The Use of Penile Prostheses in Impotence

Abstract

Thirty years ago, Couvelaire and Herlyn used ribs or parts of the tibia to reinforce the penis (see Wagenknecht et al. 1981; Wagenknecht 1987). Between 1960 and 1970, unilateral penile prostheses were used (Pearman, Lash-Loeffler, and Tudoriu, in Wagenknecht et al. 1981). Because of the penile anatomy, these devices could not be implanted in between the corpora cavernosa, but entered one or other of the corpora. Lesions and penetration of the urethra, glans, and crura penis were frequent. Rigid double prostheses were developed in 1965 by El-Masri and in 1966 by Beheri (Wagenknecht et al. 1981; Wagenknecht 1987). Tudoriu proposed a fork-shaped Teflon prosthesis to be implanted under Buck’s fascia over the corpora cavernosa. The Small-Carrion silicone double prosthesis proved to be the most widely used penile prosthesis for more than 12 years (Carrion 1986). This prosthesis was implanted in 50000 men, with a complication rate of only 3%–5% (Carrion 1986).