US3832996A - Endoprosthesis for the penis and a method of endoprosthetic repair - Google Patents

Endoprosthesis for the penis and a method of endoprosthetic repair Download PDF

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Publication number
US3832996A
US3832996A US00323364A US32336473A US3832996A US 3832996 A US3832996 A US 3832996A US 00323364 A US00323364 A US 00323364A US 32336473 A US32336473 A US 32336473A US 3832996 A US3832996 A US 3832996A
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endoprosthesis
bars
penis
piece
cross
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V Kalnberz
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/26—Penis implants

Definitions

  • the fascia and the albuginea tunica of the cavernous bodies channels are formed, through which the endoprosthesis is inserted, with its spherical bulges directed toward the glans, until-these bulges are immersed in the cavernous bodies near the glans.
  • the cross-piece is positioned at the pubic bone. Then the endoprosthesis is sutured to the surrounding tissues, the ligature being passed through the orifices in the endoprosthesis.
  • the present invention relates to surgical methods of treatment of impotence, and more particularly, to endoprosthesis for the penis.
  • the endoprosthesis implies a prosthesis fitted within a human organism
  • the alloplastic materials imply materials compatible with the human tissues, such as the widely known polyethylene.
  • an endoprosthesis surgically fitted in the penis imparts to the latter a permanent elasticity (passive erection, the desired volume and length, requiring no fitting or removal of. the prosthesis); an endoprosthesis does not irritate the mucous membranes of the male and female genitals; endoprosthetic repair gives good results where the other methods of treatment fail; and endoprosthetic repair ensures a good cosmetic concealment of the fact of prosthesis.
  • an endoprosthesis formed by two bars of an alloplastic material polyethylene fitted in the cavernous body (see, for example, J. Med. Lib., 1965, 18, 365-369).
  • the bars of this prosthesis are freely placed in the cavernous bodies, so that they are likely to be displaced or may even emerge out of the cavernous bodies. Besides, such displacements contribute to the formation of scar tissue and prevent the patient from getting back his. own erection.
  • endoprostheses for the penis formed by two bars placed in the cavernous bodies and-stitched to the surrounding tissues. These prostheses, though not obstructing the restoration of autoerection, are unreliable, for in many cases they are fastened in place insecurely.
  • the known prostheses are completely immersed in the cavernous bodies or in thespace between the cavernous bodies (T-shaped prosthesis), which is fraught with injuries and adversely affects the chances of having autoerection restored.
  • an endoprosthesis for the penis made of an alloplastic material and having a support limiting its travel in a longitudinal plane, which, in accordance with the invention, is defined by a pair of bars rigidly interconnected at one end by means of a cross-piece placed proximally at the pubic bone and serving as a support for the prosthesis, whereas the other ends of the bars have spherical bulges placed, when fitted in the cavernous body, close to the glans.
  • the invention offers'an advantage which consists in that the cross-piece, ensuring the invariability of the spacing between the endoprosthesis bars, provides for a volumetric passive erection.
  • the crosspiece interacts with the pubic bone, thereby providing for a permanent lengthwise passive erection and for a secure attachment of the prosthesis.
  • the cross-piece is preferably bow-shaped, with the prominence turned toward the bulging ends of the bars, and disposed in a plane inclined at an angle of 50 to to the plane passing through the longitudinal axes of the bars.
  • Such an embodiment of the crosspiece provides for the greatest possible degree of compatibility of the prosthesis with the penis anatomy and also for the optimum interaction of the'support with the pubic symphysis.
  • the surfaces of the bars facing each other may be formed concave, which reduces the traumatism of the cavernous bodies at a permanent volumetric passive erection and also assists in the restoration of autoerection.
