CA1134554A - Penile implant - Google Patents

Penile implant

Info

Publication number
CA1134554A
CA1134554A CA000348266A CA348266A CA1134554A CA 1134554 A CA1134554 A CA 1134554A CA 000348266 A CA000348266 A CA 000348266A CA 348266 A CA348266 A CA 348266A CA 1134554 A CA1134554 A CA 1134554A
Authority
CA
Canada
Prior art keywords
implant
chamber
rod
distal portion
sleeve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA000348266A
Other languages
French (fr)
Inventor
Roy P. Finney
Henry W. Lynch
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medical Engineering Corp
Original Assignee
Medical Engineering Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Medical Engineering Corp filed Critical Medical Engineering Corp
Priority to CA000348266A priority Critical patent/CA1134554A/en
Application granted granted Critical
Publication of CA1134554A publication Critical patent/CA1134554A/en
Expired legal-status Critical Current

Links

Abstract

PENILE IMPLANT A penile prosthesis which is adapted to be surgically implanted in man for the treatment of erectile impotence includes two separate penile implants each comprising an elongated, flexible rod having a short proximal portion of relatively stiff material which is adapted to be implanted into the root end of the corpus cavernosum to support the implant and a longer distal portion of softer material which is adapted to be implanted into the corpus cavernosum of the pendulus penis. A flexible, cylindrical sleeve is positioned axially about an intermediate section of the distal portion of the rod and is sealed at its ends to the rod in a fluid tight manner to form a chamber for pressurizing fluid. The implant also includes a pressure bulb for pressurizing fluid; tubing communicating between the chamber and the pressure bulb; and valve means for controlling the flow of fluid between the pressure bulb and the chamber. In a preferred embodiment, the entire implant is made of silicone elastomer and the pressure bulb is sized to be implanted into the scrotal sac.

Description

s~

In some instances of erectile impotence in which the patient does not respond to more conventional therapy, the surgical implanting of a penile prosthesis may be the only practical means of remedying the impotency.
In the past, several types of penile prostheses have been employed. The first type is a rod oE suitable stiffness which is surgically implanted into the corpus cavernosum of the penis. The major disadvantage of the rod-type implant is the permanent stiffness of the rod which can be a source ; 10 of physical pain as well as embarrassment to the patient.
The other type of penile prosthesis which is available is the inflatable prosthesis. The most common inflatable prosthesis includes two fairly long inflatable tubes that are surgically implanted in the corpus cavernosum of the penis. Each of the two tubes is connected by tubing to a pressure bulb of inflating fluid which is implanted elser~here in the body. Because of the volume required to pressurize and rigidize the inflatable tubes, the pressure bulbs are relatively large.
Ano-ther inflatable penile prosthesis has two implants each having its own relatively large pressurizing bulb which is surgically implanted in the scrotal sac. The penile implant includes a non-distensible stem portion made of a relatively stiff silastic material which supports the implant and an integral collapsible bag-like distensible portion which is implanted into the cavernosum of the pendulus penis.
Inflatable implants currently available must be inflated periodically to prevent the scar tissue capsule which forms a~out the implant from bridging folds in the abric of the inflatable or distensible portion and preventing the implant from becoming fully inflated~

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It is tlle general object of the present invention to disc].ose a superior inflatable penile prosthesis.
The present invention provides a penile implant comprising: ~a) an elongated, flexible rod of physiologically inert Material having a relatively short proximal portion adapted to be inserted into the root end of the corpus cavernosum of a penis, and a longer distal portion adapted to be implanted in the corpus cavernosum of the pendulus penis; [b) a sleeve - axially positioned about an intermediate section of the distal portion of ~:~ said rod and sealed at each end of the rod to form an elongated pressurizable chamber; (c) a pressure bulb for pressurizing fluid for said chamber; (d) means connecting the chamber and the pressure bulb so that pressurizing fluid can be introduced into and removed from the chamber; and (e) valve means for controlling the flow of fluid.between the chamber and the bulb. In a preferred form of the invention, there are two separate penil implants each having its own separate pressure bulb which is adapted to be implanted into the scrotal sac.
; The short, proxlmal portion of the flexible rod of the implant is preferably relatively stiff and, when impanted into the root end of the corpus cavernosum, anchors and supports the implant. The longer distal ~: 20 portion of the rod may be relatively soft and more flexible than the proximal portion. A more flexible, soft distal portion of the rod causes a minimum of irritation to the tissue of the penis and permits the pendulus penis to assume a normal. position when the implant is not inflated. In a preferred embodiment, the tip of the distal portion of the rod is paraboloidal in shape to ,~

