Surgical treatment of impotence with Small-Carrion prosthesis. Preoperative, intraoperative, and postoperative considerations.

Since 1974, 900 patients with erectile dysfunction from various causes underwent implantation of a semi-flexible prosthesis, generally of the Small-Carrion type. The largest group had arteriosclerotic or hypertensive cardiovascular disease. The second largest group was composed of patients with diabetes mellitus. Those in the third group had undergone prostatectomy, cystectomy, or abdominal-perineal resection. For a large number of patients a diagnosis of psychogenic impotence was reached, mainly from the results of the history questionnaire and the Minnesota Multiphasic Personality Inventory. Complications were rare (8.1%). Preoperative, intraoperative, and postoperative considerations include correct selection of prosthesis, rigorous antibiotic coverage, prevention or care of perforation, and possible need for reoperation. The results were almost uniformly successful. Psychogenic cases and instances of infertility related to the impotence are reviewed.