Penile Prosthesis Surgery

  • O. Kalejaiye
  • Amr Abdel Raheem
  • D. Ralph


Erectile dysfunction (ED) is the inability to attain and/or maintain an erection sufficient for sexual intercourse. Fifty percent of men aged 40–70 years will be affected by ED. This may result in a significant deterioration in their quality of life and relationships. It is often associated with conditions affecting vascular circulation such as diabetes mellitus, hyperlipidaemia, smoking, obesity and hypertension. However, it may also be due to conditions affecting nerve innervation (pelvic surgery) or smooth muscle. Montorsi et al. provided the first significant evidence linking ED with cardiovascular disease [1]. In their landmark paper, 50% with acute chest pain and proven coronary artery disease also reported ED. Subsequent studies have strengthened their findings and ED should now be considered to precede a cardiovascular event by 3–5 years [2–5]. The reduction of risk factors associated with vascular disease may improve erectile function [6]. The second large group of men who will experience ED are those undergoing pelvic surgery; this group is increasing in numbers every year.


  1. 1.
    Montorsi F, Briganti A, Salonia A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute coronary artery disease. Euro Urol. 2003;44:360–5.CrossRefGoogle Scholar
  2. 2.
    Gandaglia G, Briganti A, Jackson G, Kloner R, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Euro Urol. 2014;65:968–78.CrossRefGoogle Scholar
  3. 3.
    Greenstein A, Chen J, Miller H, Matzkin H, Villa Y, Braf Z. Does severity of ischemic coronary disease correlate with erectile function? Int J Impot Res. 1997;9:123–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Montorsi P, Ravagnani PM, Galli S, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J. 2006;27:2632–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Yaman O, Gulpinar O, Hasan T, Ozdol C, Ertas FS, Ozgenci E. Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol. 2008;40:117–23.CrossRefPubMedGoogle Scholar
  6. 6.
    Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomised controlled trial. JAMA. 2004;291:2978–84.CrossRefPubMedGoogle Scholar
  7. 7.
    Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57:804–14.CrossRefPubMedGoogle Scholar
  8. 8.
    Le B, Burnett A. Evolution of penile prosthesis devices. Korean J Urol. 2015;56:179–86.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Minervin A, Ralph DJ, Pryor JP. Outcome of penile prosthesis implantation for treating erectile dysfunction: experience with 504 procedures. BJU Int. 2005;97:129–33.CrossRefGoogle Scholar
  10. 10.
    Natali A, Olianas R, Fisch M. Penile implantation in Europe: successes and complications with 253 implants in Italy and Germany. J Sex Med. 2008;5:1503–12.CrossRefPubMedGoogle Scholar
  11. 11.
    Culley CC, Mulcahy JJ, Govier FE. Efficacy, safety and patients satisfaction outcomes of the AMS 700CX inflatable penile prosthesis: results of a long-term multicentre study. J Urol. 2000;164:376–80.CrossRefGoogle Scholar
  12. 12.
    Mulhall JP, Ahmed A, Branch J, Parker M. Serial assessment of efficacy and satisfaction profiles following penile prosthesis surgery. J Urol. 2003;169:1429–33.CrossRefPubMedGoogle Scholar
  13. 13.
    Menard J, Tremeaux J-C, Faix A, Pierrevelcin J, Staerman F. Erectile function and sexual satisfaction before and after penile prosthesis implantation in radical prostatectomy patients: a comparison with patients with vasculogenic erectile dysfunction. J Sex Med. 2011;8:3479–86.CrossRefPubMedGoogle Scholar
  14. 14.
    Akin-Olugbade O, Parker M, Guhring P, Mulhall J. Determinants of patient satisfaction following penile prosthesis surgery. J Sex Med. 2006;3:743–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Carson CC, Mulcahy JJ, Harsh MR. Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants: up to 7.7 years of followup. J Urol. 2011;185:614–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Wilson SK, Delk JR 2nd, Salem EA, Cleaves MA. Long-term survival of inflatable penile prostheses: single surgical group experience with 2,384 first-time implants spanning two decades. J Sex Med. 2007;4:1074–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Rajpurkar A, Dhabuwala CB. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin and penile implant surgery for erectile dysfunction in Urology. J Urol. 2003;170:159–63.CrossRefPubMedGoogle Scholar
  18. 18.
    Muneer A, Arya M, Jordan G. Atlas of male genitourethral surgery. Hoboken, NJ: Wiley; 2013.Google Scholar
  19. 19.
    Yeung LL, Grewal S, Bullock A, Lai HH, Brandes SB. A comparison of chlorhexidine-alcohol versus povidone-iodine for eliminating skin flora before genitourinary prosthetic surgery: a randomized controlled trial. J Urol. 2013;189:136–40.CrossRefPubMedGoogle Scholar
  20. 20.
    Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and “no touch” surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012;79:1310–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • O. Kalejaiye
    • 2
    • 1
  • Amr Abdel Raheem
    • 1
    • 3
  • D. Ralph
    • 1
  1. 1.Department of UrologyUniversity College HospitalLondonUK
  2. 2.Department of AndrologyUniversity College LondonLondonUK
  3. 3.Department of AndrologyCairo UniversityCairoEgypt

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