Penile Implants as an option for Erectile Dysfunction: A Comprehensive Guide

If you are a male suffering from erectile dysfunction, one potential course of treatment could be getting a penile implant. Penile implants or prostheses are devices that are surgically placed inside the penis to allow men with erectile dysfunction to get an erection during sexual intercourse. They do not enlarge the penis, increase sexual desire, or sensation. Penile implants can also be used to treat Peyronie’s disease, a severe condition that causes scarring inside the penis, leading to curved, painful erections.

However, it is important to note that this procedure is usually a last resort. Most men with erectile dysfunction are able to treat the condition with medication or by using a penis pump. If you have tried these methods and they have been unsuccessful, or if you’re not a candidate for these treatments, then you should consult your physician. They will conduct a complete urological exam to determine whether or not a penile implant is right for you. If you’re suffering from an infection or have uncontrolled diabetes, you may not be eligible for the surgery.

There are two main types of penile implants. The first is inflatable implants which can be inflated to create an erection and then deflated after sexual activity. Inflatable implants come in two varieties: a two-piece and a three-piece implant. With a three-piece implant, salt water is stored in a reservoir that is implanted under the abdominal wall. This water is then manually pumped into inflatable cylinders inside the penis. After intercourse, the penis is deflated by the water exiting back into the reservoir through a release valve that is implanted in the scrotum. The two-piece implant differs in that the reservoir is part of the pump implanted in the scrotum rather than the abdominal walls.

The second type of penile implants is semirigid rods which always keep the penis firm. With this type of implant, the penis can be bent away from the body during sexual activity and toward the body at other times. There are risks and benefits for each type of implant. For example, a three-piece inflatable implant provides the most natural erection; however, the device has more parts and therefore is at a greater risk of malfunctioning. A two-piece inflatable is less likely to malfunction but provides a less firm erection. Lastly, the semirigid rod is easier to use, but since the penis is always firm it can be harder to conceal and the pressure on the penis can lead to injury. It is important to discuss the different types of implants with your physician to determine which one is right for you.

Now, in terms of what to expect during the procedure; the surgery will start off with a catheter being inserted through the penis into your bladder. The incision is usually made at the junction of the penis and scrotum. A second incision may be used to insert the balloon reservoir, which is part of the inflatable implant, into the abdomen if you have a three-piece inflatable implant. Next, the surgeon will stretch the spongy tissue in the penis that would normally fill with blood during an erection. The surgeon will then place the correct size implant inside your penis. The procedure usually lasts between 45 minutes to one hour. If an inflatable implant has been used, it may be left in the inflated position overnight to reduce the risk of bleeding, but will be deflated before you are discharged home.

In the UK, the average time spent in the hospital post-surgery is one day. The catheter will usually be removed on the morning following surgery. Once you are passing urine normally, you will be able to go home. You may feel some pain at the incision site post-surgery, but over-the-counter pain relievers should be sufficient to help you manage the pain. After surgery, you are advised not to inflate the implant or have sexual intercourse for at least 6 weeks. You will also be requested to return to the Andrology Clinic to learn how to inflate and deflate the implant properly.

Whilst negative side-effects post-operation are rare, risks include:

- Temporary bruising or swelling of the penis that may last several days
- Nerve injury which may lead to numbness of the head of the penis
- Malfunctioning of the implant that may require surgical removal
- Internal erosion or adhesion of the implant whereby the implant may stick to the skin or wear away from the skin
- Infections, which may require the removal of the implant. Infections are most common in the first three months after surgery

It is important to weigh out the risks and benefits of this procedure. If you or someone you know is considering a penile implant, make sure to have a thorough discussion with your healthcare provider to explore all available options and make an informed decision.

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