Rigi10™ Malleable Penile Prosthesis
Also Known As
Impotence, ED, male erectile dysfunction
Definition
Erectile Dysfunction (ED) is a prevalent and multifaceted condition, predominantly affecting males, characterized by the consistent or recurrent inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual performance.¹ It is important to note that ED is not considered a routine part of aging.² The condition can arise from a diverse range of causes, including organic (e.g., vascular, neurogenic, hormonal, or cavernosal) and psychogenic factors, and is often interwoven with comorbidities such as diabetes, cardiovascular disease, and neurologic disorders.¹ The mechanism of achieving an erection involves a complex interplay of psychological, neural, vascular, and hormonal signals that lead to increased arterial inflow and restricted venous outflow from the penis, resulting in tumescence and rigidity. ED occurs when there is a disruption in one or more of these pathways.¹ The primary purpose of understanding and defining ED is to facilitate appropriate diagnosis and management, thereby improving the quality of life for affected individuals and their partners.²
Clinical Context
Erectile Dysfunction is clinically relevant when a patient reports persistent difficulty in achieving or maintaining an erection adequate for satisfactory sexual intercourse.¹ It is often associated with various medical conditions, including cardiovascular disease (e.g., atherosclerosis, hypertension), diabetes mellitus, neurological disorders (e.g., multiple sclerosis, spinal cord injury, stroke), hormonal imbalances (e.g., hypogonadism), and psychological conditions (e.g., depression, anxiety, stress).¹ Patient selection criteria for evaluation and treatment typically involve a thorough medical, sexual, and psychosocial history, along with a physical examination.² Laboratory tests may be conducted to identify underlying conditions, such as checking fasting glucose or HbA1c for diabetes, lipid profiles for cardiovascular risk, and morning testosterone levels for hypogonadism.¹
Treatment approaches are typically tailored to the underlying cause and patient preferences, following shared decision-making.¹ Options range from lifestyle modifications (e.g., diet, exercise, smoking cessation) and oral medications (e.g., PDE5 inhibitors like sildenafil, tadalafil) to vacuum erection devices, intracavernosal injections, intraurethral suppositories, and, in some cases, surgical procedures such as penile prosthesis implantation.¹ Expected outcomes vary depending on the chosen treatment and the individual patient’s circumstances, but the goal is generally to restore satisfactory erectile function and improve quality of life. Success rates for treatments like PDE5 inhibitors are high in appropriate patients, while penile implants offer a permanent solution for those who do not respond to or are not candidates for other therapies.¹