[Flexible penile implants. An experience over 60 cases].

The author proposes flexible silicone elastomer penile prostheses or implants to restore erectile function. They have the advantage of being flexible, adjustable during the operation and they can be elongated by traction and are resistant to axial pressure. The surgical incisions are explained, in particular the penopubic approach, together with insertion of the implants accompanied by cavernopublic disinsertion and recentering of the glans in patients with La Peyronie's disease. Sixty patients were operated and reviewed with a follow-up of 8 months to 4 years. There were no cases of infection of rejection. 85% of patients were satisfied with the quality of their erectile function. The haemodynamic mechanisms of impotence, situated either in the corpora cavernosa or in the peripheral venous plexus, are reviewed. Flexible penile implants allow restoration of erectile function via various combinations of three possible mechanisms: reduction of the free cavernosal volume, increased resistance to venous drainage, and increased intracavernosal pressure.