  • the method of. endoprosthetic repair with the pr posed prosthesis consists in that the albuginea tunica is incised at the base of the cavernous bodies and channels are formed .between the fascia and the albuginea tunica of the cavernous bodies of the penis; the bars of the endoprosthesis are inserted into the channels thus formed, with the spherical bulges of the bars directed toward the penis glans, until the bulging ends of the bars are immersed in the cavernous bodies near the glans and the cross-piece is immersed under the slingshaped and penis-retaining ligaments in the immediate vicinity of the pubic bone, and then the endoprosthesis is sutured to the surrounding tissues, passing the ligature through the orifices in the endoprosthesis.
  • Such a technique of endoprosthetic repair is less injurious for the cavernous bodies and provides for the simplicity and high reliability of attachment of the prosthesis, both at its proximal and distal ends.
  • the thickened ends of the endoprosthesis are preferably precovered with a homofascia, which permits increasing the size of the glans and contributes to the formation of a solid capsule between the bulge of the endoprosthesis and the glans, thereby improving the reliability of attachment of the distal end of the prosthesis, preventing bed sores and ruling out the possibility of perforation of the glans tissues.
  • the bar is best sutured with a homotendon, as such a method provides for a secure fixation of the proximal end of the endoprosthesis in the initial postoperative period, and subsequently promotes the implantation of the ligature in the tissues.
  • FIG. 1 is a plan view of an endoprosthesis, in accordance with the invention.
  • FIG. 2 is a view taken in the plane II-II of FIG. 1;
  • FIG. 3 is an endoprosthesis according to FIG. 1 with homofascia and a ligature
  • FIG. 4 is a longitudinal view of a penis with an endoprosthesis fastened in place
  • FIG. 5 is a view taken inplane V-V of FIG. 4;
  • FIG. .6 is a view taken in the plane VIVI of FIG. 4.
  • the endoprosthesis is formed by two bars 1 (FIG. 1) made of an alloplastic material, say polyethylene. Both bars are of an equal length which depends on the length of the penis; generally it ranges from 125 to 210 mm. At one end of the bars, which are positioned distally when installing the endoprosthesis in the penis, there are spherical bulges 2.
  • the two other ends of the bars 1, which are positioned in the penis proximally, are rigidly coupled by a cross-piece 3.
  • the surfaces of the bars 1 which face each other are concave (see FIG. 2).
  • the cross-piece 3 is bow-shaped and lies in a plane which is inclined at an angle of from 50 to 70 to the plane passing through the longitudinal axes of the bars 1.
  • Orifices 4 are provided at the points of connection of the bars 1 with the cross-piece 3 (FIG. 1).
  • a homofascia 5 in the form of a cap is fitted over the spherical bulges 2 (FIG. 3), and a ligature 6, made of a homotendon for instance, is passed through the orifices 4.
  • a homoalbuginea tunica instead of the homofascia, use can also be made of a homoalbuginea tunica.
  • skin 8 and subcutaneous connective tissue 9 are incised, under anaesthesia, for a distance of some 5 cm at the base of the penis 7 on the dorsal surface thereof. Fascia 10 of the penis 7 is also incised along the line of the skin incision. Albuginea tunica ll of cavernous bodies 12 is pulled out through the skin incision at the base of the penis 7.
  • channels are provided for inserting the bulged ends 2 of the bars 1 of the endoprosthesis into the distal ends of the cavernous bodies 12 near the glans 13 of the penis 7; simultaneously the optimum length of the endoprosthesis is determined.
  • channels are formed about the upper lateral surface of the cavernous bodies 12 (see FIG. 5) with an expanderprobe, through which channels the bars 1 of the endoprosthesis are inserted.
  • a guide-probe (not shown) is successively inserted into each orifice of the cavernous bodies near the glans of the penis 7, and with the help of it the bulged ends 2 of the endoprosthesis bars are immersed into the lumen of the distal ends of the cavernous bodies 12 (also see FIG. 6).
  • the edges of the orifices in the cavernous bodies 12 are united above the bars 1 of the endoprosthesis with the help of the earlier applied pursestring sutures.
  • the ligaments (retaining and sling-like) of the penis 7 are unimpaired, and the bars 1 are placed beside the cavernous bodies 12 leaving their lumen intact, with only the bulged ends 2 of the endoprosthesis inserted into the distalmost end of each cavernous body 12. Since the bars are in the main laid outside the lumen of the cavernous-bodies, the potential for an independent active erection of the penis is fully preserved.
  • the proposed prosthesis provides for the maximum passive erection of the penis both by length and by volume, irrespective of the degree and duration of the patients own autoerection, and also improves the fastening of the prosthesis inside the penis.
