Narrative review of penile prosthetic implant technology and surgical results, including transgender patients

Polchert, Michael; Dick, Brian; Raheem, Omer

doi:10.21037/tau-20-1279

Cited by 15 publications

(13 citation statements)

References 101 publications

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“…In female-to-male gender-affirming surgeries with neophallus construction, the placement of a penile prosthesis represents a last step to providing functional ability to the neophallus. 47 Tactile and erogenous sensations develop in the neophallus within 4 to 6 months. 48 Unperceived chronic pressure on the neophallus can increase the risk of prosthesis extrusion.…”

Section: Safety In Transgender Patientsmentioning

confidence: 99%

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Safety and Efficacy of Inflatable Penile Prostheses for the Treatment of Erectile Dysfunction: Evidence to Date

Wang¹,

Levine²

2022

MDER

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Erectile dysfunction (ED) is a common problem, and prevalence rates are expected to rise as life expectancy increases worldwide. In more severe cases of ED, penile prosthesis implantation has been an excellent option for patients. Over the past few decades, significant design improvements have been made to the penile prosthesis and modifications to surgical technique to improve clinical outcomes. The purpose of this review is to summarize the safety and efficacy of FDA-approved penile implants in the US market. Design modifications have greatly improved the safety and reliability of the implant. Development of improved surgical techniques has decreased intraoperative injuries and reservoir-related complications. With its high overall satisfaction rates and low risk of complications, the inflatable penile prosthesis remains an excellent option for patients with erectile dysfunction.

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Section: Safety In Transgender Patientsmentioning

confidence: 99%

“…In summary, many experts consider the 3-piece IPP the highest quality option for implantation in the neophallus. 47 Despite high complication rates and the need for revision, patient satisfaction scores are consistently high.…”

Section: Safety In Transgender Patientsmentioning

confidence: 99%

Safety and Efficacy of Inflatable Penile Prostheses for the Treatment of Erectile Dysfunction: Evidence to Date

Wang¹,

Levine²

2022

MDER

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“…Few literature is reporting on the use of erectile implants following penis reconstruction in trans men. Specifically, there are several complications associated with implant placement in the reconstructed penis, such as hematoma, infection, urinary fistulas and strictures, partial or total penis necrosis, as well as implant deformity [39][40][41][42].…”

Section: Erection Implantsmentioning

confidence: 99%

“…Finally, erection implants specific for trans men post phalloplasty have been manufactured by ZSI. Generally, up to 50% of the implants need to be explanted at 5 years follow-up, usually because of infection, extrusion, or pubic pain [39,42].…”

Section: Erection Implantsmentioning

confidence: 99%

Gender Affirming Surgery: Assigned Female at Birth

Selvaggi

2022

Practical Clinical Andrology

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The acronym AFAB refers to those persons who have been ‘Assigned Female at Birth’. AFAB persons who, later in life, do not identify as female, are said to present a condition named ‘Gender Incongruence’ (GI). They might identify as men, or as non-binary. Persons presenting the condition of GI might experience a Gender Dysphoria (GD), which is defined as the discomfort due to the mismatch between their anatomical characteristics and the gender in which they are self-identifying. Thus, patients with GD are requesting surgical procedure (s) in order to align one’s body—mostly chest and genitals—to best match with one’s identity. The final aim is to reduce one’s dysphoria.The World Professional Association for Transgender Health currently publishes a series of guidelines, which are named as Standards of Care, for patients presenting GI.In this chapter, we provide an overview on surgical planning and technics, and possible outcomes for Chest-Contouring-Mastectomy (CMM) and genital surgery (metoidioplasty and phalloplasty). Nearly all trans men, and many non-binary AFAB individuals might seek for CCM; the surgery mostly consists in (partial) removal of the breast glandular tissue and, often, reduction of the Nipple-Areola-Complex. Some AFAB individuals with GI are also interested in penis reconstruction: metoidioplasty consists in the surgical enlargement of an hypertrophic clitoris, while phalloplasty consists in the construction of a penis with either larger, local, or distant flaps (including free flaps). Limitations and complications of the different surgical approaches are also presented.

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“… 1 , 2 However, much of the early experience in the field has focused on urologic outcomes and the ability to achieve penetration with the aid of an erectile device. 3 , 4 Comparably little attention has been paid to sensory outcomes. 5 , 6 Current strategies reported in the literature to optimize sensation following phalloplasty address mainly the peripheral components of sensation, focusing on the peripheral nerve coaptations that are performed during surgery.…”

Section: Introductionmentioning

confidence: 99%

Neurosensory Re-education following Gender-affirming Phalloplasty: A Novel Treatment Protocol

Peters

Annen

Berli

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Sensory nerve transfers are performed as part of phalloplasty surgery. Despite this, sensory re-education to rehabilitate these nerve transfers has not been employed. Additionally, little attention has been paid to the role of the central nervous system in experienced sensation following phalloplasty. The purpose of this article is to report on the development of a targeted rehabilitation protocol to integrate and optimize peripheral and central contributions to sensation following phalloplasty. Methods: This neurosensory re-education protocol was constructed over four phases by a multi-disciplinary team (phalloplasty/peripheral nerve surgeon, reconstructive urologist, pelvic floor physiotherapists, nerve therapist, sex therapist, sexual medicine physician) and individuals with lived phalloplasty experience. The final protocol was approved by all team members and is supported here by qualitative narratives from people with lived phalloplasty experience. Results: The protocol is built to follow each stage of phalloplasty surgery. In each stage, exercises are grouped into three core themes: visualization, tactile stimulation, and sexual/erogenous stimulation. Visualization exercises progress from static to dynamic. Tactile exercises start at simple touch and progress toward targeted sensory stimulation. Sexual stimulation focuses on developing erogenous sensation in the phallus that is separate from erogenous sensation in the natal clitoral tissue. By recommendation of individuals with phalloplasty, the protocol is now integrated into our center’s phalloplasty care pathway for all individuals undergoing phalloplasty surgery. Conclusion: We introduce a novel protocol targeting peripheral and central contributions to sensation to provide a tool to help optimize experienced sensation for transmasculine individuals undergoing phalloplasty.

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Narrative review of penile prosthetic implant technology and surgical results, including transgender patients

Cited by 15 publications

References 101 publications

Safety and Efficacy of Inflatable Penile Prostheses for the Treatment of Erectile Dysfunction: Evidence to Date

Safety and Efficacy of Inflatable Penile Prostheses for the Treatment of Erectile Dysfunction: Evidence to Date

Gender Affirming Surgery: Assigned Female at Birth

Neurosensory Re-education following Gender-affirming Phalloplasty: A Novel Treatment Protocol

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