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Surgical treatments of ED
The correction of penile deformity through
corporoplasty is the main measure in cases of
anatomical DE where the strong penis' curvature
prevents sexual activity and the patient has a normal
erection. More complex reconstructive procedures are
required in cases of partial amputation of the penis after
surgery for cancer or in case of Microphallus.
The prosthetic therapy, on the contrary, has the aim of
replacing the mechanism of erection with devices
applied inside of the corpora cavernosa that can develop
an adequate stiffness. Such therapies are indicated
when erectile dysfunction cannot be treated and gives
no positive results with the treatments described above
(oral pharmacological and intracorporeal), and after
solving the collateral pathologies. Sometimes they are
the only possible solution after demolitive surgery for
the cancer or pelvic surgery such as radical
prostatectomy, cystectomy or oncological surgery of the
lower bowel. The main types of prostheses are those
malleable or semi-rigid, which possess a degree of fixed
rigidity and maintain the penis constantly semi-rigid,
and those hydraulic or inflatable, which thanks to the
presence of a reservoir and a pump can change their
degree of rigidity. The latter are specifically constituted
by two cylinders which are implanted within the corpora
cavernosa and are connected to a pump implanted in
the scrotum, and a tank containing physiological saline
which is positioned in the space of Retzius. By acting on
the pump it is possible to inject or drain the liquid from
the tank to the cylinders thus realizing the phase of
erection and that of flaccidity.