What are penile implants. How do they work for treating erectile dysfunction. Who is a good candidate for penile implant surgery. What are the different types of penile implants available. How is penile implant surgery performed. What are the pros and cons of getting a penile implant. How effective are penile implants for treating ED.

Understanding Penile Implants: A Solution for Erectile Dysfunction

Penile implants, also known as penile prostheses, are surgical devices used to treat erectile dysfunction (ED) in men who have not responded to other treatments. These implants are designed to help men achieve and maintain erections for sexual intercourse. Unlike medications or external devices, penile implants are surgically placed inside the penis and provide a long-term solution for ED.

How do penile implants work?

Penile implants work by replacing the spongy tissue in the penis that normally fills with blood during an erection. There are two main types of penile implants:

• Inflatable implants: These consist of cylinders filled with saline solution, a pump, and a reservoir. When activated, the pump transfers fluid from the reservoir to the cylinders, creating an erection.
• Semirigid implants: These are bendable rods that allow the penis to be rigid enough for intercourse but can be positioned downward for concealment.

Types of Penile Implants: Choosing the Right Option

When considering penile implant surgery, it’s essential to understand the different types available. Each type has its own advantages and considerations:

Three-Piece Inflatable Implant

This is the most commonly used and advanced type of penile implant. It consists of:

• Two inflatable cylinders inside the penis
• A fluid reservoir placed under the abdominal wall
• A pump and release valve implanted in the scrotum

The three-piece inflatable implant offers the most natural-feeling erection and the highest degree of rigidity. However, it also involves the most complex surgery and has more parts that could potentially malfunction.

Two-Piece Inflatable Implant

This implant is similar to the three-piece version but combines the fluid reservoir with the pump in the scrotum. Benefits of this type include:

• Less complicated surgery
• Fewer parts to potentially malfunction

However, erections may be slightly less firm than with the three-piece implant, and the pump may require more effort to operate.

Semirigid Rod Implant

This type of implant consists of bendable rods that are surgically placed inside the penis. Key features include:

• Simplest type of penile implant
• Always firm, allowing for spontaneous sexual activity
• Easier to use and less likely to malfunction

The main drawback is that the penis is always semi-erect, which can be more challenging to conceal.

Candidacy for Penile Implant Surgery: Are You Eligible?

Penile implant surgery is typically considered when other treatments for erectile dysfunction have failed. You may be a good candidate if you:

• Have persistent ED that significantly impacts your sex life
• Have tried and failed to respond to oral ED medications like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), or avanafil (Stendra)
• Have not had success with penis pumps or vacuum constriction devices
• Have not responded positively to penile injection medications like TriMix
• Have a condition like Peyronie’s disease that is unlikely to improve with other treatments
• Have a history of prostate cancer or have undergone a prostatectomy

However, penile implant surgery may not be suitable for everyone. Factors that might make you ineligible include:

• ED that may be reversible
• ED primarily caused by emotional or psychological issues
• Lack of sexual desire or sensation
• Active urinary tract infection (UTI)
• Inflammation, lesions, or other skin problems on the penis or scrotum

The Penile Implant Procedure: What to Expect During Surgery

Penile implant surgery is typically performed under general or spinal anesthesia. The procedure usually takes 1-2 hours and involves the following steps:

1. The surgical area is shaved and cleaned.
2. A catheter is inserted to collect urine during the procedure.
3. An intravenous (IV) line is placed for administering antibiotics and other medications.
4. The surgeon makes an incision, typically in the lower abdomen, base of the penis, or just below the head of the penis.
5. The erectile tissue in the penis is stretched to create space for the implant.
6. The chosen implant is carefully placed inside the penis.
7. For inflatable implants, additional components like the pump and reservoir are positioned in the scrotum and abdomen.
8. The incisions are closed with dissolvable stitches.

Recovery time varies, but most men can return home the same day or the day after surgery. Full recovery and resumption of sexual activity typically take 4-6 weeks.

Advantages and Disadvantages of Penile Implants

As with any medical procedure, penile implants come with both benefits and potential drawbacks. Understanding these can help you make an informed decision about whether this treatment is right for you.

Pros of Penile Implants

• High effectiveness rate for treating ED
• Provides a long-term solution when other treatments have failed
• Allows for spontaneous sexual activity (especially with inflatable implants)
• Can be a part of gender-affirming surgery for transgender individuals
• High satisfaction rates among patients and their partners

Cons of Penile Implants

• Surgical procedure with associated risks, including infection
• Significant cost, which may not be fully covered by insurance
• Recovery period of several weeks before resuming sexual activity
• Potential for mechanical failure or need for revision surgery
• May alter the natural feel of the penis

Effectiveness and Satisfaction Rates of Penile Implants

Penile implants have proven to be highly effective in treating erectile dysfunction. Studies have shown impressive satisfaction rates among both patients and their partners. But just how effective are these devices?

Success Rates

Research indicates that penile implants have a success rate of 90-95% for treating ED. This means that the vast majority of men who undergo the procedure are able to achieve erections suitable for intercourse.

Patient Satisfaction

Multiple studies have reported high levels of patient satisfaction with penile implants:

• A review of 11 studies found that 79-97% of patients were satisfied with their implants.
• Partner satisfaction rates are also high, ranging from 82-94% in various studies.

