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Erectile Function Significant Enough for Penetration During Sexual Intercourse after Removal of Inflatable Penile Prosthesis
Authors:Daniel R Martinez  Peter A Mennie  Rafael Carrion
Institution:2. Department of Medical Psychology, St. Elisabeth Hospital, Tilburg, The Netherlands;3. Department of Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands;4. Department of Education and Research, St. Elisabeth Hospital, Tilburg, The Netherlands;2. Endocrinology Unit, Maggiore‐Bellaria Hospital, Bologna, Italy;3. Epidemiological Unit, Azienda Sanitaria Locale, Florence, Italy;4. Diabetes Section, Geriatric Unit, Department of Critical Care University of Florence, Florence, Italy;2. National Development and Research Institutes, New York, NY, USA;3. Centro Latinoamericano de Enfermedades de Transmisión Sexual, Puerto Rico Department of Health, San Juan, Puerto Rico;3. Department of Urology, Sestri Levante Hospital, Sestri Levante (Genoa), Italy;2. Psycho‐Oncology Co‐operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia;3. School of Psychology, The University of Sydney, Sydney, NSW, Australia;4. Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, NSW, Australia
Abstract:IntroductionFifty‐two‐year‐old male with history of multiple insults to his erectile tissue, including insertion and removal of penile implant, presents with significant partial erectile function, substantial enough for anal penetration during sexual intercourse.AimErectile function rigid enough for anal penetration, let alone any erectile function after removal of an inflatable penile prosthesis (IPP), is rare. This article, to our knowledge, is the first case of a patient who has undergone multiple insults to his erectile tissue, including an episode of ischemic priapism followed by implantation and removal of an IPP, who presents with erectile function sufficient enough for coitus.Main Outcome MeasuresOutcome measured via standardized patient questionnaires and penile Doppler following injection of Trimix.MethodAn objective measure of the patient's erectile function was performed via penile Doppler.ResultsPenile Doppler after 10‐mcg injection of Trimix revealed numerous perforating vessels from the corpora spongiosum providing blood flow to the corpora cavernosa. The patient obtained approximately 60–70% rigid erection.ConclusionsTo our knowledge, and after thorough review of the literature, we could not find any reports of erectile function significant enough to take part in sexual intercourse and penetration after removal of a three‐piece IPP. The implant usually disrupts the normal anatomy which allows for cavernosal arterial vasodilation and increased blood flow into the corpora. Following dilation of the corpora the cylinders are inserted and inflated, and the smooth muscle that makes up the corpora cavernosum is compressed against the wall of the tunica albuginea. Theoretically, the remaining smooth muscle tissue may retain some of its physiologic function, adding some additional girth to the penis with an already activated IPP during sexual intercourse. Martinez DR, Mennie PA, and Carrion R. Erectile function significant enough for penetration during sexual intercourse after removal of inflatable penile prosthesis. J Sex Med 2012;9:2938–2942.
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