Assoc. Prof. Dr. Akif Diri
Urology Specialist
Penile implants are devices that are inserted into the penis to help men with erectile dysfunction get an erection. It is typically recommended for erectile dysfunction after other treatments have failed. If the patient has tried all treatments but still has not regained sufficient erection for sexual activity, he may consider penile implants.
Although penile implants are the least preferred treatment method for erectile dysfunction, which requires incision in the penis, most men and their partners reported that they were satisfied with the treatment.
Types of Penile Implant
There are two types of penile implants, inflatable and semi-rigid (bendable). Inflatable devices, the most widely used type of penile implant, can be inflated to create an erection and deflated after intercourse. Three-piece inflatable implants use a fluid-filled reservoir placed under the abdominal wall, a pump and a relief valve placed in the scrotum, and two inflatable cylinders in the penis. Every part of it is inside the body. Three-piece inflatable implants produce the most natural and firm erection, but have more parts that can fail than any other implant. The two-piece inflatable implant does not require a reservoir but provides a less rigid erection compared to the three-piece implant.
Semi-rigid devices have fewer parts and require an easier surgical procedure. However, the penis is always a little hard and can be difficult to control in clothes. It needs to be bent towards the body to hide.
How to Prepare for Penile Prosthesis Implantation
To make sure penile implants are the best treatment option, the doctor will perform a physical exam, including a urological exam. It confirms the presence of the patient’s erectile dysfunction and makes sure that it cannot be treated in any other way. The patient’s current and past medical history, especially the experience of erectile dysfunction, is very important.
In addition, the doctor tries to determine whether penile implant surgery is likely to cause complications. Because using some penile implants requires more dexterity than others, the doctor also checks the patient’s ability to use the implant.
The patient should be sure of what the procedure encompasses and that he chooses the type of penile implant that is most suitable for him. It is important to know that the transaction is permanent and irreversible.
What Happens During Surgery?
Inserts a catheter into the bladder to collect urine during penile prosthesis implantation. The surgeon will then make an incision under the glans of the penis or in the lower abdomen. The surgeon selects the correct size implant and places the implant cylinders into the penis. All implants are customized to body size.
If the doctor is wearing a two-piece inflatable implant, they will place a pump and valve in the scrotum. For the three-piece inflatable implant, your doctor will also place a reservoir in the abdominal wall. After the device is placed, the surgeon sutures the incisions. Penile implant surgery usually takes 45 minutes to an hour.
Post Surgery
After penile implant surgery, medication is likely to be needed to relieve pain. Mild pain may persist for several weeks. Antibiotics may be required for a week to prevent infection.
The doctor gives individual instructions on when to resume daily life. Most men can resume strenuous physical and sexual activities four to six weeks after surgery. After about two weeks, it will be necessary to go to a doctor’s control to remove the stitches.
To train and practice the area surrounding the implants, the doctor may ask their patients to inflate and deflate the inflatable penile implants twice a day.
Who Is Not Suitable For?
It is not suitable for individuals who have an infection such as a lung infection or urinary tract infection or uncontrolled diabetes.
It is important to remember that while penile implants enable men to get an erection, they do not increase their sexual desire or feelings. Also, penile implants do not make the penis larger than it is.
Is Penile Prosthesis Implantation Risky?
The risks of penile implant surgery include:
Infection: As with any surgery, there is a possibility of infection. If the patient has a spinal cord injury or diabetes, they may be at high risk of infection.
Implant problems: New penile implant designs are reliable, but in rare cases, implants can fail. A re-surgical procedure may be required to remove, repair, or replace a broken implant.
Internal erosion or adhesion: In some cases, the implant may adhere to or damage the skin inside the penis. Rarely, the implant may separate from the skin. These problems are in some cases linked to an infection.
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