Diagnostic and therapeutic technology assessment. Penile implants for erectile impotence

Three semirigid penile prostheses (Small-Carrion, Finney Flexirod, and Jonas Silicone-Silver) and a multicomponent inflatable penile prosthesis (Scott) were considered safe and effective treatment for impotence unresponsive to medical management. Each of these prostheses has its own advantages and disadvantages. The entire semirigid prosthesis group is surgically easier to implant than the inflatable models and, except for fracturing of the silver wires in the Jonas model, has a low incidence of mechanical failure. However, the semirigid models are not as aesthetically pleasing or as sexually satisfying to both partners as are inflatable devices. Multicomponent inflatable penile prostheses have had a history of mechanical failure; however, improved design and materials have reduced this problem. Several new concepts in penile prostheses have recently been developed: the self-contained inflatable prosthesis and an articulating prosthesis made of a spring-loaded cable that runs through a series of plastic segments. The self-contained inflatable prosthesis contains a fluid reservoir within the device itself. This eliminates the need for a separate reservoir, pump, and connective tubing (AMS Hydroflex, Flexiflate). There are not yet enough long-term data available to evaluate these new single-component devices.