Titan OTR ® A Guide to Penile Implant

Titan® OTR
A Guide to Penile Implant
The Titan® OTR penile implant
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Erectile dysfunction - a common problem
Erectile dysfunction (or impotence) is the inability to achieve an erection sufficient for sexual
activity.
If you experience this, you should be aware that millions of men are in the same situation.
One in four men over the age of sixty experience some degree of erectile dysfunction.
Although it is common, men rarely discuss the subject of erectile dysfunction spontaneously
and objectively.
What is the solution?
There are many different treatments available. Oral therapy, intraurethral therapy,
injection therapy and vacuum devices can all be successful treatment options.
As an alternative, a highly effective and satisfying option is a penile implant.
Every year, approximately 20,000 men worldwide reclaim their sexual relationships
by using this device.
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How the penile implant works
Fluid is moved into the penile cylinders from the reservoir by squeezing the pump bulb in the
scrotum repeatedly. The pump has a one-way valve that is manually deactivated. As the fluid
fills the cylinders, they inflate causing an erection which can be maintained for as long as
desired. A flaccid state is reinstated when the one-way valve, which is located in the pump,
is manually deactivated allowing fluid from the cylinders to return to the reservoir.
Your healthcare professional will show you how to work your pump.
To implant the device, an incision is made at the base of the penis through which the two
cylinders are placed. The reservoir is located in your abdominal area next to your bladder.
It simply holds the fluid necessary to fill the cylinders to create the erection.
Erect
The Reservoir
Flaccid
2 Cylinders
Scrotum
The Pump
o inflate
Erect
Surgical procedure
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Momentarily depress Flaccid
the
deflate valve button
Grasp andSs
The Titan® OTR implant is inserted surgically under general or epidural anaesthesia.
The operation lasts approximately one to two hours. At the end of the operation, your surgeon
leaves the implant slightly inflated and covers your penis with a bandage. The Hospital stay is
generally very short, about one to two days, but your surgeon will advise you on this as necessary.
How to obtain an erection
The pump is located in the
scrotum. It is bulb shaped,
ribbed and about the size of
a walnut. To move the fluid from
the reservoir into the cylinders,
the pump is squeezed firmly
a few times until an erection
is achieved.
Pump
(ribbed)
Scrotum
To return Flaccid
to a relaxed state
Squeeze pump to inflate
Ere
To return to a flaccid state, just squeeze the deflate valve buttons once.
This action deativates the pump’s one-way valve and enables the fluid to return to the reservoir.
To achieve a flaccid state more quickly, squeeze the penis gently with the hand after depressing
the deflate valve buttons.
If any problems are encountered during the use of this device, or any pain or discomfort are
experienced, please contact your doctor immediately.
Release
bar
Scrotum
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Erect
Momentarily depress the
Grasp and squeeze.
Momentarily depress the
Grasp and squeeze.
deflate valve button
Erections and how they work
The penis has two chambers within it called the
Corpora Cavernosa, which extend from the Glans
(head of the penis) deep into the pelvis. The insides of
these chambers are composed of sponge-like tissue
and have the ability to gain blood volume and grow
in size.
During non-sexual activity, the arteries that supply
blood to the penis are normally constricted. This
allows sufficient blood to maintain healthy tissue.
Fig. 1
Corpora cavernosa
When sexual stimulation occurs, the brain sends
signals to trigger a hormonal response that allows
arteries to relax (vasodilate). Relaxed arteries allow
more blood to enter the corpus cavernosum faster than
the blood can leave through the veins. As the corpus
cavernosum fill and grow in size, the veins also get
compressed, allowing less blood to leave. This chain
reaction event continues until an erection is achieved
and maintained.
When the brain stops sending signals, the hormones
diminish and the arteries go back to their normal
constricted state. The erection goes down because
the volume of blood leaving the penis is greater
than the volume of blood entering it.
The erection becomes inadequate or impossible if
brain signals are absent or only minimal (neurological
conditions), when the blood flow is inadequate
(vascual conditions), or the erectile tissue is damaged.
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Fig. 2
Fig. 3
The Titan® OTR penile implant
The Titan® OTR inflatable penile prosthesis is a self-contained hydraulic system made of bioflex,
a durable yet supple material. The Titan® OTR consists of four parts: two penile cylinders,
a pump, and a reservoir. The system is connected with silicone tubing and filled with sterile
saline during the implantation process.