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fit the end of the corpus cavernosum, and to enhance the physiological compatibility of the implant.
The relatively small volume cha~ber which is formed by sealing the ends of the axially positioned cylindrical sleeve to and about the rod normally contains residual pressurizing fluid and it can be further pressurized with a small amount of fluid from the pressure bulb to rigidize the implant and to affect a penile erection. The presence of the rod in the chamber also effectively prevents the transfer of too much fluid back to the pressure bulb. The portion o ., the flexible rod which extends through the pressurizing , chamber also prevents the fabric of the sleeve which forms the outer wall of the chamber from forming deep folds when the implant is deflated. The scar tissue of the capsule which surrounds the implant otherwise could bridge such folds preventing the implant from becoming fully inflated when later pressurized.
Brief Description of the Drawings . .
- Fig. 1 is a partial sectional view of the penile prosthesis of thepresent invention in a depressurized condition as surgically implanted in a male;
Fig. 2 is a cross sectional view taken along the lines 2-2 in Fig. 1;
Fig. 3 is a view similar to Fig. 1, except the prosthesis is fully pressurized;
Fig~ 4 is a view taken along line 4 4 in FigO 3;
and ~ Fig. 5 is an enlarged vlew of a preferred sleeve `~- fabric.
As seen in Figs. 1-4, the penile implant 10 comprises an elongated rod 11 of a physiologically iner~ material such ~L~3~5Si~

as medical application sillcone rubber. The rod ll has a short, proximal portion 12 of relatively stiff material which is implanted in the root end of the corpus cavernosum to support and anchor the implant, and a longer distal portion 13 of a softer, more flexible material which is implanted into the corpus cavernosum of the pendulus penis. The distal portion 13 has a tip 14 which is paraboloidal in shape to conform to the inner shape of the end of the corpus cavernosum.
Positioned axially about an intermediate section of the distal portion 13 is a sleeve 15 of silicone coated fabric which is sealed at its ends 16 and 17 to the rod in a fluid-tight manner to form a cylindrical chamber 18 for pressuriziny fluid. The seals between the ends 16 and 17 of the sleeve 15 and the rod ll are preferably made with a suitable silicone adhesive~
Referring to Figs. 1 and 3, it can be seen that communication between the chamber 18 and a pressure bulb ; assembly 19 containing a pressurizing fluid 20, such as saline is provided by a length of silicone rubber tubing 21. ~he pressure bulb assembly 19 which is implanted in the scrotal sac includes a pressure bulb 22 and a valve 23 for controlling the flow of pressurizing fluid 20 between the pressure bulb 22 and the chamber 18. The valve means 23 is preferably a normally closed valve which is opened manually be squeezing the valve body or the pressure bulb and which can either be closed by additional manipulation or which although not completely closed delays the return of fluid to the bulb for a suitable period of -time.
Referring specifically now to Fig~ l, it can be seen that when the chamber 18 of the implant is depressurized the soft, relatively flexible distal portion 13 of the rod ll ~L~3~

permits the penis to assume a substantially normal, flaccid position. As seen only in Fig. 2, the chamber 18 contains a small amount of residual fluid 20 even when the implant 10 ; is depressurized. The residual fluid 20 within the chamber 18 cooperates with the rod 11 to keep the fabric of the sleeve 15 from forming deep folds into which the scar tissue of the capsule which forms about the implant 10 can grow to interfere with the later expansion of the chamber.
Referring now to Figs. 3 and 4, it can be seen that when the penile implant 10 is pressurized the chamber 18 is filled and distended by pressurized fluid 20 and the soft, flexible distal portion 13 of the rod 11 is supported by the pressurized sleeve 15 so that the penis assume a substantially normal erectile form.
As seen in the drawings in both its depressurized and pressurized states the proximal portion 12 of the penile implant 10 is anchored in the root end of the corpus cavernosum, and the paraboloidal tip 14 is positioned in the glans end of the corpus cavernosum. As a result~ the implant 10 is at all times positioned correctly in the corpus cavernosum of the penis and the likelihood of displacement is minimized.
Although in the drawings a single penile implant 10 is shown, the complete penile prosthesis will normally include two separate penile implants each having its own - pressurizing ~ulb which is surgically implanted in the scrotal sac The unique construction of the penile implant of the present invention which includes an intermediate section of the distal portion of the rod 11 within the chamber 18 minimizes the amount of fluid 20 needed to pressurize and regidize the lmplant 10. As a result, the pressure bulbs ~L~3~i5~1L