Longevity of Implants

Modern penile implants are designed to be durable and long-lasting. On average:

• 60-80% of implants are still functioning after 10 years
• Some may last 15-20 years or more with proper care

It’s important to note that while these statistics are encouraging, individual experiences may vary. Factors such as proper device usage, regular follow-ups, and overall health can influence long-term outcomes.

Preparing for Penile Implant Surgery: Essential Steps

If you and your doctor have decided that a penile implant is the right choice for you, proper preparation is key to ensuring the best possible outcome. Here are the essential steps to take before your surgery:

Medical Evaluation

Your doctor will perform a thorough physical examination and review your medical history. This typically includes:

• A complete urologic exam
• Examination of your genitals and prostate
• Urine sample analysis
• Blood tests to check for infections or other health issues

Discussing Expectations and Concerns

It’s crucial to have an open and honest conversation with your surgeon about:

• Your expectations for the surgery and its outcomes
• Any concerns or questions you may have about the procedure
• The different types of implants available and which might be best for you
• Potential risks and complications

Pre-Surgery Instructions

Your doctor will provide specific instructions to follow before the surgery, which may include:

• Stopping certain medications, such as blood thinners, a few days before surgery
• Fasting from food and drink for a specified period before the procedure
• Showering with an antibacterial soap the night before and morning of surgery
• Arranging for someone to drive you home after the procedure

Lifestyle Preparations

To ensure a smooth recovery, consider:

• Preparing your home for post-surgery comfort (e.g., setting up a recovery area)
• Arranging time off work for recovery (typically 1-2 weeks)
• Stocking up on necessary supplies, such as loose-fitting clothing and ice packs

By following these preparatory steps, you can help minimize risks and set yourself up for a successful surgery and recovery.

Post-Surgery Care and Recovery: Ensuring Optimal Results

The recovery process after penile implant surgery is crucial for ensuring the best possible outcomes. Here’s what you can expect and how to care for yourself during this period:

Immediate Post-Op Care

In the hours and days immediately following surgery:

• You may experience pain and swelling, which can be managed with prescribed pain medications
• A catheter may remain in place for 24-48 hours to assist with urination
• You’ll be instructed on how to care for your incision site
• Antibiotics may be prescribed to prevent infection

Recovery Timeline

The typical recovery process involves:

• 1-2 days of hospital stay (in some cases, outpatient surgery is possible)
• 1-2 weeks of limited activity and rest at home
• 4-6 weeks before resuming sexual activity (your doctor will provide specific guidance)
• Full recovery and optimal implant function usually achieved within 2-3 months

At-Home Care

To promote healing and prevent complications:

• Keep the incision site clean and dry
• Wear supportive underwear as directed by your doctor
• Apply ice packs to reduce swelling
• Avoid strenuous activities, heavy lifting, and sexual activity until cleared by your doctor
• Attend all follow-up appointments

Learning to Use Your Implant

For inflatable implants:

• Your doctor will teach you how to operate the pump
• Practice inflating and deflating the device as instructed
• Follow guidelines on when to start using the implant for sexual activity

Long-Term Care

To ensure the longevity of your implant:

• Attend regular check-ups with your urologist
• Report any issues or concerns promptly
• Follow manufacturer guidelines for implant maintenance

Remember, every patient’s recovery is unique. Always follow your doctor’s specific instructions and don’t hesitate to ask questions if you’re unsure about any aspect of your recovery or implant use.

Penile Implant: Procedure, Effectiveness & More 

A penile implant, or penile prosthesis, is a treatment for erectile dysfunction (ED).

The surgery involves placing inflatable or flexible rods into the penis. Inflatable rods require a device filled with saline solution and a pump hidden in the scrotum. When you press on the pump, the saline solution travels to the device and inflates it, giving you an erection. Later, you can deflate the device again.

This procedure is usually reserved for men who have tried other ED treatments without success. Most men who have the surgery are satisfied with the results.

Continue reading to learn about different types of penile implants, who is a good candidate, and what you can expect after surgery.

Pros

• Penile implants are considered highly effective for treating ED.
• A penile implant might be suitable when oral medication isn’t working for ED.
• It can be a part of gender-affirming surgery.

Cons

• A penile implant can be costly.
• There’s a risk of infection.
• It will take several weeks to fully recover.
• Not everyone is a good candidate for an implant.

Was this helpful?

You may be a good candidate for penile implant surgery if you have:

• persistent ED that impairs your sex life
• already tried medications for ED, such as:
  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil (Levitra)
  • avanafil (Stendra)
• tried a penis pump (vacuum constriction device)
• not had positive results from penile injection medications like TriMix
• a condition, such as Peyronie’s disease, that is unlikely to improve with other treatments
• a history of prostate cancer or have previously undergone a prostatectomy

You may not be a good candidate if:

• there’s a chance ED is reversible
• ED is due to emotional issues
• you lack sexual desire or sensation
• you have a urinary tract infection (UTI)
• you have inflammation, lesions, or other problems with the skin of your penis or scrotum

Find out which medications may cause ED »

Your doctor will perform a thorough physical examination and review your medical history. This will help them determine whether a penile implant is right for you.

The physical exam will include a complete urologic exam. This can include examining your genitals and prostrate, and getting a urine sample.

Your doctor will probably advise against penile implant surgery if you have:

• an infection, such as a pulmonary infection or urinary tract infection (UTI)
• diabetes that isn’t well managed
• cardiovascular disease

All other treatment options will be considered before going ahead with a penile implant. Most doctors will only recommend surgery after you’ve tried less invasive treatments for ED, such as oral medications or a penis pump.

