Today, penile implants prove to be a reliable and durable solution for men experiencing erectile dysfunction.
Penile implants have increasingly become a convenient and long-term solution for erectile dysfunction. Thousands of penile implants are surgically placed each year, giving men the ability to engage in spontaneous sexual relations with their partner.
Although less drastic today, potency still plays a large part in men’s self-image and impacts their relationship with their partners. Before 1960, urologic therapy for erectile dysfunction (ED) was rare. More recently, insight has been gained into the pathophysiology of male sexual dysfunction, and both medical and surgical treatments of ED now are common.
What are penile implants?
Penile implants are FDA approved medical devices that are surgically inserted into the body by a urologist. These devised produce an erection-like state that enables men to engage in inpromptu sexual intercourse with their partner. Both semi-rigid and inflatable devices are available to men. Typically, an inflatable implant is favored since it results in a more normal looking penis in both the flaccid and erect state. Penile implants do not change a man’s ability to urinate, ejaculate, or have an orgasm.
Types of penile implants
Penile implants are constructed with medical-grade plastic or silicone, and produce a degree of permanent penile rigidity that enables the recipient an ability to have sexual intercourse.
There are two types of penile implants:
- Semi-rigid malleable prosthesis (implant)
- Inflatable implantable device
A semi-rigid malleable implant usually consists of paired rods, which are inserted surgically into the corpora cavernosa. A malleable rod prosthesis can be manually bent downward for urination, or upward for intercourse. Adjustment does not affect the width or length of the penis. This prosthesis is generally considered for patients who:
- Are significantly obese
- Have limited manual dexterity
- Cannot have abdominal hardware implanted: patients who have had extensive abdominal surgery.
- Individuals receiving peritoneal dialysis
Advantages of semi-rigid devices are:
- Easier placement
- Less dependence on patient manual dexterity
- Lesser chance of part failure
- Lower cost
The disadvantages of semi-rigid devices are:
- Higher risk for device erosion
- Not as easy to conceal
- Inability to change girth
The inflatable penile implant consists of two cylinders, a fluid reservoir, and an embedded hand pump that are surgically inserted into the body. The patient inflates the cylinders by pressing on the small pump located under the skin in the scrotum. The pump pushes fluid from the reservoir into the cylinders which expand and create an erection. A benefit to inflatable implants is that they expand the length and width of the penis. They are also durable and long-lasting. The entire device is antiseptic, and the fluid reservoir is sealed so that it will not leak after insertion.
When should a penile implant be considered?
Penile implants are recommended for patients:
- With erectile dysfunction who desire the ability to engage in sexual intercourse.
- Patients who have failed at least one (and usually more) conservative treatments.
- Patients with sickle cell anemia who have suffered long-term erections (priapism) and/or penile scarring associated with Peyronie’s disease.
Contraindications for penile implants
While penile implants are a good solution for erectile dysfunction, they are not always recommended. Some contraindications include:
- Psychogenic erectile dysfunction – a man’s inability to have an erection or maintain an erection due to psychological issues.
- Patients without good or reliable manual dexterity.
- Patients with active or chronic infectious processes such as pressure ulcers and venous stasis ulcers are at high risk for infecting their devices.
Following implant surgery
After penile implant surgery, many men will experience pain for up to four weeks. However, men who limit their activity may experience pain for a shorter duration of time. Initially, an oral pain medication is prescribed, and driving is prohibited. Patients are instructed to refrain from sexual activity for up to six weeks.
The surgery will permanently change an individual’s ability to have a natural erection, and should be regarded as permanent and non-reversible.
An ideal penile implant will result in a normal-appearing penis when flaccid and erect. However, a penile implant will not restore the full length once achieved by natural erections.
Outcomes and prognosis
On average, penile implants typically last from four to eight years. Feedback indicates that high numbers of penile implant recipients are happy with their decision to have surgery. While wound infection and malfunction of the device is possible, statistics indicate that this occurs in very small numbers (3%). In some cases, surgery may be needed for removal or repair of the device.
If you have struggled with erectile dysfunction and have questions about penile implants, contact Urology Austin to schedule an appointment with one of our urologists.
Dr. Bryan Kansas, Board Certified Urologist at Urology Austin, discusses the causes and treatment options for Erectile Dysfunction, including penile implant surgery.
Dr. Bryan Kansas, Urologist at Urology Austin, presents a men’s health webinar titled Signs, Symptoms and Treatment Options for Erectile Dysfunction. This webinar was co-hosted by Boston Scientific.