The first penile prosthesis was implanted 50 years ago, but few get it after cancer © ANSA/Ansa
Half a century ago a team of surgeons in Texas had the intuition to create the first prosthesis that replaces the hydraulic system of the penis. But 50 years later, today’s safe and effective intervention, essential for many men affected by prostate cancer, is not yet included in the essential levels of assistance (Lea) of our country. Thus, due to budget constraints, only a few public facilities ensure it and just 10% of Italians who need a penile prosthesis manage to have surgery in the hospital to return to normal sexual activity. The remaining 90% are forced to resort to the private sector.
The intervention, is the request of the experts of the Italian Society of Andrology (SIA) from the national congress underway in Rome, “must be included as soon as possible in the Lea because gender differences in oncological treatments are no longer acceptable, despite the problem affecting thousands of men and imposes a decisive change of pace”. Every year in Italy, in fact, around 20,000 men undergo radical prostate removal surgery following a tumor and of these, at least 10,000 undergo erectile dysfunction with indications for penile prosthesis implantation to resolve it. But most candidates do not have access to treatment because it is excluded from the new tariff decree and the Regions are not required to provide it. Thus, the andrologists denounce, there are very few systems available, in just as few public centres, distributed unevenly throughout the territory. Penile prostheses “are not a habit or a luxury but a right to continue a normal and dignified life as a couple when medical therapies fail – declares Alessandro Palmieri, president of Sia -. However, contrary to what is now consolidated for women, for whom Breast implants have been reimbursable for a long time, following a mastectomy, men don’t get the same treatment after radical pelvic surgery.” According to data from the SIA National Register, out of 3,000 requests, around 400 prostheses are supplied each year, 75% concentrated between the North and Centre. Sia therefore renews its appeal to the ministry and the Regions to modify the recently approved tariff decree and to include penile prosthesis surgery in the Lea as soon as possible. At the congress, the models of the prostheses of the future were also illustrated: from the first prosthesis in 1973, research in the surgical field and in the production of devices has made great strides and today aims to create touchless prostheses, capable of functioning without a pump, easier to use . For the future, another mechanism is also being studied which allows the erection function to be triggered by thermal induction. Increasingly closer are therefore innovative prostheses that will be activated by a neurotransmitter or an electromagnet.
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