Rigi10™ Malleable Penile Prosthesis
Also Known As
Penile prosthesis implantation with modeling, IPP with straightening maneuvers, prosthetic correction of penile curvature, penile reconstruction with prosthesis, surgical penile deformity correction, penile prosthesis with adjunctive straightening procedures
Definition
Penile straightening refers to the surgical correction of penile curvature during prosthesis implantation, a procedure primarily performed for patients with Peyronie’s disease (PD) who also have erectile dysfunction (ED).1 This therapeutic approach involves the implantation of an inflatable penile prosthesis (IPP) with or without additional straightening maneuvers to correct the abnormal curvature or deformity of the penis caused by fibrous plaques in the tunica albuginea.2 The procedure aims to simultaneously address both erectile function and penile deformity, allowing for satisfactory sexual intercourse.3 Various techniques may be employed during the procedure, including manual modeling, plication, plaque incision/excision with or without grafting, depending on the severity and characteristics of the curvature.4
Clinical Context
Penile straightening during prosthesis implantation is primarily indicated for patients with Peyronie’s disease who also have concurrent erectile dysfunction refractory to medical therapy.1 This condition affects approximately 3-9% of the general male population, with erectile dysfunction occurring in up to 58% of these cases.2 The procedure is typically performed during the chronic phase of Peyronie’s disease, characterized by stabilized penile deformity and resolved inflammation, usually occurring 12-18 months after disease onset.3
Patient selection is crucial for optimal outcomes, with comprehensive preoperative counseling being essential to manage expectations regarding potential penile shortening, which occurs in up to 54% of patients.4 The surgical approach depends on several factors, including the degree of penile curvature, penile length, presence of extensive plaque calcifications, and the patient’s preoperative erectile function.1
The procedure begins with the implantation of an inflatable penile prosthesis, which alone may resolve curvature in 33-90% of patients.5 For residual curvatures, additional straightening techniques may be employed:
- Manual modeling can correct residual curvature with an 86-100% success rate, but carries a 4% risk of urethral injury5
- For post-modeling residual curvatures exceeding 30 degrees, plaque-releasing incision or plication is recommended5
- Grafting is typically employed if the resulting incisional defect is larger than two centimeters5
Patient satisfaction rates range from 72-100%, with partner satisfaction rates reported at approximately 89%.5 Potential complications include penile shortening, reduced sensitivity, device deviation, infections (3-9%), mechanical failure (7%), persistent curvature (4%), and erosion (2%).4,5