Tell your doctor about your expectations and concerns. You’ll have to choose the type of implant, so ask about the pros and cons of each type.

Your doctor will also inform you about the risks of penile implant surgery as well as follow-up care steps.

Your doctor will probably advise you to avoid eating or drinking after a certain time before your surgery. You’ll also need to arrange a ride home after the surgery.

3-piece implant

Inflatable devices are the most commonly used type. A three-piece implant involves putting a fluid reservoir under the abdominal wall. The pump and release valve is implanted in the scrotum. Two inflatable cylinders are placed inside the penis.

It’s the most extensive type of penile implant surgery, but it creates the most rigid erection. There are more parts to potentially malfunction, however.

2-piece implant

There’s also a two-piece implant in which the reservoir is part of the pump that is placed in the scrotum. This surgery is a little less complicated. Erections are generally a bit less firm than with the three-piece implant. This pump may take more effort to work, but it requires less hand dexterity.

Semirigid implants

Another type of surgery uses semirigid rods, which aren’t inflatable. Once implanted, these devices stay firm all the time. You can position your penis against your body or bend it away from your body to have sex.

Another type of semirigid implant has a series of segments with a spring on each end. This makes it slightly easier to maintain positioning.

Surgery to implant semirigid rods is simpler than surgery for inflatable implants. They’re easier to use and less likely to malfunction. But semirigid rods put constant pressure on the penis and can be somewhat harder to conceal.

The surgery may be performed using spinal anesthesia or general anesthesia.

Prior to surgery, the area is shaved. A catheter is placed to collect urine, and an intravenous line (IV) for antibiotics or other medications.

The surgeon makes an incision in your lower abdomen, the base of your penis, or just below the head of your penis.

Then the tissue in the penis, which is normally filled with blood during an erection, is stretched. The two inflatable cylinders are then placed inside your penis.

If you’ve chosen a two-piece inflatable device, the saline reservoir, valve, and pump are placed inside your scrotum. With a three-piece device, the pump goes in your scrotum, and the reservoir is inserted under the abdominal wall.

Finally, your surgeon closes the incisions. It’s usually done on an outpatient basis and the procedure generally takes 45 to 90 minutes but those times can vary.

After surgery, you’ll be given instructions on how to take care of the surgical site and how to use the pump.

You may need pain relievers for a few days or weeks. Your doctor will probably prescribe antibiotics to cut down on the chances of infection.

You may be able to return to work within a few days, but it may take several weeks to fully recover. You should be able to resume sexual activity in about four to six weeks.

Many inflatable penile implant surgeries are considered successful. (That is, they result in erections for intercourse.) Among men who have had the surgery, around 86% report satisfaction, according to a 2015 study.

Penile implants mimic a natural erection so you can have intercourse. They don’t help the head of the penis to get hard, nor do they affect sensation or orgasm.

As with any type of surgery, there’s a risk of infection, bleeding, and formation of scar tissue following the procedure. Rarely, complications like mechanical failures, erosion, or adhesion need surgery to repair or remove the implant.

If you have an established medical cause for ED, your insurer may cover the cost in whole or in part. Total costs depend on a variety of factors such as:

• type of implant
• where you live
• whether providers are in-network
• your plan’s copays and deductibles

If you don’t have coverage, your doctor may agree to a self-pay plan. Request a cost estimate and contact your insurer before you schedule surgery. Most providers have an insurance specialist to help you navigate financial matters.

To get an idea of patient satisfaction rates, researchers have sent questionnaires and interviewed people who had undergone the procedure.

Responses to a 2019 study found that 1 year or more after the procedure, study participants reported an 83.2% satisfaction rate. Their partners had an 85.4% satisfaction rate.

However, a 2021 study noted that questionnaires had room for improvement to better contextualize the very high satisfaction rates often found in the literature and studies into penile implant satisfaction.

If you frequently find it difficult to maintain an erection, consider booking an appointment with a doctor, even if you’re not sexually active. Although ED might be a temporary issue that goes away on its own, it could also be a sign of an underlying condition.

If an underlying condition is causing your ED, your doctor’s likely first step is to treat that condition before treating the ED.

Before penile implant surgery, your doctor will probably recommend other, less invasive treatments. These can include:

• medication
• penis pumps
• penis injections
• lifestyle changes, such as quitting smoking if you smoke
• talk therapy, if ED is linked to stress or emotional difficulties

Medication

A number of oral medications are available for ED. Nowadays, you can find cheaper generic versions of popular erectile dysfunction medication. Sometimes, insurance might cover it.

ED medication is noninvasive and easy to use. However, it can cause side effects. Your doctor might suggest a different kind of ED medication if one causes side effects.

In some cases, ED medication might not be recommended if you’re taking certain medications (such as alpha-blockers) or if you have certain cardiovascular conditions.

Penis pumps

Penis pumps are ideal if you can’t, or don’t want to, use medication to treat your ED. Also called a vacuum pump or a vacuum erection pump, it’s ideal for someone with moderate ED.

To use a penis pump, you place the pump over your penis. Turn on the pump (or use the hand pump) to remove air from the tube. The change in air pressure causes blood to flow to the penis, engorging the blood vessels. This causes an erection.

There are many kinds of penis pumps out there, and they’re not too expensive. Although it doesn’t work for everyone, it’s a noninvasive, non-drug treatment that can be effective.

