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    Removal

    Penile prostheses have been used for over 25 years, and have the highest patient satisfaction ratings of any treatment for erectile dysfunction. Once these devices are inserted, the tissue around them deteriorates, so it's a permanent solution-a man can't go back to using drugs or injections.

    About two to three percent of men develop infections after their prostheses are implanted. In the past, this has been devastating, because doctors had to remove the prosthesis to treat the infection, and the men would have to have another surgery months later to replace the device. With each new insertion, about two inches was lost in length of the erect penis because of tissue scarring.

    A researcher from the Indiana University Medical Center in Indianapolis recently reported a new approach to treating these infections. Instead of removing the prosthesis and replacing it months later, says John J. Mulcahy, M.D., he and his colleagues have been removing the device, thoroughly treating the surrounding tissues with antibiotics, and then replacing the prosthesis during the same surgery.

    Writing in the February 2000 issue of the Journal of Urology, Dr. Mulcahy reports that this procedure was successful in 45 of 55 men who had it, with no further infections occurring. Five men became reinfected within one month of surgery, and five had problems with the new prosthesis that required additional surgery.

    Dr. Mulcahy notes that with thorough antibiotic treatment during the procedure, and additional treatment with oral antibiotics for a month afterwards, most men are able to retain the erectile function they achieved with the first surgery. This is good news for the small percentage of men who do develop infections after having penile prostheses implanted.


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