Hydraulic prosthesis: how it works
The cylinders are installed into the corpora cavernosa through a penoscrotal incision, the pump is placed between the testicles in the scrotum, and a reservoir with a volume of 65–100 ml is placed in the retropubic space; the components are connected by tubes. After 3-4 weeks, the patient is taught: 10-15 presses on the pump pump liquid into the cylinders - the erection lasts as long as necessary; pressing the valve returns the liquid to the reservoir. Patient and partner satisfaction exceeds 90-95%, service life 10-15 years, mechanical failures - 5-10% over 10 years with the possibility of replacement. Requires manual dexterity and antibiotic prophylaxis (AMS implants have an antibacterial coating).
Who is a penile prosthesis indicated for?
Penile prosthesis is the final solution for erectile dysfunction, when pills, injections and vacuum therapy do not help or are contraindicated: with vascular and neurogenic ED, after radical prostatectomy and radiation, with diabetes, severe Peyronie's disease with ED, cavernous fibrosis after priapism. The prosthesis does not affect sensations, orgasm, ejaculation and urination - only mechanical rigidity is restored.
Semi-rigid or three-piece
Semi-rigid (plastic) prostheses are flexible rods that give the penis constant elasticity; they are bent downwards at rest and straightened for the act. Simple, reliable, cheaper, suitable for people with limited manual dexterity. Three-component hydraulic prostheses (AMS, Coloplast) consist of cylinders, a pump in the scrotum and a reservoir: pressing the pump fills the cylinders - the erection is as natural as possible, the penis is soft at rest. More expensive, they contain mechanics, but give the highest satisfaction. The service life of both types is 10–15 years or more.
