The penile implant for erectile dysfunction.
BACKGROUND
Penile prostheses, introduced as the first effective organic treatment for erectile dysfunction over three decades ago, have an important role in the treatment of erectile dysfunction when other nonprosthetic treatment options have proven unsatisfactory. Although they are the least chosen and most invasive treatment option, they have the highest satisfaction rate of all available ED options and provide a predictable and reliable result.


OBJECTIVE
To provide recommendations/guidelines concerning state-of-the-art knowledge for utilization of the penile prosthesis in the management of men with erectile dysfunction.


METHODS
An International Consultation in collaboration with the major sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. There were 10 experts from seven countries concerning the Penile Implant for Erectile Dysfunction.


METHODS
Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.


RESULTS
Recommendations/guidelines for penile prosthesis (hydraulic, semi-rigid and soft silicone) insertion for management of men with erectile dysfunction were updated. Consensed issues included: criteria for patient selection, informed consent procedures, strategies for preoperative preparation, operative incisions/technical considerations and outcome results in terms of patient satisfaction and device survival. Updated information was reviewed concerning therapies for device failures, device insertion in scarred corporal bodies and strategies for managing implant infections.


CONCLUSIONS
There is a need for more research in developing management strategies for insertion of penile prostheses in men with ED.
Mulcahy
John J
JJ
Department of Urology, Indiana University, Indianapolis, IN, USA. jmulcahy@iupui.edu
Austoni
Edouardo
E
Barada
James H
JH
Choi
Hyung Ki
HK
Hellstrom
W J
WJ
Hellstrom
Wayne J G
WJ
Krishnamurti
Sudhakar
S
Moncada
Ignacio
I
Schultheiss
Dirk
D
Shultheiss
Dirk
D
Sohn
Michael
M
Wessells
Hunter
H
D032921:Consensus; D007172:Erectile Dysfunction / Q000209:etiology / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D019935:Penile Implantation; D015917:Penile Prosthesis; D010413:Penis / Q000601:surgery; D017410:Practice Guidelines as Topic / Q000592:standards