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Penile Prosthesis

Overview

Penile prostheses are mechanical devices that are implanted and concealed completely within the body. The goal of penile prosthesis surgery is to provide rigidity of the penile shaft to allow for normal penetrative sexual intercourse.  For most men, penile prosthetic surgery is only considered after more conservative treatments have failed.

Initial satisfaction rates exceed 90% for both men and their partners.

Prior to penile prosthesis surgery, a careful history and physical examination are necessary to confirm the nature of the erectile dysfunction, prior treatments, and to identify any additional sexual dysfunction such as loss of desire, inability to ejaculate, or premature ejaculation. Penile implant surgery will not affect these other aspects of sexual function. Physical examination is focused on the genitalia to identify characteristics of the penis, scrotum or pelvis that may impact surgery.  Specific characteristics of importance are penile length and stretchability, previous surgical scars, and any penile fibrosis or scarring which may complicate the implant surgery. There are two main categories of penile implant:

Malleable Penile Prosthesis
A malleable penile prosthesis is always the same length and firmness. The largest and longest device which can be accommodated by a man’s penile dimensions will be inserted via a small incision at the base of the penis in the penis-scrotal junction. Concealment is achieved by bending the malleable rods downward. Sexual intercourse is possible by bending the  rods in the desired direction. Implantation is straight forward, usually requiring one to one and a half hours of surgery, and can be performed as an outpatient.

Inflatable Penile Prosthesis
Inflatable penile prosthesis uses fluid to achieve rigidity. This fluid is shifted from a reservoir placed near the urinary bladder into two paired cylinders placed within the erectile bodies of the penis through an incision at the junction of the penis and scrotum. Fluid movement is controlled by a pump, which is placed in the. The main advantage of the inflatable penile prosthesis is complete flaccidity and concealment when the device is deflated. Additionally, when the device is inflated, excellent girth is achieved, with full rigidity and a sense of change in penile size similar to a natural erection. Importantly, the head of the penis will not become rigid with this device, as it is merely supported by the device.



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