Penile implants in spinal cord injury

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Penile Implants in Spinal Cord Injury[edit | edit source]

Penile retraction and condom slipping

Penile implants are medical devices surgically placed into the penis to allow men with erectile dysfunction (ED) to achieve an erection. These devices are particularly beneficial for men with spinal cord injury (SCI), as such injuries often result in significant challenges to sexual function, including the ability to achieve and maintain an erection.

Types of Penile Implants[edit | edit source]

There are two main types of penile implants used in men with spinal cord injuries: inflatable implants and malleable (or semi-rigid) implants.

Inflatable Implants[edit | edit source]

Inflatable implants consist of two or three components: two cylinders placed in the penis, a pump placed in the scrotum, and sometimes a reservoir placed in the abdomen. The pump is used to transfer fluid from the reservoir to the cylinders, creating an erection. Inflatable implants provide a more natural erection and flaccidity compared to malleable implants.

Malleable Implants[edit | edit source]

Malleable implants are simpler devices consisting of bendable rods placed within the penis. These rods can be manually adjusted to an erect or flaccid position. While they are easier to use and require less manual dexterity, they do not provide the same natural appearance as inflatable implants.

Benefits for Spinal Cord Injury Patients[edit | edit source]

ZSI 100 CF penile implant with condom

For men with spinal cord injuries, penile implants can significantly improve quality of life by restoring sexual function. They can help overcome the erectile dysfunction that often accompanies SCI, allowing for sexual intimacy and improved self-esteem.

Penile implants can also aid in the management of urinary incontinence, as they can help support the use of external urinary devices like condoms or catheters.

Surgical Considerations[edit | edit source]

The surgical procedure to implant a penile prosthesis is typically performed under general or spinal anesthesia. The choice of implant type and surgical approach depends on the patient's specific condition, preferences, and the surgeon's expertise.

Post-surgical recovery involves a period of healing and adjustment, during which patients are advised to avoid sexual activity until cleared by their healthcare provider.

Complications and Risks[edit | edit source]

As with any surgical procedure, penile implant surgery carries risks, including infection, device malfunction, and erosion of the implant through the skin. However, advances in surgical techniques and implant design have reduced these risks significantly.

Rehabilitation and Outcomes[edit | edit source]

ZSI 100 CF easy catheterisation

Rehabilitation following penile implant surgery involves education on the use of the device and managing expectations. Patients with spinal cord injuries may require additional support to adapt to the changes in their sexual function and to integrate the use of the implant into their daily lives.

Overall, penile implants have a high satisfaction rate among men with spinal cord injuries, with many reporting improved sexual function and quality of life.

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Contributors: Prab R. Tumpati, MD