Penis injections

With penis injections, you’ll have to inject medication into the shaft of the penis before sex. An erection will usually follow within 5 to 15 minutes.

Injectible medication can cost around $5 per dose, according to GoodRx. In some circumstances, it might be covered by insurance.

According to a 2019 study of 105 men, around 70% of men who have used penile injection therapy for more than 8 years were happy with the results. However, it has its drawbacks: Some people experience side effects, and many dislike injections in general.

Lifestyle changes

Lifestyle changes, such as quitting smoking and managing stress, can help with ED.

These lifestyle changes can be free (or cheap), and they can have the added bonus of improving your overall wellness.

However, if your lifestyle isn’t contributing to your ED, changing your habits might not necessarily help.

Talk therapy

In many cases, your doctor might recommend talk therapy before penile implants. This is especially the case if your ED might have an emotional root, such as stress, anxiety, or trauma.

While penile implants typically cost over $10 000, talk therapy is usually $100 to $200 per hour. Most therapists recommend a minimum of six to eight sessions, although it can be longer. Overall, talk therapy might be cheaper and it can benefit your mental health more generally.

But, as with lifestyle changes, it’s not always easy to say whether talk therapy will help with your ED or not. If your ED is not the symptom of a larger emotional problem, talk therapy is unlikely to help.

How long does a penile implant last?

It usually lasts between 15 and 20 years. After this time, you may need to replace the implant.

Is a penile implant noticeable?

Although there will be a small scar on the bottom of your penis, it won’t be very noticeable to other people. However, penile implants that aren’t able to inflate could be seen as a non-flaccid penis.

Does a penile implant increase penis size?

No, penile implants can’t increase penis size.

Do doctors recommend penile implants?

Yes, when they are needed. Doctors recommend penile implants if other ED treatment options are unsuitable or ineffective. Penile implants can also form a part of gender affirming surgery.

What is the recovery time after a penile implant?

It usually takes several weeks to fully recover from a penile implant. Like with any procedure, recovery time depends on your unique situation.

Generally, you can resume sexual activity in 4 to 6 weeks. The recovery period will be longer if you have an infection or other complications.

Penile implants are designed to stay hidden and help you achieve erections for intercourse. It’s a viable option when other treatments are ineffective.

What Is a Penile Implant? Salt Lake City | University of Utah Health

Does the Implant Work Well?

Yes, very well. Satisfaction rates for patients and their partners in most studies is well above 90 percent.

Çayan S, Aşcı R, Efesoy O, Bolat MS, Akbay E, Yaman Ö. Comparison of Long-Term Results and Couples’ Satisfaction with Penile Implant Types and Brands: Lessons Learned From 883 Patients With Erectile Dysfunction Who Underwent Penile Prosthesis Implantation. J Sex Med. 2019 Jul;16(7):1092-1099.

Does My Insurance Pay for It?

Most insurances companies, including Medicare, cover the device and surgery. For those without insurance, we have specialists who can work with you on costs and payment.

Who Should Do the Surgery?

As with other specialized surgeries, you should be careful about who you choose to perform it. Penile implant surgery requires specialty training and expertise. Make sure you’re confident in your surgeon’s abilities and experience.

What Are the Risks?

As with any surgical procedure, there are potential risks. The greatest risk is infection. Just like having a knee or hip prosthesis, having a penile implant means there is a “foreign body” in place and an infection can be quite serious (just like with a hip or knee). However, the risk of infection is typically fewer than one percent in most patients.

If you someday need an MRI, implants are safe. It is important to tell other health care providers that you have an implant. For example if you are having a dental procedure, you will likely need additional antibiotics.

What Can I Do to Avoid Infection?

Infection rates with modern implants are quite low, around one percent. One of the great advances of modern implants is the use of coatings that hold in antibiotics to prevent bacteria from getting on the device.*

There are, however, certain conditions that do increase the risk of infection, which include the following:

• Spinal cord injury
• Diabetes (especially if the blood sugars are consistently high)
• Re-do surgery or surgery in the setting of extensive scarring
• Taking chronic steroids, such as prednisone

Our team uses many techniques to minimize infection in patients, both before the operation and during the operation. It is critical that surgeons are very meticulous in technique and are aware of the many things that can be done to prevent infections.

* Dick B, Tsambarlis P, Reddy A, Hellstrom WJ. An update on: long-term outcomes of penile prostheses for the treatment of erectile dysfunction. Expert Rev Med Devices. 2019 Apr;16(4):281-286. 

Do I Need to Stay in the Hospital?

The procedure may be done as an outpatient (where you go home from the hospital the day you have surgery) or with an overnight stay. If done as an outpatient, you will need to return to clinic the next day so we can remove the dressings.

What Is My Expected Recovery Time?

Everybody heals at different rates, so recovery times can vary between patients. Generally, you will likely begin to feel better after the first week.

How Active Can I Be After Surgery?

There are some restrictions following your surgery, specifically, no heavy lifting (nothing over 15 lbs) for the first four weeks and no rigorous exercise. You can resume normal day to day activities as you feel up to it.

Many men ask if they can ever return to their favorite activities such as bike riding and running. Yes! You can return to those activities after you are fully healed.

Will I Have to Have My Stitches Removed?

No. The sutures we use are dissolvable and are made to stay in for a long time. Your sutures will likely dissolve over four to eight weeks.

Is Bruising and Swelling Normal?

