Erections are natural reactions to sexual stimulation.
But in some men, this kind of sexual response is nonexistent due to sexual dysfunction.
Erectile problems have a negative impact on a man’s confidence and overall quality of life.
Various treatment approaches are available, though.
A penile prosthesis is one of them.
Read on to learn everything you need to know about penile implants.
What is a penile prosthesis?
A penile prosthesis is a device placed inside the penis to allow men to achieve an erection.
The first penile implant was designed in 1973 to allow artificial erectile tumescence.
These devices had a relatively high rate of mechanical failure in 21% to 45% of cases
Modern devices are a lot simpler, safer, and more effective.
In fact, penile prosthesis surgery is considered the gold standard in patients whose erectile dysfunction (ED) didn’t improve with oral medication and intracavernous pharmacological therapies.
Studies confirm penile prosthesis is a safe, effective, and durable treatment option for erectile dysfunction.
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How it works
A penile prosthesis is a quite simple device, but the exact mechanism depends on the type of penile prostheses.
These include inflatable devices or malleable prosthesis:
Three-piece inflatable pump
This includes placing two penile cylinders, the fluid-filled container in the abdomen, and an inflatable pump in the scrotum.
Special tubing connects all these parts together.
As you squeeze the scrotal pump, the fluid moves from the container to the inflatable cylinder, and you achieve a rigid erection.
By squeezing the release valve, fluid returns to the container, and the penis becomes flaccid again.
Two-piece inflatable pump
This works almost the same way as the abovementioned inflatable implant.
The only difference here is that the fluid is in the pump, not in a separate container.
That said, the two-piece inflatable prostheses are not as rigid as the three-piece inflatable penile prosthesis.
Semi-rigid prostheses or malleable rods
Two flexible rods are implanted into the corpora cavernosa.
One rod is inserted into one corpus cavernosum. The penile length and stiffness remain the same.
Basically, the penis always maintains a semi-rigid state and never becomes flaccid as it is firmly attached to corpora cavernosum.
The position can be changed, so if you want to have sex, you can set the malleable prosthesis into an upward position.
Most men don’t like malleable penile prosthesis as they find the constant semi-rigid state uncomfortable.
Who is a good candidate?
You are a good candidate for penile prosthetic surgery if you:
- Have persistent erectile dysfunction that negatively affects your sex life
- Tried a penis pump (vacuum constriction device)
- Tried medications for ED
- Have Peyronie’s disease that doesn’t improve with other treatments
Men who are not good candidates for implantation of the penile prosthesis are those with:
- Reversible erectile dysfunction
- ED caused by emotional problems
- Urinary tract infection (UTI)
- Low libido and lack of sensation
- Lesions, inflammation, and other problems with penile and scrotum skin
When would it be recommended?
A penile prosthesis is recommended to men with erectile dysfunction and sometimes with Peyronie’s disease.
Doctors recommend this approach only when other treatment options don’t work.
Therefore, if you have ED, the doctor may first recommend medications and other treatment approaches before suggesting surgery.
Some men may have ED due to severe systemic diseases such as diabetes, neurological disorders, and cardiovascular conditions.
In many of those cases, conventional treatment approaches don’t work.
That’s when the doctor may recommend a penile prosthesis.
Some men may need the implant after radical prostatectomy.
How to prepare
Everything starts with a consultation with your doctor or urologist.
They need to make sure you’re a good candidate for the penile implant procedure.
To do so, your healthcare provider will review your medical history and ask questions about current or past health conditions, including your experience with erectile dysfunction.
During the consultation, you should also mention all medications you’re taking, if any.
A physical exam, including a complete urologic exam, is also necessary.
It helps a doctor or urologist determine the best type of penis implant for your needs.
They can help you decide whether you need inflatable prosthesis or malleable devices.
Also, your doctor needs to make sure you have ED that cannot be treated any other way.
Make sure to ask the doctor about the pros and cons of each type of implant before you decide.
Most men opt for inflatable penile prostheses, but it’s always good to know the advantages and disadvantages of different options before bringing a final decision.
The most important benefit of penile prosthesis implantation is a significant improvement in sexual function.
Men with ED finally get to overcome their sexual dysfunction, which reflects on their confidence.
Whether we like it or not, the greatest source of confidence for a lot of men is their sexual prowess.
For that reason, erectile problems take their toll and affect a man’s confidence and self-esteem.
Thanks to this implant, patients notice a boost in their confidence stemming from satisfactory intercourse.
But other benefits are also worth mentioning. These include:
No one knows you have the penile implant because it is entirely encased within the body.
It’s a great solution for men who want to achieve erections without taking pills or trying other, quite noticeable solutions.
The implant doesn’t interfere with intimate moments and allows men to achieve fast results.
For instance, you can get an erection in 15 seconds.
This makes penile prosthesis practical, as you don’t have to wait for 30 minutes or so to start having sex.
Simple and easy to use
To achieve penile rigidity, you don’t need to use some special or complicated technology. The pump is simple and makes it easy for you to get an erection whenever you want it.
