Cairo Plastic Clinic 

Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail.

There are two main types of penile implants, semirigid and inflatable. Each type of penile implant works differently and has various pros and cons.

The placement of penile implants requires surgery. Before choosing penile implants, Dr Wilson will explain what surgery involves, including possible risks, complications and follow-up care.

Why it's done

For most men, erectile dysfunction can be successfully treated with medications or use of a penis pump (vacuum constriction device). You might consider penile implants if you aren't a candidate for other treatments or you can't get an erection sufficient for sexual activity by using other methods.

Penile implants can also be used to treat severe cases of a condition that causes scarring inside the penis, leading to curved, painful erections (Peyronie's disease).

Keep in mind that while penile implants allow men to get an erection, they don't increase sexual desire or sensation. Most penile implants also won't make your penis any larger than it naturally is at the time of surgery. In fact, your erect penis might be slightly shorter than it used to be.



Risks

Risks of penile implant surgery include:

• Infection. As with any surgery, infection is possible. You might be at an increased risk of infection if you have a spinal cord injury or diabetes.
• Implant problems. New penile implant designs are reliable, but in rare cases the implants might malfunction. Surgery is necessary to remove, repair or replace a broken implant.
• Internal erosion or adhesion. In some cases, an implant might stick to the skin inside the penis or wear away the skin from inside the penis. Rarely, an implant breaks through the skin. These problems are sometimes linked to an infection.

Types of penile implants

There are two main types of penile implants:

• Inflatable implants. Inflatable devices, the most common type of penile implant used, can be inflated to create an erection and deflated at other times. Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis.

  To achieve an erection, you pump the fluid from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. The two-piece model works in a similar way, but the fluid reservoir is part of the pump implanted in the scrotum.

• Semirigid rods. Semirigid devices are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment.

  A positionable penile implant is a semirigid device with a central series of segments held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.

Other special designs can fit a shortened penis, or one that's larger than average. Some inflatable penile implants are also available with antibiotic coatings, which might help reduce the risk of infection.

Comparing implant types

When choosing which type of penile implant is right for you, consider your personal preference and your medical history. Dr Wilson might suggest one type of design over another based on your age, risk of infection, and health conditions, injuries or medical treatments you've had in the past.

What you can expect

A tube (catheter) might be inserted into your bladder via your penis to collect urine at some point during surgery.

Dr Wilson will choose the correct size implant and place the implant cylinders inside your penis. All sizes are customized to your exact body measurements.

If you are getting a two-piece inflatable device, a pump and valve are placed inside the scrotum. For a three-piece device, Dr Wilson will also implant a fluid reservoir under the abdominal wall through an internal incision.

Once the device is in place, Dr Wilson will sew the incisions closed. Penile implant surgery usually takes 45 minutes to an hour.

After surgery

After penile implant surgery, you'll likely need to take medications to ease pain. Mild pain might persist for several weeks. You might also need to take antibiotics for one week to prevent infection.

Dr Wilson will provide specific instructions about when you can resume normal activities. Most men can resume strenuous physical activity and sexual activity about four to six weeks after surgery.

Results

Although penile implants are the most invasive and least often chosen treatment for erectile dysfunction, most men and their partners report satisfaction with the devices. Their sex life and love making are markedly improved.  The 10-year device survival is between 60 and 80 percent.





A 68 year old man with Erectile Dysfunction following irradiation to a cancer of a prostate. Semirigid Implants were Inserted in the Penis.