Yes. As with any surgery, there will be bruising and swelling. We will prescribe post-operative pain medication for you and you may use an ice pack to help with swelling.

When Can I Begin to Use My Device?

Your provider will teach you how to use your implant at your two-week follow-up appointment. We will give you physical therapy instructions to inflate it for a certain amount of time each day.

You may not be feeling 100 percent by this time, but the earlier you can begin your physical therapy the better your ultimate function and size will be.

Depending on how quickly you are healing, you may be able to resume sexual activity. The average time to resume sexual activity is between four to six weeks.

What Will the Penile Implant Look Like After Surgery?

Once healed, your implant will be completely undetectable. It is fully concealed in the body and no one will know unless you tell them.

Will the Implant Affect Penis Size?

A penile implant is not intended to add length to the penis. Most implants expand in length and girth in order to achieve the maximum size of the patient’s natural erection.

The sizing is done during surgery and customized to each patient. Some men do experience some penile shortening, although it can be subjective. For example, men who have had erection problems for a long time might not accurately recall their earlier penis size.

What Will the Penile Implant Feel Like for Me and My Partner?

A man’s erection after implant surgery looks and feels very natural. The penile implant does not change your sensation or ability to climax. The implant is replacing the erectile tissue that does not function anymore.

Does a Penile Implant Affect Urination?

No, the implant will not affect urination since the urethra is separate from where the penile implant cylinders are placed.

Are People Ever Dissatisfied?

When a man has had ED for a long time, the penis shrinks and scars. This is similar to a weightlifter who stops working out and the muscles shrink. For this reason, the penis is often shorter than it was when he was younger. This loss of length is the most common cause for dissatisfaction.

Does the Device Ever Fail?

These devices are mechanical, so eventually they will fail. With modern devices, they usually last 10–15 years and may last even more than 20 years. When they fail, an additional surgery is required to replace the device (very similar to the original surgery).

Penile prosthesis in Moscow, prices for procedures at the IPHK clinic

General information

Penile prosthesis is a surgical treatment for erectile dysfunction in men. This technique is the final option for the treatment of erectile dysfunction (third line therapy), which is used when other methods of treatment are ineffective.

In essence, penile prosthetics is a surgical operation, during which the patient’s own system, which provides an erection, is replaced with an artificial (artificial) one. At the same time, during the operation, the cavernous bodies are replaced with special functional implants that allow the penis to achieve the necessary rigidity (stiffness) necessary for sexual intercourse.

At the same time, penile prosthesis is the most effective treatment for erectile dysfunction, providing among patients the highest satisfaction compared to all other methods of treatment. The efficiency of this technique approaches 100%.

Penile prostheses are completely placed inside the patient’s body. At the same time, they provide a high quality erection whenever a man needs it for sexual intercourse.

With the use of modern prostheses, sexual intercourse becomes as physiological as possible, while the penis looks completely natural in an erection and in a relaxed state. The implant does not affect sexual sensations, ejaculation, urination in any way. In this case, the patient himself can determine the appropriate time for the onset of an erection and its duration.

You can carry out penile prosthetics in Moscow at the Institute of Plastic Surgery and Cosmetology. First, the doctor will assess the condition and prescribe an examination. Also, at the initial consultation, contraindications are excluded and the price of the operation is determined. After completion of the procedure, the patient continues to be observed by the doctor until full recovery.

A little more about penile prosthetics

Penile prosthesis is the only method of surgical correction of erectile dysfunction at present. The main reasons for this: a stable result, a small number of complications, a simple and short recovery period.

Erection is a physiological reaction of the body, which consists in an increase in the size and hardening of the penis as a result of filling with blood of the cavernous bodies of the penis, located inside the semi-rigid albuginea. Erection is a complex coordinated process, which involves neurogenic and vascular mechanisms. In this case, damage to these mechanisms can lead to a weakening or complete loss of the possibility of an erection. At the same time, it must be understood that the lack of erection does not affect the possibility of sexual arousal and changes in sensitivity during this, in addition, the possibility of obtaining an orgasm and even ejaculation is preserved. However, sexual intercourse is not possible due to the lack of rigidity (elasticity and hardness) of the penis.

With the development of severe forms of erectile dysfunction, its achievement by various methods of conservative influence (tablets, physiotherapy, intracavernous injections) becomes impossible, or an erection is achieved, but does not allow high-quality sexual intercourse. In this case, the only way to maintain the possibility of sexual activity is phalloprosthesis.

During penile prosthetics, the cavernous bodies are replaced with special prostheses that are installed inside the albuginea of ​​the penis and make it possible to impart rigidity (elasticity and hardness) to the penis. At the same time, the range of sensations in patients with a phalloprosthesis is absolutely similar to that in a person with a normal erection mechanism.

There are several fundamentally different types of penile implants (falloprostheses). This:

Unguided semi-rigid prostheses. They are made of special medical silicone and consist of two rods without a special internal structure. At the same time, after the installation of such a prosthesis, the penis is always in a state of erection and its axis is constant (the shape and position do not change). For the normal use of such a prosthesis, it is necessary to constantly wear special slimming underwear. This causes sufficient discomfort for patients, and can also lead to chafing of the skin of the penis. This type of prosthesis has no fundamental advantages, except for the price, and is currently used extremely rarely.

