title: The Evolution and Utility of the Small-Carrion Prosthesis, Its Impact, and Progression to the Modern-Day Malleable Penile Prosthesis.
abstract: BACKGROUND
  Erectile dysfunction has plagued humanity for millennia. For years, treatment had been in the hands of mental health professionals. It was not until the 1970s that urologists created a modality that was marketable, reproducible, and consistently successful at treating impotence, the Small-Carrion Penile Prosthesis.
  
  
  OBJECTIVE
  We present the evolution of the malleable/semi-rigid penile prosthesis, concentrating our efforts reviewing and critiquing the pivotal article published by Drs. Michael P. Small, Hernan M. Carrion, and Julian A. Gordon. We then discuss its continued advancement, current-day utilization, and the future of the malleable prosthesis.
  
  
  METHODS
  From the early 1900s, surgeons have been toying with the idea of creating a penile implant. These initial attempts utilized rib cartilage, and eventually synthetic materials, including acrylic, silicone, and polyethylene.
  
  
  RESULTS
  In 1975, Drs. Carrion and Small presented their initial experience of 31 patients utilizing their silicone implant. In their manuscript titled, "The Small-Carrion Penile Prosthesis: New Implant for the Management of Impotence," they discuss their technique, perioperative management of complications, and results.
  
  
  CONCLUSIONS
  The malleable penile prosthesis continued to evolve throughout the years to the current day Genesis and Spectra. Although the current market is dominated by the inflatable penile prosthesis, there are specific situations where the malleable is ideally utilized. The pivotal article by Drs. Carrion and Small helped pave the way for the "New Era" of penile prosthetics and still remains one of the most impactful contributions to the management of erectile dysfunction.
authors.affiliation: Urology Specialty Care, Miami, FL, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Martinez
authors.affiliation: Department of Urology, Medical Center Blvd, Winston Salem, NC, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Terlecki
authors.affiliation: Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, UT, USA.
authors.forename: William O
authors.initials: WO
authors.lastname: Brant
mesh_terms: D000328:Adult; D018450:Disease Progression; D007172:Erectile Dysfunction / Q000503:physiopathology / Q000601:surgery*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D019935:Penile Implantation / Q000266:history / Q000379:methods* / Q000639:trends; D015917:Penile Prosthesis / Q000266:history / Q000706:statistics & numerical data / Q000639:trends*; D010413:Penis / Q000503:physiopathology / Q000601:surgery*; D012828:Silicones
chemical_list: D012828:Silicones
keywords: Erectile Dysfunction; History of the Penile Implant; Malleable Prosthesis; Penile Prosthesis; Semi-Rigid Penile Implant; Small-Carrion Penile Prosthesis