Surgical treatment of erectile dysfunction with malleable penile prosthesis: first experience in Benin

Resumo

Introduction: Erectile dysfunction (ED) is a common condition affecting patients’ quality of life. When first- and second-line treatments fail, penile prosthesis implantation is an effective option. This study reports the first penile prosthesis implantation performed in Benin, including  complete preoperative evaluation and postoperative follow-up.

Observation: A 58-year-old patient with severe ED for two years, resistant to medical therapy, underwent implantation of a malleable penile prosthesis (ZSI 100D9 Zephyr Surgical Implants, Geneva, Switzerland) under general anaesthesia via a penoscrotal approach. The patient had several comorbidities, including hypertension, a history of pulmonary embolism (treated with Préviscan in 2021), chronic venous insufficiency, and haemorrhoidal disease. The patient did not smoke or consume alcohol. Hormonal evaluation, including testosterone, was normal, confirming vasculogenic ED. The postoperative course included penile oedema, phlyctaenae formation, minor secondary suppuration, and fibrous ring formation, all managed with 14% bicarbonate dressings and topical Baneocin. Corticosteroid therapy was initiated on day 10 after confirming the absence of infection, with strict glycaemic control. At five months postoperatively, the patient reported total satisfaction after the first sexual intercourse despite mild penile pain.

Conclusion: This first penile prosthesis implantation in Benin represents a significant advancement in ED management, demonstrating feasibility in resource-limited settings, and highlighting the importance of thorough preoperative assessment and patient education. It provides educational value for urologists and encourages patient awareness of this therapeutic alternative.