  • the albuginea tunica of the cavernous bodies was pulled out, with the sections of the albuginea tunica adjoining the penis glans mobilized into the wound.
  • Stay-sutures were applied to the albuginea tunica of the right and left cavernous bodies at the glans, and the albuginea tunica was incised along the length of the cavernous bodies for a distance of 0.9 cm.
  • a capron purse-string suture was applied to the edges of each orifice in the cavernous bodies, the ends of the sutures clamped.
  • a channel was formed with a curved clamp between the albuginea tunica at the base of the penis, the penis-retaining ligament and the sling-like ligament.
  • the endoprosthesis was installed with its cross-piece abutted against the pubic bone. Fascia] homocaps were fitted over the rounded and thickened ends of the bars.
  • channels were formed between the fascia of the penis and the albuginea tunica on the upper lateral surface of the cavernous bodies, and the bars of the endoprosthesis were immersed in these channels.
  • a guide-probe successively inserted into each orifice of the cavernous bodies at the glans, was used to immerse the homofascia-covered ends of the endoprosthesis into the lumen of the distal ends of the cavernous bodies.
  • the edges of the orifices in the cavernous bodies were joined above the endoprosthesis bars with the help of the previously applied purse-string sutures.
  • capron threads passed at the base of the endoprosthesis, the latter was fixed to the albuginea tunica of the right and left cavernous bodies at the pubic bone. Sutures were applied to the wound in layers.
  • the penis was ligature-fastened in an elevated position to the front abdominal wall.
  • the patient had been continuously treated throughout the entire three decades: took a variety of drugs, underwent physical therapy and was even subjected to surgical intervention transplantation of bovine testicular tissues according to Rumyantsev. Nevertheless, all the treatment strategies used had failed.
  • the patient was subjected to surgical endoprosthetic repair of the penis according to the present invention for impotence due to inadequate autoerection.
  • the bars of the endoprosthesis were mm long.
  • the postoperative period passed without complications.
  • the patient reports an improved general state of health, a higher tonicity, better sleep, etc.
  • the advantages of the above-discussed technique of endoprosthetic repair of the penis stem from a special shape of endoprosthesis, whereby it can be securely fastened to the penis tissues with the help of a homotendon, homofascia, homoalbuginea tunica, or other plastic material. Furthermore, thanks to its configuration, the endoprosthesis of this invention does not obstruct the restoration of autoerection.
  • the use of an endoprosthesis of the described construction and the combination of an alloplastic endoprosthesis with a biological fastening material provided for the following:
  • the patients who have undergone this kind of endoprosthetic repair, report that the results are stable and, in most cases, that they have autoerection back.
  • the operation has another manifest benefical effect: improved tonicity of the organism,'higher spirits, better sleep, .and so forth.
  • the patients would resume sexual life three months after surgery.
  • An endoprosthesis for the-penis comprising a pair of elongated bars constructed from an alloplastic material, a transverse cross-piece rigidly interconnecting respective ends of said bars, said cross-piece being disposed proximally at the pubic bone and defining means for supporting the prosthesis, the other respective ends of said bars each having a spherical bulge positioned at the glans when said bars are placed in the cavernous bodies.
  • a method of endoprosthetic repair utilizing a prosthesis comprising a pair of elongated bars rigidly interconnected at respective ends by a cross-piece with the other respective ends of the bars each having a spherical bulge, said method comprising the steps of successively incising the skin, the subcutaneous connective tissue and the fascia of the penis at the base of the cavernous bodies, forming channels between the fascia and the albuginea tunica of the cavernous bodies, inserting the bars of the endoprosthesis in the channels thus formed between the fascia and the albuginea tunica, with the spherical bulges on the ends of the bars directed through said channel toward the glans until the bulged ends of the bars are immersed in the cavernous bodies near the glans, and until the cross-piece of the endoprosthesis is immersed under the sling-like and penis-retaining ligaments in the immediate vicinity of the pubic bone, and thereafter suturing the endoprosthesis to the surrounding

