Surgical methods of erectile dysfunction treatment

Abstract

Erectile dysfunctions are one of the most common sexual problems in men, appearing in 50% of the population at 40–70 years of age. Treatment regimen includes oral preparations — first-line treatment, injections to the corpora cavernosa — second-line treatment and surgical treatment — third-line treatment. An indication for the third-line treatment includes no effect after previous therapy or denial for such methods, anatomical and organic disorders, ED after operations within the pelvic (a.o. after radical prostatectomy). The surgical procedures can be divided into vascular surgery and implantation of penile prostheses. Among the first group we can distinguish penile microarterial bypass surgery — arterialization and revascularization and surgical treatment of dysfunction of veno-occlusive dysfunction (CVOD) within the corpora cavernosa (venous leak). The above techniques are an alternative that can be used only in selected patients. Implantation of penile prostheses is a recognized method for treatment of ED recommended by The European Association of Urology (EAU). At the moment, we have at our disposal two models of three-piece inflatable penile prostheses — AMS 700 and Coloplast Titan. Penile prostheses implantation treatments have very good clinical outcomes with mechanical failure estimated at less than 5% in the five-year period of observation, and the risk of infection approximately 1–2%. The level of satisfaction of the patients and their partners reaches 95%. In the Western countries implantation of penile prostheses is an established and are routinely performed surgery. Since February 2013 the surgery of implantation of the three-pieces inflatable penile prostheses are being performed in Poland.