1986 Volume 77 Issue 5 Pages 760-765
During the last 5 years noninflatable penile prostheses were inserted in 37 patients with spinal cord injury. An operation was done for securing adequate stability of the penis so as to hold an external urinary device, for easy self-catheterization and for the treatment of erectile impotence. In the 37 patients (10 tetraplegic, 23 paraplegic and 4 walking patients with caudal lesion), 10 with self-catheterization were dry and 27 with trigger voiding required external device for urinary incontinence. A pair of Shirai-type silicone penile prosthesis with soft ends of silicone elastomer which is designed in the shape of a rib to protect the spongiosum penis were inserted into the corpus cavernosum through dorsal skin incision of the penile base. Observation period was from 6 to 46 months, average 19 months. Thirty-two out of the 37 patients had excellent results with complete satisfaction. Unilateral and bilateral extrusion of the prosthesis occured in two cases one month after surgery due to infection and a patient who has had causalgia in the lower extremities insisted that his prostheses should be removed because of irritation. A tetraplegic patient who used to turn on his stomach during clothing showed backward retraction of the prostheses. One patient complained that his prostheses were smaller than expected. Transurethral operations just before and after the surgery made no influences on the prosthesis though the combination of this operation should be avoided. Questionaire survey revealed that 32 (86%) were satisfied and 5 (41%) were unsatisfied with the prosthesis, while in the sexual aspects, 15 (41%) were satisfied, 18 (48%) were unchanged and 4 (11%) were unsatisfied. Penile prosthesis is an effective maneuver for the management of urinary incontinence and sexual disability of patients with spinal cord injury.
