Spontaneous tumescence after implantation of three-piece hydraulic penile prostheses: a short-term experience

Abstract

We evaluated spontaneous tumescence after penile prostheses implantation in a retrospective study. A total of 32 patients with three-piece hydraulic implants (17 Mentor Alpha I, 15 AMS Ultrex Plus) were enrolled. Consultation, personal interviews and questionnaires for both the patients and their partners provided the necessary information. The average follow-up period was 29 months. In total, 50 % of the patients reported spontaneous tumescence without activation of the implant and one further patient (3%) claimed full rigid spontaneous erections. General satisfaction with the prosthetic result was high at 91%. The following complications arose: one case of prosthesis infection, one case of mechanical failure, one case of cylinder dislocation and two cases of paraphimosis. A possible explanation for spontaneous tumescence after penile prosthesis implantation is the elevated preload of the compressed rather than destructed cavernous tissue. The artificial erection evoked by the prosthesis then takes the form of a normal physiological reaction and/or a good objective ridigity, and could account for the high patient satisfaction rate with three-piece hydraulic implants.

Spontaneous and prolonged drug-induced erection in a patient with inflatable penile implant

“…Even special penile implants (soft or fenestrated) have been developed with the aim at avoiding this adverse event and the fact remains that spontaneous tumescence or even erection was achieved with these devices in accordance with the expectations (Subrini, 1982;Shafik, 1997). Regular spontaneous tumescence is not surprising in men with specially designed implants, because these devices restore erectile function by the initiation of a new haemodynamic status in the corpora cavernosa which are dilated lesser than that of standard procedure (Subrini, 1982;Shafik, 1997;Manning et al, 2003).…”

“…Although the latest pharmacological developments have revolutionised the management of erectile dysfunction, penile implant surgery remains one of the most effective treatments for all types of erectile dysfunction (Lue & Broderick, 1998). Nevertheless, it is a common belief that erectile tissue is destroyed utterly during dilatation of corporeal space in penile implant surgery and the penis thus loses its erectile function permanently (Shafik, 1997;Manning et al, 2003). Even special penile implants (soft or fenestrated) have been developed with the aim at avoiding this adverse event and the fact remains that spontaneous tumescence or even erection was achieved with these devices in accordance with the expectations (Subrini, 1982;Shafik, 1997).…”

“…The remaining functional cavernous tissue between the cylinder of implant and the tunica albuginea plays a pivotal role in men who experienced spontaneous tumescence, with this special penile implant (Shafik, 1997;Manning et al, 2003). However, the same condition was not expected theoretically in men with three-piece hydraulic implants.…”

“…Several hypotheses were proposed to explain the phenomenal aspect (Subrini et al, 1982;Goldstein et al, 1997;Shafik, 1997;Manning et al, 2003). Several hypotheses were proposed to explain the phenomenal aspect (Subrini et al, 1982;Goldstein et al, 1997;Shafik, 1997;Manning et al, 2003).…”

Operative Therapie der erektilen Dysfunktion

“…So konnten Manning et al [13] zeigen, dass nach einer Prothesenimplantation 53% der Patienten über spontane Erektionen berichteten. …”