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Urethral Strricture
Urethral stricture is a medical condition caused by the narrowing of the urethra due to the development of scar tissue. This condition can make urination difficult and, if left untreated, lead to serious complications such as recurrent infections, bladder stones, and kidney damage. Men are more commonly affected, and the causes include trauma, infections, prior surgeries, or prolonged catheter use.
Symptoms of urethral stricture vary but often include a weak urine stream, painful urination, frequent urination, and the sensation of incomplete bladder emptying. Early diagnosis and treatment are crucial to restoring normal urinary function and preventing further health problems.
Open Surgery Urethroplasty
1. Inflatable Penile Implants
Inflatable implants are devices that can be inflated to create an erection and deflated afterward. These come in two designs:
○ Three-piece inflatable implants:
Consist of three components:
■ A fluid reservoir placed under the abdominal wall.
■ A pump and release valve in the scrotum.
■ Two inflatable cylinders inside the penis.
○ Fluid is pumped into the cylinders for an erection, and after intercourse, the fluid is returned to the reservoir, restoring the penis to its normal state.
○ Two-piece inflatable implants:
Combine the reservoir with the pump, both located in the scrotum, simplifying the structure and implantation process.
2. Semi-Rigid (Malleable) Implants
Semi-rigid implants consist of flexible rods placed inside the penis. These rods can be manually adjusted for sexual activity or positioned discreetly when not in use.
○ The design includes segmented rods with springs for easier bending.
○ This type has fewer mechanical parts, reducing the risk of malfunction or complications.
How is a Penile Prosthesis Implanted?
Penile prosthesis surgery is performed under general or spinal anesthesia by skilled urologists. The steps include:
1. An incision is made near the base of the penis, lower abdomen, or scrotum.
2. The corpora cavernosa (two spongy chambers in the penis that usually fill with blood for an erection) are prepared for the implant.
3. The chosen prosthesis is inserted:
○ For a two-piece inflatable implant, the pump and valve are placed in the scrotum.
○ For a three-piece implant, the fluid reservoir is placed under the abdominal wall, possibly requiring a second incision.
4. The incision is closed, and post-operative care begins.
How Do Penile Prostheses Work?
● Semi-Rigid Implants: These remain in a semi-erect state and can be manually positioned for intercourse. Bendable versions allow discreet positioning.
● Inflatable Implants: A pump in the scrotum is used to transfer fluid to the penile cylinders, creating an erection. After…
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