What is a Penile Implant for Erectile Dysfunction?
Men with erectile dysfunction who have not experienced acceptable return to normal sexual activity using other treatments may choose to receive a penile implant. For men who cannot achieve or sustain an erection for satisfactory sexual relations, this penile implant device is surgically placed inside the penis to produce an erection as desired.
There are two primary types of penile implant devices. Those are inflatable and semirigid devices. Each offers its own benefits and negative points, so a doctor is best suited to aid in discussion regarding which type of penile implant is most appropriate for the individual’s lifestyle and sexual needs. Because placement of the penile implant is surgical, the doctor should also guide the erectile dysfunction patient through the surgery’s associated risks, complications and healing expectations.
When a Penile Implant is the Right Choice
A penile implant is best suited for the patient who has been through other treatments for erectile dysfunction, when those treatments have failed. A penile implant should never be the first option or choice for treatment. That is because a penile implant involves a surgical procedure.
As compared to a penile implant, other types of treatment are non-invasive and more appropriate for shorter term or more easily solved erectile dysfunction. Medications, a vacuum constriction device known as a penis pump, and other treatments are generally successful for men with difficulty in attaining and maintaining an erection adequate for sexual activity.
A penile implant is generally provided as an option for men who have a clear medical reason for erectile dysfunction, without a prognosis of eventual reversal of the condition. Peyronie’s disease, a condition which causes scar tissue to grow within the penis and results in penile curvature and pain, is sometimes treated through a penile implant.
There are several conditions which will generally prohibit a doctor from recommending or prescribing a penile implant. Some of those conditions are:
• Situational erectile dysfunction occurring because of relationship issues or other reversible stressors
• Presence of infection, such as pulmonary or urinary tract infections
• Penile or scrotum area dermatitis, skin ailments or wounds
Many men mistakenly believe that a penile implant can be surgically placed in order to increase sexual desire, sensation, length or performance. To the contrary, a penile implant may actually reduce the length of the erect penis.
Risks Associated with Penile Implant Devices
Placement of a penile implant is a surgical procedure. Because of that, standard cautions associated with any surgery must be regarded. Infection is certainly a possibility as a result of a penile implant surgery or due to its continued existence in the penis. People with certain long term illnesses who are susceptible to infection should be particularly careful with penile implant devices, including those with spinal cord injuries or diabetes.
When a man experiences problems with a first penile implant, and thus needs to have an adjustment or replacement surgery, there is always increased risk of infection or other problems as part of a second, revision surgery.
Penile implant prostheses have improved in design as medical technologies have progressed. The latest versions of penile implant devices are indeed reliable. But, as with any device, sometimes the implant can stop working properly and may need to be removed, repaired or replaced. Semirigid penile implant prostheses more frequently experience breakdown of device parts while inflatables can suffer a failed pump or fluid leakage. For both devices experiencing common deficiencies, a second surgery would result.
There are other physiological problems that men with penile implant devices experience. Although more rare, a penile implant may erode or cause adhesion. Adhesion is indicated by the implant adhering to the skin inside the penis, which wears away the skin over time. The implant then may rupture through the skin’s surface. Of course, these conditions are optimum for causing infection.
Penile Implant Infection
All surgeries involve risk of infection. Penile implant surgery is no different. Infection may occur immediately following the procedure or even years after the penile implant is placed. Serious complications such as scrotum inflammation, buildup of pus and high fever can occur as side effects. Having to endure a second surgery is not just problematic in that the procedure itself is a hassle or painful. An additional surgery is also expensive and can result in added scarring, sensation loss, and slight shortening of the penis.
Getting Ready for Penile Implant Surgery
Prior to recommending penile implant surgery as a solution for erectile dysfunction, a urologist or other doctor will review patient medical history, ask health related questions, discuss the erectile dysfunction experience and gain information about the patient’s prescriptions or other medications.
There are several tests the doctor will conduct or recommend prior to setting up penile implant surgery. Those include a thorough physical checkup and examination of manual dexterity, as some penis implant prostheses require hand operation. The physician will also ensure that the patient is presently experiencing erectile dysfunction to a degree that a penile implant is necessary.
After checkups and any diagnostic tests to classify the patient as a good candidate for penile implant, the doctor will discuss the surgical procedure to help establish expectations for aftercare. He or she will talk about risks and potential complications, as well as the benefits a penile implant patient should experience following implantation.