Semi-rigid dentures with shape memory. These are also silicone penile implants, which are supplemented with a semi-rigid shape memory rod installed inside them. This fact allows you to give the penis one or another bend, which allows you to bend it in the absence of the need for an erection and straighten it for the duration of sexual intercourse. This significantly increases the convenience of using these prostheses compared to unmanaged ones. In this case, the size of the penis always remains constant. Low cost and relative ease of use make these prostheses one of the most commonly used in the world.

Two-piece hydraulic prostheses. Hydraulic prostheses, unlike semi-rigid prostheses, are filled with liquid. At the same time, a special control mechanism (hydraulic pump) is able to pump fluid from the reservoir into cylinders (which are installed directly in place of the cavernous bodies). When filled, the cylinders acquire rigidity (elasticity and hardness), which allows you to bring the penis into a state of erection and perform a full-fledged sexual intercourse. After that, using the same control pump, it is possible to move the liquid back into the reservoir. As a result, the cylinders become empty, and the erection disappears. In the case of two-piece prostheses, the control pump is also a reservoir for a special fluid used in the hydraulic system. This reduces the filling efficiency of the cylinders, increases the size of the pump, which, after installation, is located in the scrotum and can be visualized. Currently, the percentage of use of this type of prosthesis is very small.

Three-piece hydraulic prostheses are the most modern type of penile prostheses. The mechanism of their action is most similar to the mechanism of action of two-component penile prostheses, however, in them the reservoir for the liquid is taken out separately. In this case, the reservoir is installed outside the scrotum or penis, and in the pubic region deep in the pelvic cavity. With such an installation, the reservoir is completely inaccessible for visualization, it cannot be detected by hand. Such a design, on the one hand, can provide maximum rigidity when pumping the cylinders, which gives an excellent quality of erection and at the same time minimize the size of the control pump, which makes it completely invisible. In the most modern types of prostheses, the function of both increasing the diameter and increasing the length of the cylinders during their filling is implemented. This allows you to make an erection when using such phalloprostheses as physiological as possible. To date, this type of penile prosthesis is the most common, although the most expensive of these devices.

So, currently there are two main types of penile implants: semi-rigid shape memory implants and three-piece hydraulic penile prostheses. It is worth saying that the period of use of modern phalloprostheses of both types can be more than 20 years.

There are a number of methods for installing penile prostheses. Can be used as a pubic access, when the incision for the installation of implants is made on the skin of the pubis, and scrotal access, when the incision is formed in the area of ​​the root of the penis on the scrotum. There are methods of phalloprosthesis combined access. The access option is always chosen individually for each patient in accordance with the characteristics of physiology, the possibilities of the clinic and the skills of the operating surgeon.

Features of work in our clinic.

At the Institute of Plastic Surgery and Cosmetology, all possible options for penile prosthetics are performed.

The presence of its own diagnostic base, which allows you to fully examine and prepare the patient for surgery.

Equipping the clinic with modern equipment and the highest quality consumables.

High level of training of medical personnel.

The versatility of the center allows you to involve any specialists in treatment and postoperative care.

An integrated approach to treatment and the use of the most modern implants can reduce the number of complications to a minimum.

Benefits

• High erection efficiency
• Erection at the right time
• Complete control of the duration of sexual intercourse
• Natural looking penis in any condition
• Full opportunity for natural conception
• Complete preservation of natural ejaculation and urination
• Opportunity to eliminate defects of the penis during the operation (curvature, insufficient size)
• Complete relief from erectile dysfunction
• No restrictions in daily life
• The effectiveness of the prosthesis is not affected by the progression of the disease that led to erectile dysfunction
• Minimum number of possible complications

Indications

• Indications for penile prosthetics are various reasons that caused severe erectile dysfunction. The most common reasons for the installation of penile prostheses include:
• Peyronie’s disease
• Insufficient effectiveness of conservative therapy for erectile dysfunction
• Cavernous fibrosis
• Diabetic neuropathy and vasculopathy
• Spinal cord injuries
• Neurological diseases
• Previous radical prostatectomy
• Post-traumatic erectile dysfunction
• Past priapism
• Severe endocrine and vascular pathologies
• Underdevelopment of the penis
• Psychogenic erectile dysfunction not amenable to other methods of correction

Contraindications

• The surgeon may refuse to perform the operation if the patient has:
• mental deviations in any form and severity,
• malignant tumor,
• uncontrolled hypertension,
• individual intolerance to analgesics, anticoagulants, sutures, disinfectants,
• bacterial infection at the time of referral,
• any inflammatory process in the area of ​​the proposed intervention,
• bleeding disorder,
• some venereal diseases, as well as other pathology of the pelvic organs.

Penile prosthesis: a surgical method for the treatment of erectile dysfunction in questions and answers

Penile prosthesis is a surgical method for the treatment of erectile dysfunction, in which the destruction of the cavernous bodies of the penis and the installation of a penis implant in their place. Penile prosthesis (installation of a penile prosthesis / penile prosthesis) allows you to get rid of severe forms of erectile dysfunction that are not amenable to other methods of treatment. At the same time, all natural processes are preserved in patients – urination and ejaculation, as well as the appearance and sensitivity of the penis (except in cases of removal of the prostate gland).

Indications for penile prosthesis include:

• Cavernous body fibrosis
• Erectile dysfunction refractory to other treatments
• Injuries of the penis
• Erectile dysfunction after operations on the pelvic organs and prostate (prostatectomy, cystectomy, TURP, adenomectomy)
• Peyronie’s disease

What happens during a penile prosthesis?

