Penile Prosthesis

A penile prosthesis is a small device implanted inside the penis that allows men with erectile dysfunction (ED) to get an erection. Penile prosthetics are carried out by the Urology Division of Premier Medical Group. The surgery is not complicated and can be done as an outpatient. These devices are either bendable or inflatable. When all other options have been explored and you and your doctor have decided that there is a clear medical cause for ED, then a penile prosthesis should be considered. Most men with penile implants, and their partners, say they’re satisfied with the results.

What makes you a candidate for a penile prosthesis?

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For most men, erectile dysfunction can be successfully treated with medications or use of a penis pump (vacuum erection device). Penile implants may be an option to consider if you can’t get an erection sufficient for sex with these other methods. However, no one should consider this procedure until all other methods have been considered carefully.

Some common causes that could make a man suitable for penile prosthesis:

  • Damage from a previous surgery, such as cancer or prostate surgery
  • When scarring causes erections to curve, Peyronie’s disease
  • Injury to the erectile tissue within the penis
  • Repeated injection treatment has caused fibrosis within the erectile tissue
  • All other treatments for erectile dysfunction have failed
  • Paraplegia

Types of Prosthesis

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The simplest type of prosthesis consists of a pair of bendable rods. These rods are surgically implanted within the erection chambers of the penis. With this implant, the penis is always semi-rigid and simply needs to be lifted or adjusted into the erect position to initiate sex.

The other type is an inflatable prosthesis, which allows a man to have an erection whenever he chooses and is much easier to conceal. It is also more natural. When the penis is inflated, the prosthesis makes the penis stiff and thick, similar to a natural erection. The inflatable penile prosthesis has a reservoir and a pump which are surgically implanted and connected to the penis by tubing to a separate reservoir of fluid. To inflate the prosthesis, the man presses on the pump. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them and causing an erection. A penile prosthesis does not change sensation on the skin of the penis or a man’s ability to reach orgasm. Men usually cannot get an erection without inflating the implant and when removed, the man may never again have natural erections. A prosthesis is not noticeable and no one in the locker room will know you have one.

What if I do not want the surgery?

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There are many other ways to enhance your sex life. If all the other available treatments have been tried and none of them succeeded, be creative.

Use of finger play and vibrators can be very satisfying as can oral sex. It’s very probable to gain substantial satisfaction from knowing that you can still love and satisfy your partner.

Risks of penile prosthesis

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The inflatable penile prosthesis has been dubbed the Cadillac of all prosthesis. They are made from synthetic materials, which make them extremely durable, and they’re usually implanted as a one-piece device. With this type of prosthesis, your risk of infection and needing removal is less than 5 percent. The inflatable prosthesis also has a low risk of mechanical failure. The failure rate is less than 5 percent.

Common after testicular cancer surgery, testicular implants also have a very low failure rate and generally very safe.

Complications of the penile implant can include:

  • Infections which may lead to prosthesis removal. An infected prosthesis can be very expensive to treat and could cost more than original implant.
  • Possible perforation into the urethra or glans penis. If this happens, it will need to be corrected surgically. In fact, any perforation to an infected area would necessitate termination of the procedure.
  • Other complications include tubing kinks, fluid leaks, breakage of the wire, silicone spillage, loss of rigidity to the prosthesis, erosion of the reservoir, spontaneous deflation, spontaneous inflation, penile curvature, which is a variant of Peyronie’s disease, pump or pump reservoir migration.

Bottom line, any man who is contemplating penile implant surgery must find an experienced surgeon and know all of the risks before consenting to the procedure.

Dr. Michael Solliday is a specialist in penile prosthesis. He sees patients in the Poughkeepsie office.