Department of Urology, University of California Irvine, CA, USA.
Department of Andrology, University College London Hospitals, London, UK.
J Sex Med. 2021 Jul;18(7):1158-1166. doi: 10.1016/j.jsxm.2021.04.011. Epub 2021 Jun 25.
During the last century, surgical management of erectile dysfunction has evolved from an experimental concept to a core treatment modality with widespread use among the men's health community. Over time, innovations in materials, mechanical design elements, device coatings, and surgical technique have provided patients with low-risk, reliable, and reproducible erectile function with high satisfaction rates.
To provide a foundation for future innovation by improving understanding of historical penile prosthetics and the rationale behind incremental technological improvements for the contemporary Men's Health physician.
Literature review was conducted to generate a comprehensive review of historical technological innovations in penile implant surgery. Companies with FDA approved penile prosthetics in use in the United States were contacted for information regarding technological innovations in the past and future devices in development. A separate literature review was performed to identify any significant future device design elements being tested, even in the ex vivo setting, which may have future clinical applications.
Technological innovations in penile implant surgery were described.
Current options for the prosthetic surgeon include malleable penile prostheses (MPP), self-contained (2-piece) inflatable penile prostheses, and multicomponent (3-piece) inflatable penile prostheses. Current MPPs consist of a synthetic coated solid core which allow for manipulation of the penis for concealability while maintaining sufficient axial rigidity to achieve penetration when desired. Multi-component (3-Piece) IPPs currently include the Coloplast Titan and Boston Scientific/AMS 700 which consist of a fluid reservoir, intrascrotal pump, and intracavernosal cylinders. The devices have undergone numerous design updates to the cylinders, pump, reservoir, tubing, and external coatings to increase reliability and decrease short- and long-term complications.
Future innovations in penile prosthetic surgery seek to broaden the indications and applicability to the transgender community and improve both safety and functionality for patient and partner.
STRENGTHS & LIMITATIONS: The review is limited primarily to penile prosthetics approved for current or historical clinical use in the United States and may not be representative of the global prosthetic environment. Additionally, the research and development of future innovations, particularly those provided by device manufacturers, is likely limited by non-disclosure to maintain a competitive advantage.
Penile prosthetic surgery will undoubtedly remain integral to the treatment of erectile dysfunction, and education regarding the current state of technological innovation will empower the prosthetic surgeon and biomedical engineering community to improve contemporary patient care and drive the development of the next generation of implantable penile prosthetics. Barnard JT, Cakir OO, Ralph D, et al. Technological Advances in Penile Implant Surgery. J Sex Med 2021;18:1158-1166.
在上个世纪，勃起功能障碍的手术治疗已经从一个实验性的概念发展成为男性健康领域广泛应用的核心治疗方式。随着时间的推移，材料、机械设计元素、器械涂层和手术技术的创新为患者提供了低风险、可靠和可重复的勃起功能，满意度很高。
通过提高对历史阴茎假体的理解和对当代男性健康医生渐进式技术改进背后原理的理解，为未来的创新提供基础。
进行文献回顾，生成阴茎植入手术历史技术创新的全面综述。联系在美国获得 FDA 批准的阴茎假体的公司，以获取有关过去技术创新和未来开发中设备的信息。还进行了单独的文献回顾，以确定任何正在测试的重要未来设备设计元素，即使是在体外环境中，这些元素可能具有未来的临床应用。
描述了阴茎植入手术的技术创新。
阴茎假体手术无疑将仍然是勃起功能障碍治疗的重要组成部分，了解当前技术创新的现状将使假体外科医生和生物医学工程界能够改善当代患者的护理，并推动下一代可植入阴茎假体的发展。
