Surgical management of impotence using the inflatable penile prosthesis. Experience with 36 patients

Inflatable hydraulic penile prostheses were implanted in 36 patients who had organic impotence. Selection of patients was based on a series of guidelines that included the historical aspects of the patient's initiative, acceptance of the device by patient and partner, motivations, and psychiatric evaluation. Minor complications after implantation were not associated with the ultimate successful function of the device. Major complications were mainly mechanical in origin and readily corrected by secondary surgical procedures. The single failure in this series was associated with infection around the prosthesis, which necessitated removal of the entire device. A nearly physiologic erection was produced in 375 patients. Functional application of the implanted device was successfully achieved in 34 of 35 patients who retained their device. Patient-partner acceptance has been excellent.