What is a Penile Prosthesis?
A penile prosthesis is an excellent surgical option for men with erectile dysfunction in which a prosthetic device is placed into the erectile capsules of the penis in order to gain rigidity during sexual intercourse. The three forms of penile implants are:
- Semi-rigid prostheses: silicon-covered flexible metal rod are implanted into the erectile bodies, providing rigidity for intercourse. These implants remain rigid at all times, patients must bend the prosthesis straight when they want to engage in sexual activity. Malleable penile implants are mainly offered to patients without the manual dexterity in their hands to activate an inflatable prosthesis.
- Inflatable penile prostheses two soft silicone tubes are implanted into the penis, along with a small reservoir in the abdomen, and a small pump in the scrotum. This has a more natural appearance with erections and is easier for patients to conceal when they are not active.
- Self-contained inflatable implants consist of a pair of inflatable tubes inserted into the penis with a pump attached to the end of the implant and a reservoir located in the shaft of the penis.
The penile implant surgery usually takes under an hour and can be done with a short hospital outpatient admission or patients can be discharged the same day. Most patients can activate and engage in sexual activity within 2 to 6 weeks after surgery. A urinary catheter will be in place for one day after surgery and antibiotics will be prescribed for two weeks after surgery to prevent post-operative infections. Tight clothing should be avoided for up to six weeks to avoid pushing the saline reservoir out of position. We recommend minimizing strenuous physical activity and sex for one month after the surgery.
How does a penile implant work?
An inflatable penile implant is comprised of two hydraulic capsules placed into the penile corporal bodies, a pump located in the scrotum, and a reservoir of saline tucked under the pubic bone. In order to activate the prosthesis, patients will squeeze the pump with located between the testicles and in doing so this allows the fluid in the reservoir to flow into the two hydraulic cylinders located in the penile erectile bodies. When the cylinders are full of fluid, this results in a straight and very rigid erection. In order to deflate the implant, patients simply press and hold a small valve at the top of the pump device, thereby causing the fluid to flow out of the cylinders and back into the reservoir resulting in a flaccid penis
How obvious is a penile implant?
A penile implant is not highly noticeable given that all of the components are surgically implanted under the skin. On close visual inspection there may be a small scar just above or beneath the penis, but this is typically concealed in the pubic hair or underneath the penis. A man with a penile prosthesis does not have to fear embarrassment in a public restroom or locker room. A sexual partner would be able to feel the pump in the scrotum with manual inspection, but the erection would be similar to or more rigid than a natural erection.
How satisfied are patients after penile implant surgery?
Penile implant surgery is the current gold standard for treating erectile dysfunction. It has the highest efficacy and patient satisfaction of all treatment options for erectile dysfunction including oral agents, injections, vacuum devices and shockwave therapy with satisfaction rates of 80%-90%.
Is Penile Implant Surgery Safe?
As with an surgical procedure, penile implant surgery does carry some risk. Possible complications associated with penile implant surgery include the risk of infection (less than 5%), bleeding, pain, mechanical failure of the device requiring removal or replacement, erosion of the device through the surrounding tissue, or injury to abdominal structures upon reservoir placement.
Have a question or want to schedule an appointment?
Board-certified, fellowship-trained urologists staff Tower Men’s Health. We will pair you with one of our many experienced physicians to help address any concerns you may have and help you on your journey towards improved quality of life. Feel free to reach out to the physicians at Tower Men’s Health at 310-854-9898.