IMPLANT INFORMATION about the Urogenital System

09 basic information about UROGENITAL SYSTEM, SEX ORGANS INFORMATION by ANATOMY


	What … for? (Indications) Urinary tract implants help at · Female/male stress urinary incontinence (SUI), · urinary retention · overactive bladder in patients who have failed or could not tolerate more conservative treatments (Sacral Neuromodulation) and · Postprostatectomy incontinence (PPI)
				Injection of an implantable material to reduce flow at incontinence
	Sex organ implants (only male) help at · Erectile dysfunction · Micropenis and · Repair after removal of testicels			Penile Implants (types) · Non inflatable penile implant · Two-Piece inflatable penile implant · Three-piece (multicomponent) inflatable penile implant
	Numbers No reliable statistic numbers. Penile prosthesis: 20000-30000 devices annualy worldwide (Urology Team, P.A.)			Principle of string surgery
	Times n/a
	Contraindications	behavioral	Quite a number of incontinence as well as penis problems don´t need surgical intervention and may be treated on a psychological basis Considering the following facts: · One in three women who have had a baby experience loss of bladder control. · One in five children wet the bed at some time. · One in 100 adults never achieve bladder control at night. · One in 20 adults experience bladder and bowel control problems





		medical	Incontinence: Severe incontinence is not likely solved with sling procedures, bladder disorders, inadequate tissue integrity at the bladder neck or urethra, active urinary tract infection, pure urge incontinence, prior radiation therapy, cancer.


			Bladder Neurostimulation is not indicated at mechanical obstruction, prostatic hypertrophy, cancer, urethral stricture, no adequate response to test stimulation, unability to operate the tool.
			Penis implants: They are not indicated at psychogenic reasons, diseases of the lower urinary tract, internal erosion or adhesion, low reliability for follow-up care.
		during surgery	n/a
	Risks	during surgery	Nerv cutting.
		short term	Infection, hemorrhage, urethral obstruction, stress urinary incontinence, urge incontinence, urinary retention

		long term	Sling rejection, perforation.
			Chronic infection, tearing of skin, scarring, permanent loss of sexual function, loss of sensation in the penis, impotence.
			Malfunction of implant, penis implants may stay for 4-8 years.
		restrictions	Sling surgery: 2-3 days in hospital, 2-4 weeks recovery period, obstipation possible.

			Penis implant: pain for about 4 weeks. oral medication, driving is prohibited, no sexual activity for 6 weeks.
	Failures	n/a, too many varieties
	Material	autologous	fascia lata		fresh frozen/freeze dried,
					solvent-dehydrated
					irradiated
			fat
		allogenic	human dermis
			collagen bovine
			porcine collagen		Fortagen® CuffPatch™
		xenogenous	dermis porcine
			small intestinal submucosa		porcine
		alloplastic	Silicone
			Polymethylsiloxane
			Polyethylene		Marlex®,
			Polypropylen		Prolene®
			Acellular Collagen Matrix		Pelvicol®
			Polyglactin 900		Vicryl mesh
			Expanded polytetrafluoroethylene PFTEe		Gore-Tex
			Polyethylene terephthalate		Mersilene
			Hydroxyapatite		Coaptite®
			Belladerm matrix graft		(penis widening)
			Titanium beads with magnetic cores		Effectiveness has not been demonstrated
		Implantable bladder pacing system, bladder stimulator
	Statistics	Incontinence surgery: 80-85% success rate (Comiter CV)
		Bladder stimulation/Sacral Nerve Stimulation (SNS)/Percutaneous Tibial Nerve Stimulation (PTNS): 63-64% success rate (Anthem)
		Penis implant: n/a
	Literature	– Basic	Materials for Reconstructive Gynecologic Surgery, Dooley et al. 2009 Opinion on the safety of surgical meshes used in urogynecological surgery (EU Scientific Committee)
		– Problems	n/a
		– Science/ Future	n/a
	Medical societies	see here

	Criticism	Urinary incontinence: n/a
		Penis Enlargement: Does it work?
	Selected patient informations	Urinary Incontinence (NIH) Urinary incontinence – Surgery and procedures (NHS) Bladder and Urethral Surgery (Intermountain Healthcare) Penis Enlargement Fact vs. Fiction Penis enlargement Penile implants (Statement: We didn´t find any independend, scientific research data about penis enlargement. Beside surgical interventions there are different options)




Register for patients	n/a
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