Penile Implant Types
The two primary types of penile implant devices are inflatable implants and semirigid rods. Each offers benefits and negatives in regard to expectations. Discussions with a health care practitioner familiar with each will help in the decision of which penile implant is best for the individual patient’s needs.
Inflatables are the most commonly used penile implant as part of surgical erectile dysfunction treatment. As part of a three-part inflatable penile implant, a fluid filled reservoir is implanted into the patient’s abdomen and a pump and release valve are placed in his scrotum. In the penis, two inflatable cylinders receive pumped fluid that flows from the abdominal reservoir as a result of activation of the pump in the scrotum. When the patient is finished with sexual activity, he releases the fluid from the penis cylinders back to the abdominal reservoir by releasing the scrotum-placed valve.
A two-part inflatable penile implant consists just of the penile cylinders and a combined reservoir and pump that sits behind the scrotum. Surgery for the two-part inflatable is a bit less invasive than for the three-part inflatable penile implant, as there is no abdominal reservoir placement. Patients who have received the two-part inflatable penile implant do sometimes complain that the achieved erection is not as firm or satisfying as one from a three-part inflatable penile implant device.
Regardless of whether a two-part or three-part inflatable penile implant is surgically placed, inflatable penile implant varieties are easier to conceal in daily life, seem more natural than semirigid rod penile implant devices and are most convenient to operate.
Semirigid rod penile implant prostheses, also known as malleable penile implant devices, are always firm enough for sexual activity, yet the penis can be maneuvered toward the body to conceal it. Semirigid device surgery is less invasive than inflatable surgery and there is a lower frequency of infection because of fewer mechanisms and surgical sites on the body.
A surgical center or hospital is the typical location for penile implant surgery. Some patients are provided with general anesthesia which causes a loss of consciousness during the operation. Others are given spinal anesthesia to block pain in the lower half of the body without a loss of consciousness. Intravenous antibiotics are also administered to prevent infection. Patients are often shaved before surgery to prevent infection or contamination of the incision area.
As part of the penile implant surgery which takes about 45 minutes to an hour to complete, a catheter tube may be inserted into the bladder for urine collection. An incision will be made either on the penis or abdomen for insertion of the penile implant which has been customized to the patient’s body measurements. For inflatable penile implants, there may also be an abdominal incision, if the inflatable has a reservoir for implantation.
Patients of penile implant surgery are provided with medications to relieve pain post-operatively and antibiotics to fight infection. Pain may persist for several weeks, but it will diminish over that time. Sexual activity can usually be resumed in about four to six weeks following surgery.
Penile Implant Expectations After Surgery
Patients with penile implant prostheses report that most partners do not notice they have a penile implant device. A small surgical scar may be visible in the areas of implantation, but such scars heal well over time.
Patients who have a penile implant do not notice a difference in the sensations of an erection or sexual activity. Ejaculation with a penile implant feels the same to the surgical patient as ejaculation pre-surgery. The only major change to sexual activity after a penile implant is inserted is that the man cannot usually gain an erection naturally anymore. With a penile implant in place, all erections must be created through the implant.
Studies report that 80 to 90% of penile implant patients are very satisfied with the outcome of their surgery. For the most part, the penile implant surgery is safe with standard complications of any implant surgery:
• Uncontrolled bleeding that would require a follow-up surgery
• Infection at the surgical areas or due to the penile implant
• Scar tissue development
• Erosion of tissues around the penile implant
• Penile implant device mechanical failure
If a medical cause for erectile dysfunction justifies penile implant surgery, patients are often provided with penile implant cost relief through their health insurance.
Is a Penile Enlargement Implant Different than a Penile Implant for ED?
Penile enlargement implant placement is different than a penile implant for erectile dysfunction. Enlargement devices are relatively new to the market and are meant merely to extend length and girth. These penile implant devices do not improve sexual function for men with erectile dysfunction.
Most men who have received penile implant devices for erectile dysfunction in the past have noted that their erection is slightly shorter in length than prior to the implantation. However, advancements in the device technology has brought some changes to penile implant prostheses, enabling some newer devices to offer enhanced length, girth and stiffness of the erection. For men who suffer from erectile dysfunction, enlargement is a possibility through these newer devices. But, a penile implant designed only for enlargement will not alleviate erectile dysfunction.