22 can be relatively small in size, approximately 10 to 15 cc in volume, and thus, can be conveniently implanted in the scrotal sac, if desired, replacing the testes.
The pressure bulb 22 which is of flexible resilient material can be provided with a small, integral resealable valve (not shown), if desired, so that additional fluid can be added to the pressure bulb 22 with a hypodermic needle after the bulb 22 has been implanted.
; To effect a penile erection, the chamber 1~ of a ~ 10 properly implanted prosthesis is filled by forcing pressurizing ; fluid 20 from the pressure bulb 22 through the valve 23 via the tubing 21 into the chamber 18 formed by the rod 11 and sleeve 15. The pressurizing fluid 20 fills the chamber 18 and stiffens the penis adequately for sexual intercourse. ~ `
When it is desire to depressurize the implant 10, the pressurizing fluid ~0 is permitted to drain from the chamber 19 ;~
back via the tubing 21 through the valve 23 into the pressure ; bulb 22~ Once an adequate amount of fluid 20 has been returned to storage in the pressure bulb 22 the penis is flaccid and the patient can engage in activities without fear of embarrassment of pain.
In the foregoing description, the proximal portion 12 of the rod 11 has been described as being stiff whereas the distal portion 13 has been described as being relatively flexible. While the term '1stiff" has been used to describe the desired physical properties of ~he material of the rod, a more precise and technical term is fle~ural modulus, which is the ratio of applied force to resulting deflection. How-ever, most tables of properties do not descrlbe the stiffness properties of rubber or rubber-like material 4 However~ they do list related properties such as hardness.

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Hardness is measured by a durometer such as a Shore A durometer which ascertains the depth of penetration of a specific indentor into a specimen under specified conditions.
A scale is chosen 50 that 9 represents a material showing no measurable resistance to indentation and 100 represents a material showing no measurable indentation.
;~ In the preferred embodiment of the invention, the proximal portion 12 of the rod 11 has a Shore hardness of about 70, the distal portion 13 has a Shore hardness of about 20, and the material has sufficient tensile strength for its intended use. Although a material of the described characteristics is preferred~ any material which performs satisfactory under conditions of use can be employed.
The rod 11 is preferably molded as a single piece or the distal and the proximal portions can be ~oined by a hinge.
The stiffness of a silicone rod can be controlled by the type and amount of catalyst used to cure the elastomer and the amount of heat and time employed during the curins or ;~ vulcanizing process.
The rod 11 may take other form than that described.

For example, the rod may instead of being a solid silicone piece be a cylinder of sponge or foam, with or without reinforcement. Thereforel the word "rod" as used in the specification and claims is intended to cover any structure functionally eq~ivalent to that described for purposes of illustration.
The sleeve 15 is preferably made of a silicone elastomer coated woven or knit fabric which provides to a limited predetermined expansion to allow the penis to become longer and to contain the pressure so that the tunica albuginea will not distend. A preferred form of woven fabric !

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is shown in Fig. 5. As seen in the drawing, the axial threads 24 of the fabric are normally crimped and the lo~gitudinally extending threads 25 are straight. A silicone coated fabric of this design wlll expand to a limited extent axially and not expand longitudinally~ Alternatively, the sleeve 15 also can be made of a material which does not distend either axially or longitudinally.
The diameter of the sleeve 15 is preferably such that the rod 11 fills the major portion of the chamber 18.
Therefore, even when the implant is depressurized and the ~; sleeve is of the nonexpanding fabric, the rod 11 will cooperate with the small amount of residual fluid 20 which remains in the chamber 1~ to prevent deep folds from forming in the fabric of the sleeve. The use of a sleeve material which does not distend or distends only to a limited extent makes is possible ~ to raise the fluid pressure in the sleeve to the desired high - -,~ level with only a minimum of pressurizing fluid. Therefore,small volumepressure bulbs which can be implanted in the scrotal sac can be usedO
The preferred method of implantation of implant 10 is througll the perineum. After appropriate incision, the corpus cavernosum is dilated distally and proximally to , accept the implant. The appropriate anatomical measurements; are made to insure that the proximal portion 12 of implant 10 will be positioned at the base of the penis below the pelvic bone. An implant having an appropriately sized distal portion 13 is obtained and the distal portion inserted into the corpus cavernosum of the penis~ The proximal portion 1~ of the implant 10 is cut to the appropriate length. During the manufacture of implant 10 the length of proximal portion 12 may be deliberately made lon~er than necessary thereby ,. .
',', ~::

