70歲的陳伯伯患有勃起功能障礙已十餘年，長期飽受高血壓、缺血性心臟病及糖尿病困擾的他，五十餘歲即有勃起功能障礙。一開始陳伯伯還可藉助幫助勃起的藥物(如威而鋼、犀利士等)來達成性行為，但隨著年齡的增加藥物的效果已慢慢降低，並且擔心勃起功能藥物也會可能影響心臟疾病的治療，於是陳伯伯來到泌尿科門診尋求醫師專業的診治。
在泌尿科吳佳璋醫師進行了詳細的評估與檢查後，建議陳伯伯裝設最新一代的”三件式人工陰莖”來徹底解決勃起功能障礙的問題。歷經了1.5個小時的手術時間，手術隔天陳伯伯即在恢復良好的情況下出院了。
何謂”三件式人工陰莖”?
三件式人工陰莖是由三件構造組合而成，分別為植入陰莖海綿體內的圓柱管(A)、置於下腹部的水球(B)及置於陰囊內的幫浦(C)，如圖一。三件式人工陰莖的運作原理是當手指壓迫幫浦時，水球內的水即會注入原本扁平的圓柱管內，在圓柱管充滿水後陰莖即完成勃起狀態，有如正常勃起時的充血現象(圖二)。如此一來，即可進行性行為。
起初，陳伯伯擔心植入人工陰莖後會造成射精功能喪失及影響排尿的順暢度。事實上，此項手術進行的部位僅止在海綿體及其周圍處，並沒有觸及儲精囊及攝護腺等射精反應相關的器官上，因此完全不會影響射精功能，更不會造成排尿困難。
手術完畢後的一個月內，陳伯伯按時回診檢查傷口並規律服用抗生素以避免傷口感染，術後第六週開始，陳伯伯即開始重啟規律的性生活。最新一代的三件式人工陰莖的裝設讓陳伯伯重拾過往的自信與歡愉，除了夫妻感情的增溫外，整個人都感到年輕起了!!
圖一：三件式人工陰莖的外型 (Figure 1, adopted from Boston Scientific, AMS 700 model)
A: 圓柱管 B: 水球 C: 幫浦
圖二：三件式人工陰莖的作用原理
(Figure adopted from Boston Scientific, AMS 700 model)
附註: 人工陰莖作用模擬影片(Video adotped from AMSMensHealth.com)
本文作者 吳佳璋醫師
現職：
- 衛生福利部雙和醫院泌尿科主治醫師
- 台北醫學大學醫學系泌尿學科主任
- 台北醫學大學醫學系泌尿學科助理教授
- 台灣疝氣醫學會理事
- 台灣男性學醫學會監事
- 台灣泌尿科醫學會泌尿內視鏡委員會委員
- 台灣泌尿科醫學會前列腺疾病委員會委員
專長領域：
- 人工陰莖植入手術
- 低能量體外震波治療男性勃起功能障礙及慢性攝護腺發炎
- 攝護腺肥大雷射汽化及切除手術
吳佳璋醫師至韓國參加人工陰莖植入手術交流會議
How to restore musculinities and improve erectile function?
By means of the implantation of latest model of inflatable penile prosthesis (IPP, AMS 700™, by Boston Scientific), an impotent man can retore his musculinites and erectile function and have successful sex life again.
It takes about one hour to implant the device into man's penis (corpous cavernosum), either under local anesthesia or general anesthesia.
The IPP was composed by 3 parts: cylinder, reservoir and pump. (Figure 1, A: cylinder, B: reservoir, C: pump)
The working principle of this device is when one is pumping the pump, the water within the resevoir will flow into the cylinders. After adequate water flowed into the cylinders within corpus cavernosum, the penile will erect and be ready for sex.
Figure 2 shows each part of the IPP is placed properly inside the penis, retroperitoneal space and scrotum.
The attached video demostrates how to make the IPP work successfully. (Video adopted from AMSMensHealth.com)
The benefits of implantation of IPP include:
1. Simple operation and rare operation associated complications.
2. 100% successful rate of sex behavior whenever necessary.
3. Ejaculation function is totall reserved without sacrificing orgasm.
Conclusion:
Under experiened hands of urologic surgeon, the successful rate of implanting the IPP can be as high as nearly 100%, and the post-operative infection possibilities may also decrease under adequate antibiotics using.
Author:
Dr. Chia-Chang Wu M.D., Ph.D
Employment:
Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
Other Experience/Activities:
Member of Taiwan Urological Association
Member and director of Taiwan Hernia Society
Member and supervisor of Taiwanese Association of Andrology
Member of Taiwanese Continence Society
Main Area of Interests:
Erectile dysfunction:
--Extracorporeal shock wave treatment of erectile dysfunction
--Penile prosthesis implantation
Chronic Prostatitis/Chronic Pelvic Pain Syndrome:
--Diagnosis and Extracorporeal shock wave treatment
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