The Penile Prosthesis and Diabetic Impotence: Some Caveats

Literature published as of January 1978 contains reports of 103 diabetic men who have undergone implantation of a penile prosthesis as treatment for sexual impotence. Two forms of prosthesis have been used. One procedure involves the use of semi-rigid silicone rods. The other procedure uses inflatable silicone rubber cylinders. Both devices have yielded very high success rates within diabetic populations. Prospective recipients of a penile prosthesis should undergo extensive evaluation geared toward discrimination of organic versus psychogenic factors contributing to the sexual dysfunction. Before recommending prosthesis implantation, the physician should assess the expectations of the patient and his regular sex partner regarding the effects of the procedure. The stability of the patient's relationship with his regular sex partner should be considered an important determinant of response to implantation. Controlled investigations regarding the short- and long-term effects of this procedure are still needed.