Penile prosthesis is a radical method for the treatment of erectile dysfunction of various origins. The operation is irreversible, as a rule, it is prescribed for those patients who do not respond to other methods of treatment, medication, physiotherapy. Penile implant placement is the third line of therapy. The goal of treatment is to ensure the elasticity and hardness of the penis, sufficient for a full-fledged sexual intercourse. To this end, rigid or hydraulic cylinders are implanted into the penis, allowing the erection process to be fully controlled. To do this, during the operation of phalloprosthesis, the cavernous bodies of the penis are destroyed and cylinders are installed in their place.

Cavernous (cavernous from Latin caverna “cavity, cave”) body is a structural unit of the erectile tissue of the male penis shaft (penis). This tissue also includes his spongy body. Two longitudinal cavernous bodies, together with one spongy body located longitudinally below them, form the shaft of the penis. Cavernous bodies provide blood supply to the penis – its erectile function.

During penile prosthetics, one of the types of penile implants (prostheses of the penis, penile prostheses) is installed in the patient: one-component or three-component. Prostheses are fundamentally different in design, mechanism of operation, cost. Below we will consider the features of each type of prosthesis.

One-component (rigid, semi-rigid) penile implants (penoprostheses) are a pair of cylinders installed in the body of the penis. Such penile prostheses provide the axial hardness of the penis necessary for sexual intercourse. Before sexual intercourse, the penis with the implant installed must be straightened by hand to the desired position, and after the end, returned to a non-erect state, lowering it down. In the presence of a one-component penile prosthesis, the penis is constantly solid, a man can only raise or lower it.

One-piece prostheses are cheaper than three-piece ones. They are best suited for patients with limited arm mobility, poor finger sensation, coordination problems, or limited range of motion. Dentures are very easy to use, reliable and durable. Of the advantages when installed by a doctor – a smaller volume of surgery compared to a three-component one and less pronounced pain in the postoperative period. Drainage is almost never used. Of the minuses, one can note the “cold penis”, that is, it is less hot to the touch than with a natural erection, and the penis is more noticeable in everyday life, for example, when wearing tight clothes.

Coloplast manufactures one-piece Genesis implants. They are a pair of rods for installation in the body of the penis. The outer shell of the implant is made of medical hypoallergenic silicone in two layers. The outer one is softer, more transparent, the inner one is denser. Inside each rod is a double helix made of a reliable and durable titanium and silver shape memory alloy. Working tests have shown that Genesis implants can easily withstand 8,000 (eight thousand!) cycles of flexion at an angle of 90° without breaking the integrity. Genesis prostheses also have a lifetime warranty against mechanical failure.

Three-piece penile implants (hydraulic penile prostheses) are a more advanced design, both technically and physiologically. They completely imitate a natural erection and are practically invisible to a partner. The prosthesis consists of three components: a pair of cylinders, a pump and a reservoir. The components of the penile implant are connected to each other by flexible and durable tubes, through which sterile saline is pumped from the reservoir into the cylinders. That is why the prosthesis is also called hydraulic.

In order to bring the penis into an erect state, the patient needs to squeeze the pump to pump fluid from the reservoir into the cylinders. Due to the fact that the fluid is pumped gradually, the erection process looks as natural as possible. To bring the penis into a relaxed state, you need to squeeze the valve on the pump, which will empty the cylinders and pump fluid from the cylinders back into the reservoir.

The advantages of hydraulic three-component prostheses include a high degree of reliability of the device, a complete imitation of a natural erection, almost complete invisibility to a partner, a stable return of erectile function. The patient can cause an erection at will at any time, an unlimited number of times, while the duration of the erection itself is determined by the patient himself. Also, the advantages include the possibility of installing a penile implant in patients with diabetes and elderly patients.

Disadvantage: Pump activation requires precise movement and sensitivity, which can be difficult for patients with neurological disorders, loss of sensation in the fingers or elderly patients. The disadvantages include a more complex procedure for installing a phalloprosthesis, which leads to an increase in the time of the operation and a longer period of rehabilitation. A three-piece penile implant is significantly more expensive than a one-piece penile implant. However, a large proportion of patients choose three-piece penile implants because of their reliability, natural appearance and ease of use. When solving the problem of erectile dysfunction, the result itself is more important than economic costs.

Coloplast introduces Titan Touch three-piece penile implants. Titan Touch is one of the market leaders in the field of penile prosthetics with hydraulic implants. Many surgeons choose it as the “gold standard”. The Titan Touch penis prosthesis has variable stiffness to fully simulate a natural erection.

Other features of the implant:

• Titan Touch cylinders are made of the unique Bioflex material, an elastic but very strong biopolymer. It does not cause allergic reactions and has a long service life. Unlike standard silicone, this material withstands over 6.5 million activation/deactivation cycles.
• All components of the Titan Touch penile prosthesis have a hydrophilic coating! This increases the adsorption of aqueous solutions of antibacterial agents on the implant surface (this is very important for the prevention of infectious complications in the postoperative period), fits implantation and allows the use of combined antibiotics. The hydrophilic coating reduces the risk of infection and facilitates the installation process, reducing the operation time.
• Unique “One Touch” pump for quick and easy activation of the prosthesis with one hand, also for patients with disabilities. The ribbed surface of the pump makes it easy to find and interact.
• The tips of the cylinders are anatomically shaped to give the penis the most natural look.
• Lock-out tank valve protects the system from accidental activation due to increased pressure on the tank.
• The “clover leaf” reservoir has a perfect anatomical shape, which makes the implant placement process more comfortable. This shape also provides more volume in a smaller tank compared to the previous generation tank.
• All components of the Titan Touch penile implant are covered by a lifetime warranty against mechanical failure!

