The Minimally invasive technique penile prosthesis implant, has the characteristic of being minimally invasive and therefore revolutionary: I set up after a long period of training in the United States, where I worked with one of the foremost American surgeons urologists, Professor Paul Perito of Coral Gables Hospital in Florida. The use especially in patients having surgery for prostate cancer and in those suffering from Peyronie Penis
An active and fulfilling sex life is possible, even if it is undergone a prostate operation that left a functional deficit. The ultimate solution is the penile prosthesis, or endocavernoso device, which can now be implanted with a mini non-invasive surgery. He explained the details of this innovative technique Gabriele Antonini, the first and only one in Italy to perform it, urologist andrologist of the Urology Department “U. Bracci” Policlinico Umberto I in Rome.
Erectile dysfunction after prostate cancer surgery: when it is necessary to use a penile prosthesis?
The erectile dysfunction problems mainly concern operated for prostate cancer, but also those who underwent interventions of colorectal cancer and patients with diabetes. The erectile dysfunction may be more or less important, depending on the given vascular micro-lesions. The post-surgery rehabilitation involves the use of oral medications such as sildenafil and tadalafil, but are not guaranteed for resumption of sexual activity. Indeed, most of the times prove ineffective. In these cases, the only therapeutic solution thus appears to be the implantation of a device endocavernoso stating at perfect operation the sexual organ.
How does a penile prosthesis?
The blood no longer circulates so necessary to make up for this lack to operate the organ. Hydraulic prostheses used by me are called three-component. They are formed by two inflatable cylinders as an activator device and a reservoir of spherical shape. Manually starts the activation mechanism, which is hidden inside the scrotum between the two testicles, and that does get the liquid, a saline solution, from the reservoir within the cylinders placed in the two corpora cavernosa that thus it is swell and stiffen.
What are the characteristics of the technique she used and what the benefits than others?
The technique I used, called Minimally invasive penile prosthesis implant, has the characteristic of being minimally invasive and therefore revolutionary: I learned and developed after a long period of training in the United States, where I worked with one of the most leading surgeons American urologists, Professor Paul Perito of Coral Gables Hospital in Florida. The use especially in patients having surgery for prostate cancer and in those with deformities of the penis for Peyronie.
Innovation is all in the technique used to place the implant: infrapubica making an incision at the base of the penis of just 2.5 cm for the installation of hydraulic penile prosthesis. The operation lasts twenty minutes compared to 50 minutes by the traditional one. To the benefit of post-operative pain, which is almost non-existent, and the risk of infection decreases considerably and is close to zero percent. Before the surgical incision was made between the penis and scrotum, with a far higher post-operative discomfort and the patient’s ability to activate the system only after a month. Now with this new approach, the times have been significantly shortened, and already after 7 days after the operation you can activate the system, and the resumption of sexual activity begins in one month apart.
How important is the psychological aspect of the prosthesis acceptance?
Once past the appearance of oncology, you must dwell on the psychological aspect and the patient’s sex life. In principle the operated of prostate cancer are over the age of 60, although the early diagnosis thanks to the introduction of the PSA also allows to locate the tumor about 50 years. All this does not mean that we should, once the disease, give up an active and satisfying sex life, which gives psychological and physical well-being and energy also to manage the disease.
We must accept the problem. Many patients give up an active sex life because the thought of implanting a penile prosthesis is experienced as a deficit and an impairment. popular imagination is believed that the endocavernoso device is something external to the body, with the famous bulb visible to the naked eye. On the contrary this type of system is internal to the body and totally invisible and allows a turgidity of the penis equal to that of a 20 year old guy. It should for this reason be compared to the utility on a hip implant or a heart valve in quality of life.
What is important in these cases the doctor-patient relationship?
The pathology oncology steals aptly time to the specialist that in the vast majority of cases, after having brilliantly solved the basic problem, ignores the quality of sexual life of the patient, creating a deep state of depression and frustration. In my way of seeing the urologist must be completely dedicated all’andrologia, to be able to establish a relationship of friendship and trust with the patient, creating an empathy between the parties and to allow him to open up and deal in peace is the surgical phase is the next phase of follow-up.