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Penile prosthesis
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Penile prosthesis : ウィキペディア英語版
Penile prosthesis
A penile prosthesis, or penile implant, is one of the oldest effective treatments for the condition of erectile dysfunction.〔Simmons M, Montague D. Penile prosthesis implantation: past, present, and future. International Journal of Impotence Research 2008; 20: 437-444.〕 The medical device which is surgically implanted within the corpora cavernosa of the penis during a surgical procedure, provides the highest levels of patient and partner satisfaction of all available treatment options.〔Rajpurkar A, Dhabuwala C. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice. J Urol 2003; 170: 159-163.〕 The device is indicated for use in men with organic or treatment-resistant impotence or erectile dysfunction that is the result of various physical conditions such as cardiovascular disease, diabetes, pelvic trauma, Peyronie's Disease, or as the result of prostate cancer treatments.〔Sadeghi-Nejad H. Penile prosthesis surgery: a review of prosthetic devices and associated complications. J Sex Med 2007; 4: 296-309.〕 Less commonly, a penile prosthesis may also be used in the final stage of plastic surgery phalloplasty to complete female to male gender reassignment surgery as well as during total phalloplasty for adult and child patients that need male genital modification.
==Reasons for use==
A penile implant is one treatment option available to individuals who are unable to achieve or maintain an erection adequate for successful sexual intercourse or penetration. Its primary use is for men with erectile dysfunction from vascular conditions (cardiovascular disease, high blood pressure, diabetes), congenital anomalies, iatrogenic, accidental penile or pelvic trauma, Peyronie's disease, or as a result of prostate cancer treatments. This implant is normally considered when less invasive medical treatments such as oral medications (PDE5 inhibitors: Viagra, Levitra, Cialis), penile injections, or vacuum erection devices are unsuccessful, provide an unsatisfactory result, or are contraindicated.〔Garber B. Inflatable penile prostheses for the treatment of erectile dysfunction: an update. Expert Rev Med Devices 2008; 5(2): 133-144.〕 For example, many drugs used to treat erectile dysfunction are unsuitable for patients with heart problems and may interfere with other medications.
Sometimes a penile prosthesis is implanted during surgery to alter, construct or reconstruct the penis in phalloplasty. The British Journal of Urology International reports〔British Journal of Urology International, Volume 100, Number 4, pp 899-905, Reconstructive Urology: Total phalloplasty using a musculocutaneous latissimus dorsi flap, Sava V. Perovic, Rados Djinovic et al., School of Medicine, Belgrade University〕 that unlike metoidioplasty for female to male sexual reassignment patients, which may result in a penis that is long but narrow, current total phalloplasty neophallus creation using a musculocutaneous latissimus dorsi flap could result in a long, large volume penis which enables safe insertion of any type of penile prosthesis.
This same technique enables male victims of minor to serious iatrogenic, accidental or intentional penile trauma injuries (or even total emasculation) caused by accidents, child abuse or self-mutilation to have penises suitable for penile prosthesis implantation enabling successful sexual intercourse.
In some cases of genital reconstructive surgery, implantation of a semirigid prosthesis is recommended for three months after total phalloplasty to prevent phallic retraction. It can be replaced later with an inflatable one.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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