Penile Prosthesis from an MD’s standpoint

As early as twenty years ago, male impotence used to ruin many marriages and put an end to even the most dedicated relationships. Men were ashamed to talk about it even with their doctors, destroying personal self-esteem and hopes for a better future. However, with the development of medicine, there’s no longer a need to silently suffer from this somewhat embarrassing yet curable condition, as specialists suggest many ways of treatment, each suitable for a particular category of patients.

What is Erectile Dysfunction?

Impotence or erectile dysfunction (ED) is a disorder affecting the blood flow to the penis, which blocks a man’s ability to achieve and sustain an erection long enough to have sex. Contrary to the wildly held belief, not only elderly men are in a risk group, with numerous factors contributing to the occurrence of impotence in men under 50, including both physical and emotional issues. According to statistics, approximately 60 percent of men aged 40 to 70 happen to deal with ED at least once.

Different for each individual, main reasons causing ED include endocrine diseases, neurological disorders, cardiac-related conditions, medication treatment, unhealthy lifestyle and emotional problems.

Drugs vs. Surgery

Treatments, available for ED today, include lifestyle changes, specially-prescribed drugs, and surgery. Before considering any therapy, you must contact your doctor and have the necessary tests done, based on which the specialist will decide what causes your ED, and what remedy should be taken.

If the problem lies in a lifestyle, you’ll be advised to cut down on smoking and drinking, exercise more and follow a healthy diet. Psychological counseling will be an option in case you struggle due to mental obstacles, and if any disease is a reason you fail in bed, you’ll be prescribed a special drug.

A variety of medicine to treat impotence grows slowly but steadily, as pharmaceutical manufacturers constantly come up with new drugs. Available only on prescription, Viagra is the most common but not the only anti-impotence medication, and such drugs as Cialis and Staxyn are also designed to address the erectile failure. However, not everyone can resort to the drug therapy due to the following factors:

  • History of heart disorders
  • Recent heart surgery
  • Angina
  • Hypertension
  • Liver damage
  • Sickle cell disease
  • Sickle cell anemia
  • Coronary artery disease
  • Stomach ulcer
  • Kidney problems
  • Leukemia
  • Any type of penis deformity
  • Allergy to any drug ingredient

If you are currently undergoing or have recently undergone treatment including administration of other anti-impotence pharmaceuticals, cancer chemotherapy medications, nitrate drugs, diuretics, guanylate cyclase stimulators, central nervous system depressants, alpha-blockers, HIV protease inhibitors, or certain synthetic hormones, you can’t take Viagra or any other medicine of the kind. However, this doesn’t mean the end of your sexual life, as modern blood vessel surgery suggests a variety of penis penile prosthesis to treat ED.

Penile Implants

A penile prosthesis is a good option for those patients with ED who can’t take anti-impotence drugs for any of the above reasons. With different types available, the simplest one consists of two malleable rods surgically inserted within the erection chambers of the penis. This enables the penis to be constantly semi-rigid, and a little adjustment is enough to place it into a position for sex.

There are various factors to consider before choosing an implant:

  • Age of both partners
  • Size of the penis
  • Size of the glans penis
  • Size of the scrotum
  • History of penile surgery
  • Peyronie’s disease or any type of penis deformity
  • History and type of abdominal surgery
  • History of peripheral vascular surgery
  • Patient’s body type

Moreover, the overall health of patients and their life expectancy also influence a choice of the implant. Upon thorough examination and necessary testing, the specialist decides what prosthesis will serve the patient in the best possible way.

Non-Inflatable

These implants keep the penis in a semi-erected condition, and you bend it up to achieve an erection, and bend down after sex. They’re a good option for patients with spinal cord injuries, limited hand dexterity or arthritis. All parts of the device are concealed in the body, meaning their presence is completely unnoticeable. Their implantation requires a simple operation, which can be performed even by surgeons with limited experience. Moreover, non-inflatable prostheses are also the cheapest of the currently available devices, which make them an opportunity for patients without the insurance coverage.

The main disadvantage of this implant is that it gives an abnormal feeling of constant erection, and it takes time to get used to its appearance. Some individuals complain of post-operative pain and discomfort related to regular erection.

Two-Piece Inflatable

This type consists of two units – two cylinders, and a pump and reservoir, surgically implanted in the penis. You pump it up when you want your penis erected, and pump down after sex. The pump may be difficult to use due to its size, so people having problems with dexterity may need to consider another type. The cylinders are capable of holding a small amount of fluid, meaning the erected penis won’t be very rigid. Moreover, their unnatural shape may be a thing to get used to.

Three-Piece Inflatable

In addition to the cylinders, reservoir, and pump, three-piece implants are additionally attached via tubing to a separate saline reservoir, placed in the lower abdomen. To activate this implant, you use the pump, inflating the cylinders with saline from the reservoir and causing the erection. There is a valve on the pump by pressing which the fluid returns to the reservoir, and the penis restores the flaccid state.

How Effective Are The Implants?

Statistics show up to 95% of inflatable implants cause the erection and keep it sufficient to have sex. Apart from high satisfaction results, the prosthesis surgery has another remarkable advantage that is the absence or visible signs of the intervention. One small surgical scar at the bottom of the penis disenables other people to tell if a person has a penile prosthesis. Be it a gym locker room or public toilet, you won’t be embarrassed or feel uncomfortable under prying eyes.

The erection caused by the prosthesis is similar to a natural process, with penis getting stiff and thick enough. The penile implant has no effect on skin sensation or ejaculation. However, implantation of the prosthesis may damage the natural erection reflex, meaning it will be hard or impossible for men to achieve the erection without the implant.

As for procedural safety, there’s a possibility of a complication in the case of any surgery. Sudden, uncontrolled bleeding, infection, scars, tissue erosion and mechanical malfunction are main complications related to the penile implants. If they occur, a removal and eventual re-operation may be required. However, each case is individual, and only a medical specialist can calculate the risk rate based on your overall health condition and a number of other factors.

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