The components are implanted within these areas: penile cylinders into the corpora cavernosa
(one each side), the pump into the scrotum, and the reservoir into lower abdominal area next to
the bladder. Once the device is implanted, it is hidden entirely within the body.
It is not visible and the penis appears relaxed and normal. The Titan® OTR penile implant is
designed to closely mimic the characteristics of a normal erection.
Reservoir
2 Cylinders
Release bar
Pump
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Questions and answers
> Risk of infection
As with any type of implant or surgery there
may be a risk of infection. If you notice an
increase in pain, redness or swelling after the
operation please contact your surgeon.
> Will my penis look normal ?
Yes, your penis will look normal.
> Will the implant show?
No, all parts ot the penile implant are placed
inside your body, and should be invisible to
the naked eye. The size is adjusted to fit your
body.
> Will my partner experience anything
different?
Your partner should have the same sensation
as during a natural erection.
> Will I feel a different sensation?
The sensations you feel will be the same as
those you felt before the operation.
> How long will I have to stay in bed
after the operation?
You may be required to stay in Hospital. This is
usually between 1-2 days, but you will need to
discuss this further with your surgeon.
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> Does it hurt?
After the operation, some areas may be painful
or uncomfortable (swelling) and it is normal to
experience some bruising.
Your surgeon will prescribe appropriate pain
relief to help you. Normally this disappears in
about a fortnight. Il you notice an increase in
pain, redness or swelling after the operation,
you should contact your surgeon immediately.
> Will the length or diameter of my penis
be increased after the operation?
No. Your surgeon chooses the size of
Titan® OTR implant to fit your anatomy.
The implant does not make your penis longer
or wider.
> When will I be able to resume sexual
activity?
You must not use the implant for four to six
weeks. With agreement from your doctor,
you can start inflating and deflating the device
two to three weeks after surgery, when any
pain has disappeared. It is normal for the first
inflation to be painful – please discuss this with
your surgeon.
> Will I still ejaculate?
Yes, you will have the same type of ejaculation
as before the operation, and orgasm will
be the same. The reproductive function is
preserved. Radical prostatectomy patients
will not ejaculate.
> Do you get involuntary erections?
You may have a feeling of an erection due
to remaining activity of your natural erectile
tissue. The risk of auto-inflation (when the
implant involuntarily inflates) is virtually
eliminated by the lock-out valve fitted to all
Titan® OTR implants.
However, general movement can cause the
implant to fill slightly. If auto-inflation occurs,
please contact your surgeon.
> Will I have any urinary problems?
No. Penile implants should have no effect on
your urinary function.
> What technical problems can occur
with the implant, and how do you solve
them?
The components of the implants are extremely
reliable. The Titan® OTR implant is made of
a material called Bioflex, which is resistant to
abrasion and durable over time. Occasionally
however, complications may occur if there
is a device malfunction. If this happens, the
components may need to be partially or
completely replaced.
> Will my implant interfere with
radiological examinations (e.g. MRI)?
Your implant will show up on X-rays. The
device is also classified as MRI-compatible.
This means that it has been tested not to
interfere within certain limits of MRI energy.
The Titan Instructions For Use (IFU) describes
the limits that will not cause interference during
MRI scans. Titan® OTR does not interfere with
security screening detectors.
Important advice
• Please follow the instructions in this manual and those given to you by your surgeon.
• Be sure to contact your surgeon, if you have any problems inflating or deflating the implant.
• Never use intracavernous injections once you have been fitted with a penile implant.
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Your own notes
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- 100359
With thanks to Mandy Spillings – Nurse Practitioner – UCLH hospitals
Coloplast and Titan® OTR are registered trademarks of Coloplast A/S. Supris™ is a trademark of Coloplast A/S. Durasphere® is a
registered trademark of Carbon Medical Technologies, Inc. Durasphere is manufactured by Carbon Medical Technologies, Inc., and
distributed by Coloplast Corp. ©2008-04. All rights reserved. Coloplast Corp., Minneapolis, MN USA. Any licensed images are for
illustrative purposes only. Any persons depicted are models.
Coloplast and Titan® OTR are registered trademarks of Coloplast A/S. All rights reserved Coloplast A/S, 3050 Humlebæk, Denmark.
February 2010
Holtedam 1
DK-3050 Humlebæk
Denmark
www.coloplast.com