Department of Urology, Hospital da Lagoa, Rio de Janeiro, Brazil.
Int Braz J Urol. 2011 Jan-Feb;37(1):94-9. doi: 10.1590/s1677-55382011000100012.
Today, we find that the implant of malleable prostheses still plays a leading role in the surgical treatment of erectile dysfunction. These may involve patients for which the cosmetic advantages of inflatable devices are not as important as low cost, the easier use and less incidence of mechanical complications in the malleable implants. This paper demonstrates infrapubic approach as a technical option for this kind of implant.
It offers technical resources and emphasizes the facility in using the method, reducing cutaneous exposure, which diminishes risks of contamination.
As occurs in inflatable implants, when implanting malleable prostheses through the infrapubic access, care must also be taken regarding the possibility of lesion to the vascular-nervous bundle. On the other hand, the approach through the dorsal surface of the corpora cavernosa has a natural capacity for anatomical protection of the urethra, not requiring transurethral catheterization. This benefit is of the utmost importance when considering possible causes of per and postoperative morbidity. Accordingly, we can consider that the infrapubic approach is an effective method and prevails as a technical option for implanting malleable prostheses.
如今,我们发现可屈性假体的植入在勃起功能障碍的外科治疗中仍然起着主导作用。这些可能涉及到一些患者,对于他们来说,可充气设备的美容优势不如低成本、更易于使用和较少发生机械并发症的可屈性植入物重要。本文展示了耻骨下入路作为这种植入物的一种技术选择。
它提供了技术资源,并强调了使用该方法的便利性,减少了皮肤暴露,降低了感染的风险。
与可充气植入物一样,当通过耻骨下入路植入可屈性假体时,也必须注意血管神经束损伤的可能性。另一方面,通过海绵体背侧表面的入路具有对尿道的自然解剖保护能力,不需要经尿道导尿。当考虑术后发病率的可能原因时,这一益处至关重要。因此,我们可以认为耻骨下入路是一种有效的方法,并且作为植入可屈性假体的技术选择占主导地位。