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  • Health & Medical Sciences (AREA)
  • Reproductive Health (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)
US00323364A 1972-02-04 1973-01-15 Endoprosthesis for the penis and a method of endoprosthetic repair Expired - Lifetime US3832996A (en)

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SU1741410A SU413945A1 (cs) 1972-02-04 1972-02-04

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US (1) US3832996A (cs)
DE (1) DE2301282C3 (cs)
FR (1) FR2170024B1 (cs)
GB (1) GB1408323A (cs)
SE (1) SE401973B (cs)
SU (1) SU413945A1 (cs)

Cited By (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3893456A (en) * 1974-08-07 1975-07-08 Heyer Schulte Corp Penile prosthesis
US3987789A (en) * 1975-10-28 1976-10-26 American Medical Systems, Inc. Malleable penile prosthesis
US3991752A (en) * 1975-12-04 1976-11-16 Dow Corning Corporation Penile implant
US4066073A (en) * 1976-10-04 1978-01-03 Medical Engineering Corporation Composite rod penile implant
US4175554A (en) * 1978-03-16 1979-11-27 Gerow Frank J Prosthesis of male impotence
US4335714A (en) * 1980-07-17 1982-06-22 Medical Engineering Corporation Implant for penile construction
US4411260A (en) * 1980-11-24 1983-10-25 Walter Koss Penis prosthesis
US4517967A (en) * 1983-04-18 1985-05-21 Dacomed Corporation Penile prosthesis
US4522198A (en) * 1983-04-18 1985-06-11 Dacomed Corporation Penile prosthesis
US4559931A (en) * 1983-03-21 1985-12-24 Fischell Robert Manually actuated fully implantable penile erection device
US4572168A (en) * 1983-12-20 1986-02-25 Fischell Robert Fully implantable vapor pressure actuated penile erection device and method
US4881531A (en) * 1986-11-21 1989-11-21 Dacomed Corporation Position stable segmented column penile prosthesis
US5088477A (en) * 1989-11-28 1992-02-18 Louis Subrini Penile filling implant
US20090124851A1 (en) * 2007-11-12 2009-05-14 Kuyava Charles C Corrugated Expansion-Constraining Sleeve for an Inflatable Penile Prosthesis Cylinder
US20090131745A1 (en) * 2007-11-20 2009-05-21 George Stephanie A Prosthetic Device with Protrusions for Girth
US20090132044A1 (en) * 2007-11-15 2009-05-21 George Stephanie A Prosthesis with Bendable Central Region
US20090186717A1 (en) * 2008-01-17 2009-07-23 Nike, Inc. Golf Clubs and Golf Club Heads with Adjustable Center of Gravity and Moment of Inertia Characteristics
US8052593B2 (en) 2006-10-24 2011-11-08 Ams Research Corporation Implantable malleable penile prosthetic device
US8114011B2 (en) 2007-10-23 2012-02-14 Ams Research Corporation Corrugated inflatable penile prosthesis cylinder
US8911350B2 (en) 2007-10-23 2014-12-16 Ams Research Corporation Malleable prosthesis with enhanced concealability
US9801702B2 (en) 2010-12-16 2017-10-31 Boston Scientific Scimed, Inc. Artificial sphincter system and method
US10952855B2 (en) 2016-03-24 2021-03-23 Boston Scientific Scimed, Inc. Inflatable penile prosthesis with reversible flow pump assembly

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2728780B1 (fr) * 1994-12-28 1999-01-29 Louis Subrini Implants peniens extra caverneux
FR2951368B1 (fr) * 2009-10-16 2012-11-16 Jacques Derhy Implants volumetriques cosmetiques du penis

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE714925C (de) * 1940-05-08 1941-12-10 Dr Med Adolf Lorenz Vorrichtung zum Strecken des maennlichen Gliedes
US3446206A (en) * 1965-10-22 1969-05-27 Artus D De Lano Surgical splint

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE714925C (de) * 1940-05-08 1941-12-10 Dr Med Adolf Lorenz Vorrichtung zum Strecken des maennlichen Gliedes
US3446206A (en) * 1965-10-22 1969-05-27 Artus D De Lano Surgical splint

