(+90) 530 336 84 99

Penile implants are devices placed inside the penis to allow men with severe erectile dysfunction (ED) to achieve rigid erection. These devices have been utilized since 1973.

Most of these men have tried oral medication (PDE-5 inhibitors-tadalafil, sildenafil etc) prior to placement of a penile prosthesis. In addition, penile prosthesis can also be concomittently used in the treatment of the Peyronie’s patients with ED and curvature. Most patients are very happy with the use of the device and the saticfaction rate is 90 % of men and 95 % of the partner.

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). Peyronie’s patients with ED also candidates implantation of penile prosthesis.

Penile implants are typically recommended in patients not responding to oral treatment alternatives. Penile implant is permenant solution of erectile dysfunction.

• The international index of erectile function (IIEF) or other validated questionnaires to objectively assess severity of ED and subsequent postoperative outcome

• Combined injection-stimulation test

• Penile colour Doppler sonography with intracorporal pharmacologic injection

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 is 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. Two companies, American Medical Systems (AMS) and Coloplast manufacture three-piece hydraulic penile implants.

Two piece (Ambicor) penile implant consists of a pair of fluid filled cylinders implanted in the penis and a pump implanted in the scrotum. During prosthesis recycling, the pump transfers the solution from small reservoirs located at the proximal end of each cylinder, into each cylinder shaft, thereby causing an erection. It provides controlled length and girth expansion through its bidirectional wave. American Medical Systems (AMS) manufacture two-piece penile implant

LGX prosthesis: this three piece implant has the ability to expand in length and girth. AMS 700 LGX is a safe and reliable prosthesis for patients with ED and is effective in preventing penile shortening in patients undergoing IPP implantation, with high patient satisfaction rate. Hovewer, the price is more expensive compared to standard inflatable penile prosthesis.

The penile prosthesis implanted by a one hour surgery into the corpora cavernosa. Both types of implants are placed completely inside the body. Inflatable implants are used more often because they mimick a natural erection on the other hand with mallable devices the penis is not as soft as in the flaccid state. Semi-rigid devices is only indicated in patients with manual dexterity. Discuss the choice between the two implants with your urologist.

For penile implant surgery, you will receive either general or spinal anaesthesia. Urinary catheter will also be indwelled, 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 the length of the chambers in order to implant appropriate size prosthesis.

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 or two days after the procedure.

How to prepare

Your doctor will advise you in detail about how to be prepared for the procedure. You must not eat, drink, or smoke for eight hours before surgery to prepare for the anaesthesia. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it several days before surgery.

Is it painful:

Most patients experience mild pain after the surgery due to inflammation. This is generally short lasting. Once the pain resolves, the patient can be trained to inflate and deflate the device. Most patients and their partners are very happy with the penile prosthesis after learning how to use it.

After surgery:

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

Your doctor 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. Absorbable sutures are used therefore you don’t to return to your doctor to have your stitches removed.

Most common complications after implantation of penile prosthesis are infection and disruption of the hydraulic system. In recent years, complications of penil prosthesis implantation have been reduced significantly bacuse of the technical developments. In order to reduce the prosthetic infection rate, the penile prosthesis is covered with antibiotics, or special material which provide the antibiotic molecules in the solution to bind on prosthesis surface. According to these developments penil prosthesis infection rates reduced <1% from 3-5%. Also, mechanical deterioration rates decreased to around 5% because of development in material technology.

1 to 2 weeks requiring pain medication

Antibiotics

Pain Medications

Stool Softener

After 48-Hours

No heavy activity or lifting

No driving while taking pain medication

Shower after the dressings are removed. No bathing or swimming for 6 weeks after surgery

Do not use the penile implant until your follow-up appointment

Most patients follow-up at 6 weeks

Have a temperature of 101F

Severe pain in the penis or scrotal pain or swelling

Severe abdominal pain

Nausea and vomiting

Unable to urinate

Once in place following your surgery for ED, your implant will be completely undetectable. It’s fully concealed in the body. No one will know unless you tell them — even in the locker room.9

To inflate a Boston Scientific penile implant, you squeeze the pump in your scrotum, which will send fluid into the cylinders in the penis. This requires good manual dexterity but should not be painful. If you experience pain, contact your doctor.9

When inflated, the implant makes the penis stiff and rigid, similar to a natural erection. Your erection will last as long as you desire. And you’ll still share the same intimate experience. Typically, ejaculation and sensation will feel similar to the way they felt before the implant.10

It is impossible to predict how long a particular implant will function in a particular patient. As with any medical device, penile implants are subject to wear and mechanical failure over time. A recent study of more than 39,000 patients showed that the 7-year mechanical survival of a Boston Scientific penile implant is 91–94%.12 To prolong the life of your implant, follow the advice of your urologist.

Because each type of implant offers unique features, you will want to discuss the risks and benefits of each device with your doctor prior to scheduling your penile implant surgery. Then choose the option that is right for you.

AMS 700™ Inflatable Penile Implant Your doctor is your best source for information on the risks and benefits of the AMS 700™ Inflatable Penile Prosthesis. Talk to your doctor for a complete listing of risks, warnings and important safety information. The AMS 700™ Inflatable Penile Prosthesis is intended for use in the treatment of male erectile dysfunction (impotence). Implanting a penile prosthesis will damage or destroy any remaining ability to have a natural erection, as well as make other treatment options (oral medications, vacuum devices or injections) impossible. Men with diabetes, spinal cord injuries or skin infections may have an increased risk of infection. Implantation may result in penile curvature or scarring. Some AMS 700 devices contain an antibiotic (InhibiZone™ Antibiotic Surface Treatment). The device is not suitable for patients who are allergic to the antibiotics contained within the device (rifampin, minocycline HCl or other tetracyclines) or those who have systemic lupus, these patients should use one of the devices that do not contain InhibiZone antibiotic surface treatment. Potential risks may include: device malfunction/failure leading to additional surgery, device migration potentially leading to exposure through the tissue, wearing away/loss of tissue (device/tissue erosion) infection, unintended-inflation of the device and pain/soreness. MH-545411-AD

Tactra™ Malleable Penile Implant Your doctor is your best source for information on the risks and benefits of the Tactra™ Malleable Penile Prosthesis. Talk to your doctor for a complete listing of risks, warnings, and important safety information. The Tactra™ Malleable Penile Prosthesis is intended for use in the treatment of erectile dysfunction (impotence) in adult males. Implanting a penile prosthesis will damage or destroy any remaining natural ability to have a spontaneous erection, as well as make other treatment options impossible. Men with diabetes, spinal cord injuries, or skin infections may have an increased risk of infection. Implantation may result in penile shortening, curvature or scarring. Additional information is provided in Patient Literature, available through your doctor. MH-611821-AA