Surgical Penile Implants

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penile prosthesis is a treatment option for men with erectile dysfunction. The simplest type of prosthesis consists of a pair of malleable rods surgically implanted within the erection chambers of the penis. However, most men choose a hydraulic, inflatable prosthesis that allows them to have an erection whenever they choose. A penile implant is used when there is a clear medical cause for ED and the problem is unlikely to resolve or improve naturally or with other medical treatments. Sometimes a penile prosthesis is implanted to reconstruct the penis when scarring has caused erections to curve.

How does the penile prosthesis work?

The inflatable penile prosthesis consists of two cylinders--a reservoir and a pump--that are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of fluid. The reservoir is implanted under the groin muscles. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles. To inflate the prosthesis, the man presses on the pump. This does not involve putting pressure on the testicles. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis.

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. A penile prosthesis does not change sensation on the skin of the penis or ability to reach orgasm. Ejaculation is not affected. Once a penile prosthesis, it may destroy the natural erection reflex. Men usually cannot get an erection without inflating the implant. If the implant is removed, the man may never again have natural erections.

Do the implants work?

About 90%-95% of inflatable prosthesis surgeries are successful, meaning the 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.

Is the implant safe?

No surgery is totally free of possible complications. Complications associated with penile implants include:

• Uncontrolled bleeding after the surgery; this condition may require an additional surgery
• Infection
• Scar tissue formation
• Erosion
• Pump or reservoir displacement
• Mechanical failure

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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 had an inflatable penile prosthesis. Most men would not be embarrassed in a locker room or public restroom, for example.

Choosing which Implant is best for you it is very difficult for patients to decide which device or manufacturer will be the best for their specific situation.

Several factors are considered prior to a selection of a device. Age of the patient and partner, overall penile size, ratio between the length to girth of penile shaft, ratio between crus (buried) and pendulous penis, ratio between penile length and size of scrotum, overall size of scrotum, size of glans penis, history of previously implant, presence of penile shaft or glans penis atrophy or deformity, previous abdominal surgery (bladder, prostate and colon) type of previous surgery (open vs. laparoscopy or robot), presence of an ostomy or ileal conduit, previous peripheral vascular surgery (femoral to femoral artery bypass), history of kidney transplant or other major pelvic surgery, presence or absence of penile curvature or fibrosis, patient’s body type, presence of a very prominent supra-pubic fat pad, whether or not the penis is circumcised, and overall patients health and life expectancy are factors that our doctors considers when choosing which implant is the best for that particular individual.

Often this cannot be decided until internal measurements of the penis are performed intra-operatively.

For this reason, a huge inventory of prosthesis is available for every case and therefore no need to compromise on size or types of device. Our doctors pick the prosthesis that will serve the patient best.