Use of penile prosthetic implants in patients with penile fibrosis.

For a subset group of impotent patients with penile fibrosis, the implantation of a penile prosthesis is their only therapy for restoration of erectile function. In many cases, using a penile prosthesis requires additional corporal reconstructive procedures to rebuild fibrotic corporal bodies. Unfortunately, the surgeon is rarely forewarned that reconstructive surgery will be necessary despite a variety of historic factors that would suggest the possibility of encountering unsuccessful corporal dilatation. To be forewarned is to possibly decide that implant surgery is contraindicated, thereby denying some patients one last opportunity to have potency restored. Corporal reconstruction with or without use of synthetic graft material will not be suitable for all patients in whom severe corporal fibrosis is encountered. There is a relatively high risk of infection in these patients and an indepth, preoperative discussion with those patients in whom corporal reconstruction is considered a possibility is essential in order to be assured of the patient's motivation to "go the extra mile." For some patients, as an elective procedure, there is definitive unwillingness to undergo such a complicated procedure. In those cases, it is usually mutually agreed that if extensive corporal fibrosis is encountered, the procedure will simply be abandoned and no attempt will be made to carry out corporal reconstruction. Many patients with penile fibrosis are young which attests to their greater motivation to not permit their sex life from being terminated at an unacceptably early age. Quite rightly, they maintain that benefits of corporal reconstruction, when successful, far outweigh the risks.