- penile prosthesis
A penile implant is an artificial device placed inside the penis, allowing men with erectile dysfunction to have an erection.
Who is a candidate for the procedure?
Different treatments are used for erectile dysfunction, depending on the cause. For example,
depression, anxiety, and drugs or medications can cause erectile dysfunction. In these cases, the cause can often be treated and an implant would not be used. Other causes of erectile dysfunction cannot be treated directly. In these cases, an implant may be useful if other treatments do not work.
Possible candidates for an implant include men with erectile dysfunction due to:
- blood vessel blockage or leakage
- previous surgery in the genital area
- prostate cancer, bladder cancer, or colon cancer
- Peyronie's disease, which is scarring inside the penis that occurs for unknown reasons
- previous injury or damage to the pelvis, genitals, or spinal cord
- long-term (chronic) disease, such as chronic renal failure, alcoholism, or Parkinson's disease
- medications that cannot be stopped, such as chemotherapy for cancer
- congenital defects of the genitals, that is, abnormalities present at birth
How is the procedure performed?
Once the decision is made to have a penile implant, the type of device must be chosen. There are three main types of implants. The three types are called rods, simple inflatable devices, and complex inflatable devices.
When rods are inserted into the penis, a permanent erection occurs. The penis can be bent down so that it is not noticed under the clothing. The penis can be straightened for sex easily. Advantages include low cost, ease of use, and the lowest risk of problems from the surgery or the device itself. The main disadvantages are the constant erection, which may show through tight clothing, and the unnatural appearance of the penis.
Simple inflatable implants allow the man to control his erections by inflating and deflating the device. The surgery is more complicated than it is for a rod device. The implant is also more expensive. This implant does not make the penis become as erect as the rod does. It also does not deflate as much as the complex inflatable devices.
The complex inflatable implants are thought to be the best devices, but they are the most expensive and complicated of the three. They also have the highest risk of malfunction or problems from the surgery. The most complex of these devices has three parts, with one in the penis, one in the scrotum, and one in the abdomen. This device provides the most natural appearance of an erection, with an increase in length and width of the penis.
Inflating and deflating the implant controls erections. The type of surgery depends on the device and the surgeon. The rod and simple inflatable devices may be done in a same day surgery setting. This means that the person can go home the same day as the surgery. The complex inflatable devices may require at least an overnight stay in the hospital.
Surgery may be done with general anesthesia, which means that the man is put to sleep with medications, experiences no pain, and has no awareness of the procedure. Other types of pain control may also be used. The healthcare professional will discuss the options for pain control before surgery.
The incisions in the skin used to insert the device may be on the penis, the scrotum, or the skin above or below the penis and scrotum. This depends on the device and the surgeon's preferred method.
Conn's Current Therapy, 1999, Rakel et al.