Prosthesis

The use of plastic splints for the penis was first described in 1952. Semi-rigid silastic rods result in an almost permanently erect penis which can be bent to different angles. Acceptability of these processes has been improved by using modified appliances. An inflatable penile implant has been used to provide improvements in both girth and rigidity. Such a device works on a fluid-filled system that allows the flaccid and erect penis to appear normal. The choice between semirigid or inflatable devices depends very much on the patient's and his partner's preferences.

The semirigid prosthesis is made of medical grade silicone rubber with a sponge core. The device may be implanted by using perineal approach to insert it in the corporeal bodies. The device is available in lengths of 12 to 22cm, and diameters of 0.9,1.12, and 1.3 mm. A flexirod prosthesis differs from the above by having a hinged area that enables the phallus to be placed in a dependent position when not being used for intercourse. The diameters here range from 0.9 to 1.2 cm and the length from 7 to 13 cm, and it can be shortened if necessary. Another type of prosthesis (called the "Jonas prosthesis") is used commonly and can be inserted through subcoronal, midshaft, penoscrotal, and suprapubic approaches, as well as through the perineal approach. In addition, it has 3 diameters of 9.5, 11.0, and 13.0 mm, and lengths of 16 to 24 cm. It is malleable and thus the penis can maintain a dependent position as well as an upright one. Variable versions of this prosthesis are now available. A newer prosthesis on the market is made of fabric-wrapped stainless steel that has flexibility of size and positioning.

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