Since the procedure is minimally invasive, it comes with minimal downtime.
Your recovery is fast, and you can expect to return to normal daily activities and sexual intercourse before you know it.
The implants provide reliable results for at least 10 years. That means they prove to be a reliable and durable ED treatment for men.
The most common risks associated with penile prosthesis procedure include:
Every surgery comes with a risk of infection.
Men with diabetes or spinal cord injury are more likely to develop a penile prosthesis infection.
Internal erosion or adhesion
An implant may stick to the skin inside the penis or wear away the skin from the inside of your genital organ.
The implant may break through the skin on rare and uncommon occasions. In some cases (very rare), contents of the penile reservoir may rupture into the urinary bladder.
These problems are associated with infection in some cases.
Malfunction of the implant may occur, but these cases are rare.
When that happens, a patient needs to undergo surgery to remove the implant or repair and replace it.
Not every patient will experience these risks and complications.
The procedure goes smoothly in a vast majority of men.
In fact, their implants don’t cause problems later on, as well.
This is especially the case with new and improved implants.
The healthcare provider will show you how to use the pump and take care of the surgical site after the procedure.
For a few days or weeks post-op, you may need to take pain medication.
Pain and discomfort are normal after the surgery, and over-the-counter pain relievers are enough to minimize them.
To minimize the risk of infection, you may receive a prescription for antibiotics.
In a few days after the surgery, you will be able to return to work.
Full recovery takes several weeks.
You will be able to resume sexual activity in four to six weeks post-op.
Swelling and bruising are also normal after the procedure.
Recovery doesn’t just depend on the expertise of a surgeon.
Things you do or don’t do after the surgery also play a role in how your body recovers. You will need to:
- Avoid moving quickly or lifting anything heavy until you feel better
- Do normal activities when it feels okay to do them
- Wear supportive underwear
- Wash the incision area daily with warm water and pat it dry
- Put a cold pack or ice on the area for 10 to 20 minutes every one to two hours during the next three days after the surgery or until the swelling goes away
Is it noticeable?
A penile prosthesis isn’t noticeable when your penis is in a flaccid state.
Your partner won’t know you’ve had an implant to treat erectile dysfunction unless you tell them.
The procedure itself is non-invasive and leaves a small scar at the bottom of your penis.
So it’s really not that easy; it’s practically impossible for anyone to tell you’ve had an implant.
What is sex like with a penile prosthesis?
The main purpose of a penile prosthesis is to give men an erection that is strong enough for pleasurable sexual intercourse.
The implant will not make the penis dramatically larger or wider.
Most men may notice their penis has become somewhat smaller.
Newer models aim to overcome this problem, though.
The implant supports the penis in an erect position.
In other words, it makes the penis stiff and thick, just like a natural erection would.
A penile prosthesis doesn’t influence your sex drive.
Also, it doesn’t change sensation on the skin or your ability to achieve an orgasm.
In other words, your sex life will remain the same.
You’ll have a stronger erection that will help you enjoy your sex life and improve the quality of your relationship.
It’s useful to mention penile prosthesis may inhibit the natural erection reflex.
Most men usually can’t achieve an erection without inflating the implant anymore.
Removal of the implant could mean you would be unable to achieve an erection naturally.
How effective is a penile prosthesis?
A penile prosthesis is considered effective in helping men with ED achieve erections.
A study from the Journal of Urology found the penile implant surgery induced a dramatic improvement in erectile function.
The satisfaction increased in one year after the implant surgery. Significant improvements occurred in the other half of the first year.
In fact, about 90% to 95% of penile implant procedures are successful.
Satisfaction rates are also high, between 80% and 90%.
A vast majority of men claim they would choose the surgery again because they’re so satisfied with the results.
Is it safe?
Every surgical procedure comes with certain risks, but penile implants are considered safe.
Some men, however, may experience adverse reactions.
The risks were mentioned above in this post, but to remind you, they may include infection, uncontrolled bleeding, and formation of scar tissue, among others.
The risk of complication is low.
Careful patient selection, counseling, and strict adherence to instructions are crucial for safety during and after the procedure.
Of course, if you opt to get a penile prosthesis, you should choose a surgeon wisely.
Your surgeon should have knowledge, expertise, and experience to perform this procedure with a high success rate.
Will medical insurance cover the procedure?
Medicare or Medicare Advantage Plan usually covers the costs of penile prosthesis procedure as long as it is considered medically necessary.
In other words, if the cause of ED is medical or health-related, you could get insurance to cover the costs of the procedure.
You may want to consult both your doctor and the health insurance provider about this subject.
Get informed about criteria you need to meet to get the coverage for the procedure or how much you’d have to pay without health insurance.
As seen throughout this post, penile prosthesis is safe and effective.
It can be helpful for men whose ED isn’t resolved with medications and other treatment options.
Consult your urologist or doctor if you are considering getting a penile prosthesis.
Healthcare providers can help you choose between inflatable and malleable penile implants.