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A. Penile implant, also called a penile prosthesis, is a medical device which is surgically implanted into the erection chambers of the penis in case of severe ED.
A. Penile implant is an option if you have tried PDE5Is and intracavernous injections and both had little effect on ED. It may also be recommended if you cannot use PDE5Is or the drugs in the injections. If you have tried PDE5Is and injections, but are unhappy with the results and you want a permanent solution, a penile implant may be an option for you.
A. The alternatives include:
A. There are two types of penile implants: semirigid, noninflatable implants and inflatable implants.
Semi-rigid implants consist of two bendable rods that are implanted in the erection chambers of the penis. They can be bent into position during sexual activity. With this type of implant the penis is always semi-rigid, which may be difficult to conceal.
Inflatable penile implants are devices filled with fluid which consist of two inflatable cylinders placed in the erection chambers of the penis, a hand-controlled pump placed in the scrotum, and a reservoir which stores fluid when the penis not erect. The device is inflated by squeezing the pump several times to move the fluid from the reservoir to the cylinders.
Afterwards, the pump is also used to move the fluid back to the reservoir.
You need surgery for both types of implants. Both types of implants are placed completely inside the body. Inflatable implants are used more often because they result in a more natural situation. In complicated cases, semi-rigid implants may be more suitable. Discuss the choice between the two implants with your urologist.
A. If you are taking blood thinning medication on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits. Aspirin does not usually need to be stopped but will be the decision of your surgeon.
You will usually be admitted on the same day as your surgery, or a day before. You will normally undergo pre assessment on the day of your clinic. After admission, you will be seen by members of the medical team which may include the consultant, junior urology doctors and nurse.
You will be asked not to eat or drink for six hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.
Please be sure to inform your urologist in advance of your surgery if you have any of the following:
A. For penile implant surgery, you will receive either general or spinal anaesthesia. You will also get a urinary catheter, which can be removed the day after surgery. Once you are under anaesthesia, the doctor will make a small incision either just above the penis or between the penis and the scrotum. The incision exposes the erectile chambers, and the surgeon measures them to place a penile implant of the correct length.
Once the cylinders are in place, the reservoir is placed behind the abdominal wall, and the pump is placed in the scrotum between the testicles to conceal the pump.
Finally, all elements of the implant are connected and the incision is sutured. The wounds are cleaned and a compressive bandage is applied. Most surgeons choose to leave the penile implant inflated for one day. Some surgeons prefer to leave a drain which is then usually removed one day after the procedure.
A. Usually you can leave the hospital the day after surgery, when the compressive bandage has been removed and the implant has been deflated by your doctor. You may experience pain or soreness and swelling of the penis and scrotum in the first few days and up to several weeks after surgery. This is normal, and can be treated with analgesics and cold packs. In the first 2-3 days after surgery there may be a small amount of discharge from the incision. There is no need to treat this because it usually stops on its own.
A. For 4-6 weeks after the surgery:
Your doctor will schedule an appointment to inflate the implant for the first time. This is done once the swelling and soreness have gone, about 4-6 weeks after the procedure.
After the appointment you may start having sexual activity.
Please notify your urologist if:
A.
Advantages:
Disadvantages: