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Mar 20, 2019/ 0 Comments / in Male health / by

The Rosselló Medical Institute receives the first distinction in Spain as “Center of Excellence for Penile Prosthesis Surgery.”

Penile prosthesis is the ultimate solution for patients suffering from severe erectile dysfunction, and to whom drugs are ineffective or contraindicated. Around 400 penile prosthesis are placed in Spain.

Dr S. Wilson, North American urologist with the largest experience in penile prosthesis surgery, awarded this distinction to Palma’s Rosselló Medical Institute.

For more than 40 years, Dr Rosselló Barbará saw in the penile prosthesis, which by then was an almost unknown option in Spain, an opportunity to restore erection and to give back to men (and their partners) their sexual life. After having placed more than 1,700 penile prosthesis, Dr Rosselló Barbará and his son, Dr Rosselló Gayá, have the greatest experience accumulated in this kind of surgery within Spain. They own two centres, one in Palma de Mallorca and another one in Madrid, which have both been elected as teaching centres for this sort of surgery at national and international level by prosthesis manufacturers.

However, in some fora, penile prosthesis has received bad press as well as unfounded criticism, due to a clear lack of knowledge, despite its unquestionable efficacy and the high degree of satisfaction on the part of prosthesis wearers. According to Dr Rosselló Barbará, “Most complications with penile prosthesis are usually due to medical teams with limited experience, who place just a few prosthesis per year. Usually, if there is not a mechanical failure, the problem is not the prosthesis but the lack of a medical protocol that entails a badly selected patient, a badly selected prosthesis model, an incorrect surgical technique or incorrect post-surgical care.

Dr Steven Wilson, who has performed many surgeries with Dr Rosselló, established the “Centre of Excellence” brand in penile prosthesis surgery, in order to distinguish those centres that place a high volume of penile prosthesis, and which master this kind of surgery due to a great experience and a minimal complication rate.

As happens in centres of excellence in other prosthetic surgeries, (e.g. hip prosthesis), it has been shown that the best results are obtained in centres that focus their activity on the prosthesis patient and in which the surgeries are performed ad personam, that is, by the same surgeon.

This is a less well-known option, because since the apparition of Viagra in 2000 as well as other drugs known as phosphodiesterase 5 (PDE-5) inhibitors, most men prefer the pharmacological option to the surgical one. The efficiency of PDE-5 to improve erection as well as the degree of acceptation by patients led to a huge success of these drugs. Dr Rosselló Gayá reminds, “Nonetheless, we must not forget that many men do not respond to medications. These patients should not give up because there is still hope for them. An exhaustive diagnosis at a specialized centre is the first step to find the effective treatment for each patient.”

Nowadays, the length of longevity is extended, and also the expectation of life quality of the population: we want to live longer, but of course, also better. From the Centre of Urology, Andrology and Sexual Medicine at Palma, they affirm that sexual health (which has so much influence on mental health) should be taken care of as one more part of our general well-being.

Dr Rosselló Barbará was one of the first European surgeons to travel to the US in the 1980s to be trained in penile prosthesis implant surgery. In that decade, drugs to restore the erection did not exist and therefore, patients who had lost their erection due to organic causes (diabetes, hypertension or after a prostate surgery, in other interventions), had no therapeutic options other than to settle to a sexuality without any intercourse or with many difficulties. This type of surgery fascinated Dr Rosselló, who came to design and to patent a surgical instrument (known as Cavernotomo Rosselló) to facilitate the implantation of penile prosthesis, especially in difficult cases.

The Institute of Sexual Medicine, through its centres in Palma de Mallorca and Madrid, receives daily several men who have been suffering from erectile dysfunction for years, and who opt for surgery since drugs do not work or are contraindicated for them. Dr Rosselló Barbará explains the most common risk factors in this group of patients. He explains, “more than 50% are diabetic and 15% suffer from erectile dysfunction as a result of a radical surgery of the prostate, bladder or colon. Within this group, there are hypertensive patients or those with excess blood fat, with high HDL and LDL cholesterol levels and triglycerides, as well as patients with hypothyroidism. The remaining 10% are mixed causes that include cardiac pathology or circulatory problems.”

Patients with penile curvature (also called De la Peyronie’s disease) are another group of patients who should evaluate the surgery of the penile prosthesis as an adequate solution to its risk factors, after a certain age and if it is accompanied by a decrease in erection and a shortening of the length of the penis. Dr Rosselló Barbará, medical director of the Institute of Sexual Medicine points out, “the penile prosthesis surgery should not be the first therapeutic option, but it is the doctor who must know how to identify which patients need this because it is their only effective option.”

Both at the Institute of Sexual Medicine in Madrid and at the Urology Center of Palma de Mallorca, they perform penile prosthesis surgery in about 60 minutes, under loco-regional anaesthesia and the patient is usually discharged in 24 hours. In Palma de Mallorca, the centre is associated with Hospital Quirón Palmaplanas, so surgeries are performed in its modern facilities. More than 80% of prosthesis wearers are men over 50 years, but “there are cases of patients under 20 years old who needed this surgery due to a case of venous leakage, a pronounced penis curvature or because of an accident with penile trauma”, says Dr. Rosselló.

Remember: we all have the right to a satisfactory sexual health and we must overcome the fear of talking about the problem and go to specialized centres to recover our life quality.

  • References: Advances in Urology, 2012, Contemporary Patient Satisfaction Rates for Three-Piece Inflatable Penile Prostheses”.
  • J. Urology, 2009, Centres of excellence concept and penile prostheses: an outcome analysis.
  • Cavernotomo o Dilatador Rosselló