Penile implant surgery

Preparation for surgery includes the necessary tests: complete and biochemical blood tests, blood clotting tests, tests for HIV, hepatitis, syphilis, ECG, chest X-ray, ultrasound of the penis, pelvic organs, scrotum. The patient is consulted by a general practitioner, anesthesiologist, andrologist to eliminate any risk during the operation. After passing all the examinations, the patient goes to the clinic. On the day of the operation, the hair in the groin area is removed. Premedication is carried out, antibiotics are prescribed to prevent infectious complications. The operation itself is performed under intravenous or spinal anesthesia. The duration of the operation is on average 1-2 hours.

After the operation, the patient remains under observation in the hospital for 2-3 days. He is fitted with a drain, a catheter, and treatment is being carried out. The patient takes antibiotics to exclude the development of infection, painkillers. Sexual rest is prescribed for 4 weeks, it is forbidden to lift weights and carry out active physical activity in the rehabilitation period. After 2-3 days the patient can be discharged home. He can recover on an outpatient basis, following the recommendations of the attending physician and periodically visit the clinic for postoperative control. Thanks to the use of modern operating equipment, special surgical instruments and high-quality consumables, the recovery proceeds as quickly as possible, without complications, leaving no cosmetic defects, noticeable sutures or scars. Approximately 4-6 weeks after surgery, the patient can gradually begin to return to an active sexual life.

You should immediately contact your doctor if:

• The edema has not decreased for a long time or has increased noticeably
• Excreted large amounts of fluid every day, it has an unpleasant odor, there is blood or pus
• Pain gets worse and does not go away
• There is swelling around the incision site, redness of the tissues, signs of inflammation, severe pain
• Fever, fever, you observe a general deterioration in the condition

Frequently Asked Questions:

• Will the natural appearance of the penis be preserved? Yes, it will. With a one-piece penile implant, the penis will look natural but permanently erect. When installing a three-component prosthesis, the penis looks as natural as possible, as well as the erection process. The user himself determines the degree of rigidity of the cylinders and the erect position. As a rule, a hydraulic penile prosthesis is even invisible to a partner.
• Will the size of the penis change? Yes, penis size can increase slightly. For clarification, a consultation with the attending physician is required.
• Will my partner’s feelings change? No, the feeling of the partner does not change.
• Will ejaculation persist? Yes, orgasm and ejaculation remain the same as before the operation. There is no ejaculation in patients after prostatectomy.
• Can there be a spontaneous erection after implant placement? No, he can not.
• Can there be problems with urination after a penile prosthesis? No, a penile implant does not affect urination.
• Are there any restrictions on sports? No, after 1 month you will be able to return to physical activity.
• Can the prosthesis break? If we talk about Titan Touch penile implants, this happens very rarely. Such breakdowns can occur due to a violation of the installation procedure by the attending physician or non-compliance with the recommendations of the doctor by the patient during the rehabilitation period. In the event of breakdowns, a reimplantation procedure is performed – replacing the prosthesis with a new one. It is important to remember that Coloplast gives a lifetime warranty on mechanical failures! This means that the new prosthesis will be free for you.

Results

Penile prosthesis is a modern and effective surgical treatment for erectile dysfunction. It must be remembered that this is a radical method of treatment – after the operation, it will be impossible to change anything, so the patient must carefully consider all the consequences, benefits and risks of the procedure. As with any surgical operation, the installation of a penile implant has its own risks and complications, but these risks can be significantly reduced by contacting an experienced implantologist. The benefits of penile prosthetics (installation of penile implants) include:

• The most natural appearance of the penis after surgery and the appearance of a natural erection (in the case of a three-piece penile implant)
• Hydraulic implants are invisible in life, they are easy to hide from a partner
• The patient himself decides when an erection occurs, how long the sexual intercourse will have, he determines the hardness of the cylinders
• High level of satisfaction after the installation of a penile implant in patients with erectile dysfunction – the return of moral and physical comfort
• No restrictions in daily life

Among the shortcomings, the following can be noted:

• The operation is final. This is a radical treatment. If the implant is removed, it will be impossible to restore an erection
• Postoperative infection risk
• Risk of penile implant complications

We offer our clients Coloplast Penile Implants (Phalloprostheses) manufactured in the USA. These are models of a one-component penile implant Genesis and a three-component hydraulic phalloprosthesis Titan Touch. Benefits of buying a Coloplast penile implant from Uromed M:

• Uromed M is the official and sole distributor of Coloplast penile implants in Russia. We guarantee the high quality of products that come to us directly from the manufacturer’s factory.
• We have a certified surgeon on staff who is present at all Coloplast penile implant procedures to validate the prosthesis warranty.
• We stock all sizes of penile implants and all the necessary accessories for the correct placement of the implant, even in the most difficult clinical situation.
• We provide doctors with a specialized surgical instrument during the operation, so that the surgical intervention is as comfortable and without complications as possible.
• Coloplast penile implants have a lifetime warranty against mechanical failure! In the event of a malfunction, we will provide a new implant free of charge.