Historical advances in penile prostheses

Abstract

In the 25 y since their introduction, semi-rigid and in¯atable penile implants have become remarkably dependable mechanical instruments associated with high patient satisfaction. This report attempts to quantify the historical milestones of signi®cance pertaining to these devices. As with any historical`best of ' list, there will be controversy and omissions. Three broad topics contributing to the advancement of penile prosthetic surgery, devices and techniques are discussed: (1) Prosthetic design changes contributing to freedom from revision: distention controlled cylinders, Bio¯ex cylinders, connectionless systems and reservoir lockout valves; (2) Instrument innovations to facilitate prosthetic surgery: Scott retractor, Furlow inserter, Brooks dilators, Carrion-Rossello cavernotomes; (3) Clever surgical applications: SST repair, transverse scrotal incision, modeling for Peyronie's disease, salvage for infection and natural tissue repair.

Erectile Dysfunction: A Review of Historical Treatments With a Focus on the Development of the Inflatable Penile Prosthesis

“…When the cylinders inflate, they become rigid to allow penetration (Lakin & Wood, 2012). When the deflation valve is pressed (also located in the scrotal pump), the cylinders empty and fluid returns to the intra-abdominal reservoir (Wilson & Delk, 2000). With the IPP, men can experience an erection when desired, but maintain a normal appearance when deflated.…”

“…Complications arose due partial inflation of the device, which gradually caused tissue expansion by compressing the corporal tissue. Over time, this led to the cylinders being of inadequate size for a rigid erection (Wilson & Delk, 2000). This device has been abandoned.…”

“…In an attempt to combine the ease of implantation of the semi-rigid devices with the concealment of an inflatable device, the first unitary inflatable device (Surgitek's Flexi-Flate® and AMS Hydroflex®, later replaced by the two-piece Dynaflex®; Simmons & Montague, 2008) was developed in 1985 (Wilson & Delk, 2000). The advantage of this device was ease of implantation like malleable devices, with the cosmetic appeal of inflatables (Sadeghi-Nejad, 2007).…”

“…In 1973, Dr. F. Brantley Scott (Scott, Bradley, & Timm, 1973), a urologist at Baylor College of Medicine, became the pioneer of the IPP. His invention of the first three-piece IPP (Henry, 2009) consisted of sponge filled silicone cylinders (Wilson & Delk, 2000). The three-piece device is composed of a pair of inflatable intracorporeal cylinders connected to a small scrotal pump and an intra-abdominal fluid reservoir (Simmons & Montague, 2008; Figure 3).…”

“…The AMS 600® and AMS 650® are made of a core of braided stainless steel. The Coloplast Genesis® (Figure 2) uses a single spiral sliver wire core (Wilson & Delk, 2000) to employ this malleable mechanism. Both of these models are available today.…”