Surgical Penile Implants
A penile prosthesis is another treatment option for men with erectile dysfunction. The simplest type of prosthesis consists of a pair of malleable rods surgically implanted within the erection chambers of the penis. Today, many men choose a hydraulic, inflatable prosthesis that allows a man to have an erection whenever he chooses.
A penile implant is usually used when there is a clear medical cause for ED and when the problem is unlikely to resolve or improve naturally or with other medical treatments. Sometimes a penile prosthesis is implanted during surgery to reconstruct the penis when scarring has caused erections to curve.
How does the penile prosthesis work?
The inflatable penile prosthesis consists of two cylinders--a reservoir and a pump--that are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of fluid. The reservoir is implanted under the groin muscles. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles.
To inflate the prosthesis, the man presses on the pump. This does not involve putting pressure on the testicles. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis.
What is sex like with the prosthesis?
When the penis is inflated, the prosthesis makes the penis stiff and thick, similar to a natural erection. Most men rate the erection as shorter than their normal erection; however, newer models have cylinders that may increase the length in addition to the thickness and stiffness of the penis.
A penile prosthesis does not change sensation on the skin of the penis or a man’s ability to reach orgasm. Ejaculation is not affected. Once a penile prosthesis is put in, however, it may destroy the natural erection reflex. Men usually cannot get an erection without inflating the implant. If the implant is removed, the man may never again have natural erections.
Do the implants work?
About 90%-95% of inflatable prosthesis surgeries are successful, meaning the implants produce erections suitable for intercourse. Satisfaction rates with the prosthesis are very high, and typically 80%-90% of men are satisfied with the results and say they would choose the surgery again.
Is the implant safe?
No surgery is totally free of possible complications. Complications associated with penile implants include:
- Uncontrolled bleeding after the surgery; this condition may require an additional surgery
- Scar tissue formation
- Pump or reservoir displacement
- Mechanical failure
Is the prosthesis noticeable?
While men who have had the prosthesis surgery can see the small surgical scar where the bottom of the penis meets the scrotal sac, other people probably will be unable to tell that a man had an inflatable penile prosthesis. Most men would not be embarrassed in a locker room or public restroom, for example.
Will insurance cover the cost of the penis prosthesis implant?
Insurance coverage for these operations is often good, as long as a medical cause of ED is established. Medicare covers the surgery, and Medicaid may in selected cases.
- National Kidney and Urologic Diseases Information Clearinghouse. Erectile Dysfunction. kidney.niddk.nih.gov Accessed 4/19/2012
- UpToDate. Surgical treatment of erectile dysfunction. www.uptodate.com Accessed 4/19/2012
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/1/2012...#10054