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permitting it to be trimmed to the correct length at the time of surgery. Only one implant of each distal portion length need, therefore, be available since other anatomical size variations may be accommodated by trimming proximal portion 12. This greatly reduces the number of implant sizes which must be produced over that which would be required i~ no such size alteration were possibleO
I Proximal portion 12 is inserted in the dilated crus ;~ a~ter trimmin~. The incision is then closed. The identica]
procedure is formed on the other side of the penis to complete the surgical procedure. Distal portions 12 of the two implants may diverge laterally to accommodate the anatomy and provide lateral stability to the penis.
In the preferred embodiment, all the paxts and components of the prosthesis are made of medical application silicone rubber which is non-reactive r non-toxic and well tolerated by the adjacent organic tissues. Silicone rubber is preferred because it i6 quite resistant to wear and tear and remains functional ~or long periods of time. However, other suitable materials may be employed, if desired.
It will be readily apparent to those skilled in the art to which this invention relates that a variety of changes and modificAtions might be made without departing from the ; spirit and scope of the invention.
For example~ although in the drawings the tubing 21 is shown as passing through the rod 11 and emptying directly into the chamber 18 other constructions may be employed.
For instance/ the intermediate portion of the rod 11 within the chamber 18 could be provided with a central bore and wall openings that communicate with the bore and chamber so that the tubing 21 could communicate directly with the bore and s~

indirectly with the chamber. Another modification that could be made would be to have the tubing ?l not pass ~hrough the body of the rod 11, but communicate with the chamber 18 through a port in the wall of the sleeve 15.
Furthermore, if desired, the sleeve 15 may take the initial ~hape of a curved tubular member as opposed to the cylinder described and shown in the drawings. The forming of a curved tubular sleeve in approximately the shape that the sleeve assumes when the implant is in the depressurized state further minimizes the likelihood of folds forming which can be encapsulated by scar tissue. However, in order to ~-~
. :~
permit the curved tubular sleeve to assume the shape of a cylinder upon pressurization, it may be necessary to have selected longitudinal threads of the woven or knit fabric of the sleeve crimped to permit a limited longitudinal extension.
From the foregoingt it will be apparent that the description has been for purposes of illustration and is not intended to be limiting.

:

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Claims (7)

The embodiments of the invention in which an exclusive property or privilege is claimed are the following:
1. A penile implant comprising:
(a) an elongated, flexible rod of physiologically inert material having a relatively short proximal portion adpated to be inserted into the root end of the corpus cavernosum of a penis, and a longer distal portion adapted to be implanted in the corpus cavernosum of the pendulus penis;
(b) a sleeve axially positioned about an intermediate section of the distal portion of said rod and sealed at each end of the rod to form an elongated pressurizable chamber;
(c) a pressure bulb for pressurizing fluid for said chamber;
(d) means connecting the chamber and the pressure bulb so that pressurizing fluid can be introduced into and removed from the chamber; and (e) valve means for controlling the flow of fluid between the chamber and the bulb.
2. The implant of claim 1 in which the distal portion has a tip of paraboloidal shape to conform to the normal shape of the tip of the corpus cavernosum.
3. The implant of claim 1 in which the proximal portion of the rod has a stiffness of about 70 Shore.
4. The implant of claim 1 in which the distal portion of the rod has a stiffness of about 20 Shore.
5. The implant of claim 1 in which the components are made of silicone rubber.
The implant of claim 1 in which the sleeve is comprised of a fabric coated with silicone rubber which fabric expands to a predetermined limited extent to allow the penis to become larger and to contain the pressure so that the tunica albuginea will not distend.
7. The implant of claim 6 in which the sleeve is formed of a silicone coated fabric which has axial threads that are crimped when the chamber is not pressurized and the degree of axial expansion of the sleeve is limited to that afforded by the straightening of the axial threads.
CA000348266A 1980-03-24 1980-03-24 Penile implant Expired CA1134554A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA000348266A CA1134554A (en) 1980-03-24 1980-03-24 Penile implant

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CA000348266A CA1134554A (en) 1980-03-24 1980-03-24 Penile implant

Publications (1)

Publication Number Publication Date
CA1134554A true CA1134554A (en) 1982-11-02

Family

ID=4116544

Family Applications (1)

Application Number Title Priority Date Filing Date
CA000348266A Expired CA1134554A (en) 1980-03-24 1980-03-24 Penile implant

Country Status (1)

Country Link
CA (1) CA1134554A (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7867162B2 (en) 2008-04-07 2011-01-11 Coloplast A/S Implantable fluid devices

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7867162B2 (en) 2008-04-07 2011-01-11 Coloplast A/S Implantable fluid devices

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