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
Pearman Dow Corning Bulletin July 1966, p. 10. *

Cited By (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3893456A (en) * 1974-08-07 1975-07-08 Heyer Schulte Corp Penile prosthesis
US3987789A (en) * 1975-10-28 1976-10-26 American Medical Systems, Inc. Malleable penile prosthesis
US3991752A (en) * 1975-12-04 1976-11-16 Dow Corning Corporation Penile implant
US4066073A (en) * 1976-10-04 1978-01-03 Medical Engineering Corporation Composite rod penile implant
US4175554A (en) * 1978-03-16 1979-11-27 Gerow Frank J Prosthesis of male impotence
US4335714A (en) * 1980-07-17 1982-06-22 Medical Engineering Corporation Implant for penile construction
US4411260A (en) * 1980-11-24 1983-10-25 Walter Koss Penis prosthesis
US4559931A (en) * 1983-03-21 1985-12-24 Fischell Robert Manually actuated fully implantable penile erection device
US4517967A (en) * 1983-04-18 1985-05-21 Dacomed Corporation Penile prosthesis
US4522198A (en) * 1983-04-18 1985-06-11 Dacomed Corporation Penile prosthesis
US4572168A (en) * 1983-12-20 1986-02-25 Fischell Robert Fully implantable vapor pressure actuated penile erection device and method
US4881531A (en) * 1986-11-21 1989-11-21 Dacomed Corporation Position stable segmented column penile prosthesis
US5088477A (en) * 1989-11-28 1992-02-18 Louis Subrini Penile filling implant
US8052593B2 (en) 2006-10-24 2011-11-08 Ams Research Corporation Implantable malleable penile prosthetic device
US9517133B2 (en) 2007-10-23 2016-12-13 Boston Scientific Scimed, Inc. Malleable prosthesis with enhanced concealability
US8114011B2 (en) 2007-10-23 2012-02-14 Ams Research Corporation Corrugated inflatable penile prosthesis cylinder
US8911350B2 (en) 2007-10-23 2014-12-16 Ams Research Corporation Malleable prosthesis with enhanced concealability
US8123674B2 (en) 2007-11-12 2012-02-28 Ams Research Corporation Corrugated expansion-constraining sleeve for an inflatable penile prosthesis cylinder
US20090124851A1 (en) * 2007-11-12 2009-05-14 Kuyava Charles C Corrugated Expansion-Constraining Sleeve for an Inflatable Penile Prosthesis Cylinder
US20090132044A1 (en) * 2007-11-15 2009-05-21 George Stephanie A Prosthesis with Bendable Central Region
US10070955B2 (en) 2007-11-15 2018-09-11 Boston Scientific Scimed, Inc. Prosthesis with bendable central region
US20090131745A1 (en) * 2007-11-20 2009-05-21 George Stephanie A Prosthetic Device with Protrusions for Girth
US8052594B2 (en) 2007-11-20 2011-11-08 Ams Research Corporation Prosthetic device with protrusions for girth
US20090186717A1 (en) * 2008-01-17 2009-07-23 Nike, Inc. Golf Clubs and Golf Club Heads with Adjustable Center of Gravity and Moment of Inertia Characteristics
US9801702B2 (en) 2010-12-16 2017-10-31 Boston Scientific Scimed, Inc. Artificial sphincter system and method
US11406483B2 (en) 2010-12-16 2022-08-09 Boston Scientific Scimed, Inc. Artificial sphincter system and method
US10952855B2 (en) 2016-03-24 2021-03-23 Boston Scientific Scimed, Inc. Inflatable penile prosthesis with reversible flow pump assembly

Also Published As

Publication number Publication date
DE2301282A1 (de) 1973-08-16
SU413945A1 (cs) 1974-02-05
SE401973B (sv) 1978-06-12
GB1408323A (en) 1975-10-01
DE2301282B2 (de) 1975-01-16
DE2301282C3 (de) 1975-09-04
FR2170024B1 (cs) 1976-05-14
FR2170024A1 (cs) 1973-09-14

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