Patient and Device Selection

Penile prosthesis (PP) has undergone significant innovation since its first inception in the early 1970s. Urologists are gradually embracing prosthetic urology practice by attending live surgical and cadaveric workshops. Knowing which PP to choose in a particular patient and what to counsel are vital to have a satisfied patient after the procedure. Modifiable risks factors such as diabetes, smoking and obesity should be optimised before the surgery. PP implantation in special scenarios such as solid organ transplant recipient, neurological impairment, HIV-positive status and synchronous artificial urinary sphincter placement have been addressed in this chapter. Involving both the patient and the sexual partner before the surgery in most of the discussions will alleviate their apprehension and expectations. Psychosexual counselling may be preferred in CURSED patients (Compulsive, Unrealistic, Revision, Surgeon Shopping, Entitled, Denial and Psychiatric) planning for PP. Majority of the papers published on PP are based on devices from Boston Scientific and Coloplast which are the major players in PP division. There are differences in antibiotic coating, material of the cylinders, axial rigidity of cylinders, lock-valve mechanism and shape and sizes of reservoirs and pump. Understanding on how to select the right device for a right patient is what this chapter offers to its readers.