Surgical treatment Italy vs USA: Penile Prosthesis Surgery

Surgical treatment Italy vs USA: Penile Prosthesis Surgery
Cardarelli Hospital, Napoli, Italy.
Director Dott. Maurizio Carrino
Surgeons:
Dr. Luigi Pucci (luigi.pucci@hotmail.it; mob.: +39 3381614575; Hospital +39 081 747 2475)
Dr. Gerard Henry
A penile prosthesis is a medical device implanted in the penis requiring a surgical procedure. The device is often used for men with organic or treatment-resistant psychogenic impotence who suffer from erectile dysfunction. A penile prosthesis is also used in the final stage of plastic surgery phalloplasty to complete female to male gender reassignment surgery as well as during total phalloplasty for adult and child patients that need male genital modification.
A penile implant is used when there is a medical need and when the problem is unlikely to resolve or improve naturally. These problems can include erectile dysfunction, congenital anomalies, iatrogenic, accidental penile trauma, micropenis or Peyronie’s disease. This implant is normally only considered when less invasive medical treatments have been exhausted or deemed unsuitable. For example, many drugs used to treat erectile dysfunction are unsuitable for patients with heart problems and may interefere with other medications.

Sometimes a penile prosthesis is implanted during surgery to alter, construct or reconstruct the penis in phalloplasty. The British Journal of Urology International reports that unlike metoidioplasty for female to male sexual reassignment patients, which may result in a penis that is long but narrow, current total phalloplasty neophallus creation using a musculocutaneous latissimus dorsi flap could result in a long, large volume penis which enables safe insertion of any type of penile prosthesis.

This same technique enables male victims of minor to serious iatrogenic, accidental or intentional penile trauma injuries (or even total emasculation) caused by accidents, child abuse or self-mutilation to have penises suitable for penile prosthesis implantation enabling successful sexual intercourse.

In some cases of genital reconstructive surgery, implantation of a semirigid prosthesis is recommended for three months after total phalloplasty to prevent phallic retraction. It can be replaced later with an inflatable one.

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