Non-inflatable penile prosthesis for the management of urinary incontinence and sexual disability of patients with spinal cord injury

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Abstract
During the last 5 years non-inflatable penile prostheses were implanted in 37 patients with spinal cord injury. Operation was done to provide adequate stability of the penis in order to hold an external urinary device, to help erectile impotence and to make self-catheterisation easier. A pair of Shirai-type silicone penile implants were inserted into the corpora cavernosa through a dorsal skin incision at the penile base. In 37 patients 33 had excellent results. Extrusion of the prosthesis occurred in two cases due to infection. Removal of the prosthesis was necessary in a patient who had causalgia in the lower extremities. Posterior migration of the prosthesis was noted in a tetraplegic patient who used to turn on his stomach when he changed clothes. Anterior sphincterotomy which was performed during the surgery in one case and after the surgery in another two cases did not affect the prosthesis. Questionnaire survey revealed that 32 (86%) were satisfied with the procedure which provided better condom fitting and easier intermittent catheterisation whereas only 5 (14%) were dissatisfied. The prosthesis improved sexual function in 15 (41%) patients, 18 (48%) patients were unchanged and four (11%) patients were dissatisfied. Penile prosthesis is an effective manoeuvre for the treatment of urinary incontinence and sexual disability of patients with spinal cord injury provided that the special aspects of the spinal cord injury is taken into consideration.