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Penile Implant Surgery

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Dr. Lawrence Jenkins

Penile Implants for Erectile Dysfunction

Overview: Penile implants are devices surgically placed inside the penis to help men with erectile dysfunction (ED) achieve erections. When other ED treatments prove ineffective, such as medications or vacuum constriction devices, penile implants may be recommended. Two main types of implants exist: semirigid and inflatable, each with its own set of pros and cons.

Why It’s Done: Men who can’t achieve satisfactory erections through other methods or suffer from conditions like Peyronie’s disease (resulting in painful, curved erections) might consider penile implants. However, these implants aren’t suitable for everyone, especially those with uncontrolled diabetes, significant heart disease, or ongoing infections.

Risks: Like any surgical procedure, penile implant surgery carries risks. Infections, implant malfunctions, and internal erosion or adhesion are potential complications. Infections typically occur within the first three months and may require implant removal.

Types of Implants: There are two main types of penile implants: inflatable and semirigid. Inflatable implants allow for erections when inflated and flaccidity when deflated. They consist of a fluid-filled reservoir, a pump, and inflatable cylinders. Semirigid implants are always firm, allowing for bending during sexual activity and concealment. Each type has its advantages and disadvantages, and the choice depends on personal preference, medical history, and the advice of healthcare providers.

Comparison of Implant Types:

Three-piece Inflatable:

  • Pros: Creates a natural, rigid erection; provides flaccidity when deflated.
  • Cons: More parts that could malfunction; requires a reservoir inside the abdomen.

Two-piece Inflatable:

  • Pros: Provides partial flaccidity when deflated.
  • Cons: Mechanically more complicated; provides less-firm erections than a three-piece implant.

Semirigid Rod:

  • Pros: Low chance of malfunction; easy to use for those with limited dexterity.
  • Cons: Results in a constantly rigid penis; can cause injury due to constant pressure.

Preparation: Before the surgery, patients must discuss medical history, undergo a physical exam, and manage expectations with their healthcare provider. Temporary cessation of specific medications might be necessary, and arrangements for post-surgery care, including transportation, should be made.

Procedure: Penile implant surgery is performed under general or spinal anesthesia. The surgeon makes incisions, stretches the spongy tissue, inserts the implant cylinders, and closes the incisions. The surgery typically takes 45 minutes to an hour.

Aftercare: Post-surgery pain management involves medications and antibiotics to prevent infection. Patients can resume regular activities within 4 to 6 weeks, including sexual activity, after 4 to 6 weeks of learning to use the implant.

Results: Despite being the most invasive treatment, penile implants boast a high satisfaction rate among men and their partners. Most individuals report positive experiences, making penile implants a viable option for those struggling with ED when other treatments have failed.

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