Penile Implant for Erectile Dysfunction
Erectile dysfunction (ED) affects millions of men across the United States and becomes more prevalent as they age. About 18% of all men over 20, over 40% of men in their 60s and over 70% of men in their 70s have ED.
The causes of ED are varied and can progress slowly, usually due to vascular (blood vessel concerns) or come on spontaneously (often due to prostate cancer surgery or radiation, trauma, or medications). Some patients may also experience ED resulting from performance anxiety, low desire, or low testosterone.
After speaking with a qualified urologist and understanding the causes of ED, patients often start their treatment with Viagra (Sildenafil) or Cialis (Tadalafil). However, these medications may not be as effective as expected, even at maximum doses, or their effectiveness may wane with time. While penile injections and vacuum erection devices are options at this point, many patients look for something more permanent and curative.
Considering a Penile Prosthesis (Penile Implant)
Surgery to correct ED, in the form of a penile implant, is a refined solution that can restore intimacy and a fulfilling sexual life. For this reason, most patients and their partners are very satisfied with the decision to have a penile implant.
The Types of Penile Prostheses
There are two main types of penile implants, both of which allow for predictable sexual function. Their way of achieving this, however, is quite different.
Inflatable (Three-Piece)
An IPP or inflatable penile prosthesis is a three-piece medical implant that allows for the most natural erections of any device currently available. During this surgery, two inflatable tubes are implanted into the penile shaft to replace the corpora cavernosa – the tissue that engorges with blood to create an erection. A fluid reservoir is placed in the pelvis, and a scrotal pump draws from the reservoir to inflate the prosthesis. The pump has a secondary release valve to drain the solution from the penis back into the reservoir, making the penis flaccid once again.
All device components are implanted inside the body. Once healed, patients need about 15 to 20 pumps to develop and maintain an erection and, with some creativity, can perform this action discreetly.
Malleable (Semi-Rigid)
A malleable penile prosthesis involves the implantation of semi-rigid rods within the penis. This allows the patient to manipulate the penis in any direction and offers a reasonable degree of stiffness – enough to have pleasurable intercourse. These are especially good for patients with compromised manual dexterity or strength.
However, the malleable penile implant has several drawbacks, including a less firm erection and never fully “deflating” when not being used for sexual activity. An Inflatable Penile Prosthesis often addresses these shortcomings.
Penile Prosthesis – A Dual-Use
In addition to being an excellent solution for severe erectile function, a penile prosthesis can also be used to straighten penile curvature, known as Peyronie’s disease (PD) in men with co-occurring erectile dysfunction, an embarrassing and often painful condition. Learn more about penile prostheses for both ED and Peyronie’s.
Penile Implant Brands
Several Georgia Urology surgeons work with and are Center of Excellence surgeons for the Boston Scientific AMS 700 and Coloplast Titan implants. Although the brands are different, the function is quite similar, and each company offers multiple types of implants.
You can speak to your urologist about their preference recommendation and which may be right for you.
Georgia Urology’s Center of Excellence Implanters
Boston Scientific AMS 700 COE physician profiles
Coloplast Titan COE physician profiles
Frequently Asked Questions
Is a penile implant a drastic measure?
Many men and their partners underestimate the effect that ED can have on their mental and physical health, and as such, a penile implant is not a drastic measure. Consider that there is no other solution for severe ED that does not respond to medication or shots injections, and when men are unhappy with erections from vacuum devices.
Does a penile implant hurt?
Penile implantation is a major surgical procedure. As such, there will be some discomfort at the incision site as well as some swelling of the genitalia for a couple of weeks after surgery. This is normal, and what to expect will be laid out in your postoperative packet. With good pain management after surgery, most patients return to everyday life within a few days and forget the discomfort.
What is the recovery time?
Everyone is different; therefore, their recovery will also be different. Typical full recovery and readiness for sex is between 4 and 6 weeks. Your surgeon will explain what you can and cannot do during this time. It is important to follow these recommendations to ensure the best outcome.
Will a penile implant increase length and girth?
The short answer is, most often, no; the penile implant matches the anatomy you have, and as such, you should not expect any significant gains in penile length or girth. However, a small number of patients may see a slight change in the penis. For patients who are a candidate, specific Specific AMS 700 implant models are designed to stretch penile tissue somewhat with regular use, leading to possible length and girth improvements.
Is a penile implant noticeable?
No. The penile implant is entirely inside the body and uses your anatomy to stay discreet. Most men are happy that their partners are unable to tell the difference other than the fact that an erection is now possible.
Can I have an orgasm with a penile implant?
You should be able to have an orgasm with a penile implant if you were able to have one before your procedure. If you were able to orgasm and ejaculate prior to surgery, the implant surgery should not interfere with your ability or orgasm and/or ejaculate after surgery. Some men who have been treated for prostate cancer, enlarged prostate, or other urologic conditions may no longer ejaculate. For these patients, the implant does not recover the ability to ejaculate.
How long does the device last?
The length of time that a penile implant can last depends in part on how often it is used. With that said, most patients can expect to get ten or more good years of sexual activity with their implant. Rarely the implant itself can fail, in which case it will be replaced.
Is the cost of a penile implant covered by insurance?
Most insurance, including Medicare, covers penile implants. If implant surgery interests you, our office will review your benefits prior to scheduling surgery to confirm your coverage details.
Are there risks associated with the penile implant?
Penile implants are surgical solutions requiring a healing period and, like any other surgical procedure, have risks associated with surgery, such as infection, pain, anesthesia reactions, or repeat surgery due to infections, or mechanical problems with the device. The implant eliminates the possibility of a natural erection. Considerations in choosing a penile implant may include your medical condition, lifestyle, personal preference, and cost.