Mehmet Bilgehan YÜKSEL, Bilal GÜMÜŞ, Erdem ÖZBEK, Volkan TATLI

Erektil disfonksiyon tedavisinde penil protez implantasyonu uygulaması sonuçlarımız: 9 yıllık cerrahi deneyim analizi

Amaç: Bu çalışmada penil protez implantasyonu konusunda 9 yıllık klinik deneyimimizin aktarılması amaçlandı.Gereç ve Yöntemler: 2003- 2011 yılları arasında kliniğimizde erektil disfonksiyon ED tanısı ile penil protez implantasyonu yapılmış 94 hastanın verileri retrospektif olarak incelendi. Protez cerrahisi yapılacak tüm hastalarla cerrahi öncesi bilgilendirme amaçlı bire bir görüşme yapıldı. Protez cerrahisi öncesi tüm hastalar istisnasız olarak bölgesel mekanik temizlik sonrası cerrahiye alındı. Protez implantasyonu için penoskrotal kesi kullanıldı. Bulgular: 94 hastaya penil protez implantasyonu yapıldı. Yaş ortalaması 58.76’ydı. 43 hasta radikal pelvik cerrahi sonrası gelişen ve 51 hasta ise radikal cerrahi dışı organik nedenlerle oluşmuş ED’ a sahipti. Uygulanan ptotezlerin 48’ i bükülebilir ve 46’ sı şişirilebilir protez olup bunların da 42’si 2 parçalı ve 4’ü ise 3 parçalı protezdi. Ortalama cerrahi süresi 70,01 dakikaydı. 94 uygulamanın 87’si %92.5 başarılı sonuçlandı. 6 hastada cerrahi sonrası penil ağrı, 1 hastada penoskrotal hassasiyet ve kaşıntılı lezyon, 6 hastada cerrahi sonrası enfeksiyon ve 2 hastada mekanik protez arızası gözlendi. Enfeksiyon gelişen 2 hasta medikal yolla tedavi edilirken, 4 hastada protez çıkarılıp enfeksiyon tedavisi sonrası tekrar malleable protez takılarak tedavi sağlandı. Mekanik protez arızası oluşan 2 hastada fonksiyonu bozulmuş protez çıkarılıp yerine 2 parçalı şişirilebilir protez takıldı. Ayrıca 3 parçalı protez takılan bir hastada hastanın penil ağrı ve protezi kullanamama şikayetleri nedeniyle protez çıkarıldı; ancak hasta istemediği için tekrar yeni protez takılmadı.Sonuç: Kliniğimizde penil protez implantasyonu kabul edilir başarı oranı ve makul komplikasyon oranları ile uygulanan bir tedavi yöntemidir

Anahtar Kelimeler:

Erektil disfonksiyon, penil protez implantasyonu, cerrahi deneyim

The results of penile prothesis implantation in the treatment of erectyle dysfunction: The analysis of 9 years surgical experience

Objectives: We aimed to present our 9 years of clinical experience in penile prosthesis implantation PPI .Material and Methods: Between 2003-2011, the data of 94 patients who underwent PPI surgery in our clinic were retrospectively analysed. Prior to the surgery, all patients had an clinical interview and also underwent psychiatric evaluation for informational purposes. A regional mechanical cleaning was performed in all patients prior to surgery. The penoscrotal incision was used in all.Results: PPI was performed in 94 patients. The mean age was 58,76. 43 patients developing after radical pelvic surgery and 51 patients due to organic reasons except for radical surgery had occurred erectile dysfunction. 48 malleable and 46 inflatable prosthesis were applied. 46 inflatable penile prosthesis contained 42 two pieces and 4 three pieces prosthesis. Average surgical time was 70.01 minutes. In 94 application, 87 92.5% was successful. Penile pain after surgery in 6 patients,1 penoscrotal sensitivity and itchy lesions, infection in 6 patients and mechanical prosthetic failure in 2 patients were observed. While infections were terated by medical treatment, 4 infected patients were treated by removing old prosthesis and re-inserting new one after medical teratment. The non-functional prosthesis related to mechanical failure was removed, new 2-pieces inflatable prostheses were inserted in. In 1 patient, the prosthesis was removed and not inserted again.Conclusion: In our clinic, penile prosthesis implantations are performed with reasonable success and complication rates

Keywords:

Erectile dysfunction, penile prosthesis implantation, surgical experience,

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