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What are penile prostheses?
A penile implant is usually used when there is a clear medical cause for ED and when the problem is unlikely to resolve or improve naturally or with other medical treatments. Sometimes a penile prosthesis is implanted during surgery to reconstruct the penis when scarring has caused erections to curve (Peyronie's disease).
Penile prostheses are devices that are implanted completely within the body. They produce an erection-like state that enables the man who has one of these implants to have normal sexual intercourse. Neither the operation to implant a prosthesis nor the device itself will interfere with sensation, orgasm or ejaculation.
The main objective is to leave the patient with a penis that allows achievement of sexual intercourse with no complications, when it is desired and in a way that satisfies both partners. There is no single penile prosthesis that is best for all patients so it is imperative that the urologist sit down with the patient and carefully review the risks, benefits, and drawbacks to each type.
What are the different types of penile prostheses?
There are two main types of penile prosthesis: semi-rigid and inflatable.
Semi-rigid
This method consists of two rods of silicone rubber that are fitted into the interior of the penis during an operation.
They provide some rigidity as well as a certain amount of flexibility: the penis can either be curved downwards in the normal position or put into an erect position for intercourse.
Inflatable
This method usually consists of two cylinders, a pump and a reservoir. The cylinders, which are placed inside the penis by the surgeon, can be inflated with fluid when you want an erection and deflated after intercourse.
The surgeon puts a little pump inside your scrotum, and you press this when you want to have sex. It sends fluid from the reservoir into the two cylinders so your penis becomes stiff.
After sex, you press a valve and the fluid runs back into the reservoir.
There are several variations of this apparatus which are available to urological surgeons, but they all rely on a system in which the man pumps fluid from a reservoir into the cylinders inside his penis.
The main advantage of this method is that it looks more natural.
Who is suitable for a prosthesis?
Men who may be suitable for this type of surgery include those who have:
- sustained injury to the erectile tissue within the penis
- sustained damage caused by repeated injection treatment, which causes fibrosis within the erectile tissue
- been damaged by previous surgery, eg for cancer
- Peyronie's disease, which causes fibrosis within the erectile tissue
- unsuccessfully tried all other treatments for loss of erection
- paraplegia.
What does penile prosthesis implantation involve?
Penile prostheses are usually implanted under anesthesia. Usually one small surgical cut is made either above the penis where it joins the abdomen or under the penis where it joins the scrotum. No tissue is removed, blood loss is small and blood transfusion is almost never required. A patient will typically spend one night in the hospital.
Men can often be instructed in using the prosthesis for sexual activity one month after surgery, but if pain and tenderness are still present, this is sometimes delayed for another month.
Is the Prosthesis Noticeable?
While men who have had the prosthesis surgery can see the small surgical scar where the bottom of the penis meets the scrotal sac, other people probably will be unable to tell that a man has an inflatable penile prosthesis. Most men would not be embarrassed in a locker room or public restroom, for example.
What Is Sex Like With the Prosthesis?
When the penis is inflated, the prosthesis makes the penis stiff and thick, similar to a natural erection. Most men rate the erection as shorter than their normal erection; however, newer models have cylinders that may increase the length, thickness, and stiffness of the penis.
A penile prosthesis does not change sensation on the skin of the penis or a man's ability to reach orgasm. Ejaculation is not affected.
How Effective Are the Implants?
About 90%-95% of inflatable prosthesis implants produce erections suitable for intercourse. Satisfaction rates with the prosthesis are very high, and typically 80%-90% of men are satisfied with the results and say they would choose the surgery again.
For consultancy call: 00 90 212 282 36 46- 00 90 533 461 12 33
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