At San Filippo Neri in Rome, Penile Prosthesis Goes Robotic: Dual Interview with Doctors Martini and Antonini
Interviewer: Today, we discuss two innovative and closely linked procedures performed at San Filippo Neri Hospital in Rome: robotic radical prostatectomy and the hydraulic penile prosthesis implant. Joining us are two experts: Professor Marco Martini, Chief Urologist at the hospital, and Professor Gabriele Antonini, a urologist and andrologist specializing in penile prosthesis implants. Let us begin with Professor Martini.
Professor Marco Martini, can you explain in which cases robotic radical prostatectomy is recommended, and what advantages the Da Vinci robot offers for this procedure?
Marco Martini: Radical prostatectomy is indicated in cases of localized prostate cancer when the goal is to completely remove the prostate gland and surrounding tissues to prevent the spread of the disease. Robotic surgery is preferable as it enables extreme precision through the Da Vinci system, allowing for finer, more controlled movements than traditional surgery.
The Da Vinci robot offers several advantages for both surgeon and patient. First, it provides a high-definition, three-dimensional view that enhances our ability to identify and preserve delicate structures, such as the nerves responsible for erectile function and the muscles involved in urinary control. Furthermore, the minimally invasive nature of the procedure reduces the risk of complications, such as bleeding and infections, and accelerates postoperative recovery.
Interviewer: So, we can say that robotic surgery increases the chances of preserving the patient’s quality of life?
Marco Martini: Absolutely. Using the Da Vinci robot minimizes common side effects, such as urinary incontinence and erectile dysfunction, which are among patients’ main concerns. However, despite technological advances, there are still cases where full erectile function is not recovered, and this is where the importance of the penile prosthesis comes into play.
Professor Antonini, let’s discuss this. What role does the three-component hydraulic penile prosthesis play, especially concerning radical prostatectomy?
Gabriele Antonini: The role of the three-component hydraulic penile prosthesis is essential for those patients who, after radical prostatectomy, experience erectile dysfunction. It is well known that approximately 99% of men operated on for prostate cancer suffer from erectile dysfunction, which often does not improve over time despite conservative treatments. Additionally, a gradual shortening of the penis occurs, estimated at about 1 cm for each year after surgery.
The penile prosthesis implant, performed simultaneously with the prostatectomy, immediately resolves the issue of erectile dysfunction and prevents penile shortening. It is an effective and definitive solution that allows the patient to resume a satisfying sexual life, enhancing his self-esteem and quality of life.
Interviewer: Could this type of intervention be considered analogous to breast prosthesis implantation in women after a mastectomy?
Gabriele Antonini: Precisely. Just as women who undergo mastectomy are often offered a breast implant as part of their cancer treatment, the same principle should be applied to men operated on for prostate cancer. The hydraulic penile prosthesis implant should be suggested and included as an integral part of the treatment, enabling the patient to face not only the disease but also its sexual repercussions with greater peace of mind.
Interviewer: What are the specific advantages of the three-component hydraulic prosthesis?
Gabriele Antonini: The three-component hydraulic prosthesis consists of three parts: two cylinders placed within the corpora cavernosa of the penis, a reservoir inserted into the abdomen, and a pump placed in the scrotum. When the patient desires an erection, simply activating the pump causes the reservoir to transfer fluid to the cylinders, allowing the penis to become rigid. This technology offers a very natural erection both in appearance and functionality, while keeping the penis flaccid when not in use.
The implant procedure is safe and well-tolerated, making it an ideal solution for patients who do not respond to medications or other conservative therapies. Performed simultaneously with the prostatectomy, it offers a strategic advantage: the patient undergoes a single surgical procedure, reducing psychological and physical stress.
Interviewer: Thank you, Professors Martini and Antonini, for clarifying the fundamental role of these techniques. With interventions like these, medicine continues to advance toward ever more comprehensive and humane treatment of oncological diseases.