maximum sexual satisfaction in the female. In any case, if patients are disappointed postoperatively with their penile length, they can be advised that daily inflation of the prosthesis may produce corporal dilatation, and surgical replacement with longer cylinders may be possible later [28]. The candidates for a penile prosthesis implantation should be in a good general health and psychologically stable and fully informed (with an informed consent for surgery, if available).…”

Experience with AMS 700 LGX penile prostheses for preserving penile length in Korea

“…However, patient satisfaction regarding penile length during erection with the prosthesis has not been achieved in some patients. Therefore, if patients are dissatisfied with their penile length postoperatively, daily inflation of the penile prosthesis is recommended to produce corporal expansion, followed by surgical replacement with a longer cylinder [2].…”