Some men with chronic impotence consider having a penile implant. These implants are also known as penile prostheses.
Most cases of impotence stem from physiologic causes that alter the blood flow through the penis. Often this is due to nerve or blood vessel damage from diabetes, atherosclerosis, pelvic surgery, prostate surgery, alcohol, or medications. Other causes are mainly psychological, although psychological distress may be a result of impotence.
Penile prostheses are one form of treatment for erectile dysfunction. They are implanted directly into the paired corporal bodies in the penis.
There are at least two kinds of implants: semi-rigid, and mechanical or hydraulic implants, which inflate on demand. Implants are manufactured in a variety of sizes and diameters.
Non-inflatable implants have flexible or malleable rods that make the penis firm enough for intercourse but flexible enough to be unnoticeable.
Inflatable implants usually have three parts: a reservoir that holds a fluid, a pump, and cylinders that run the length of the penis. To achieve an erection, the pump, located either within the scrotum or near the tip of the penis, is gently squeezed to force fluid from the reservoir (usually implanted in the abdomen) into the cylinders.
Implants are inserted surgically under general anesthesia. The procedure takes about one to two-and-a half hours and may be done on an outpatient basis, depending on the type of implant and any other conditions that may be present.
Some inflatable pieces on the market are two-piece units that combine reservoir and pump in the scrotum. Others are one-piece units that house all components within the penis only. With these, the user gently squeezes the tip of the penis to activate fluid flow into the cylinders.
Risks include:
- Infections that usually result in implant removal
- Migration/erosion of the implant (it may move to another location or injure nearby tissue or organs)
- Capsule formation - scar tissue around the fluid reservoir or pump can cause spontaneous erection or prevent an erection from softening
- Mechanical malfunctions - the implant may inflate without warning, overinflate, or inflate unevenly
- Patient dissatisfaction - chronic pain, sensory loss, and disappointment in appearance or firmness of the penis
- Possible increase in risks of cancer, immune-related connective tissue disorders, and reproductive problems
Most non-inflatable implants will function well for at least 7 to 10 years, while inflatable implants can be expected to operate reliably for 5 to 10 years. Inflatable models may result in a more cosmetic appearance, but may be associated with a greater likelihood of mechanical failure.
What is the cause of erectile dysfunction (impotence)?
What other treatments are available for erectile dysfunction?
Which type of implant do you recommend?
What are the advantages and disadvantages of inflatable and non-inflatable implants?
How will the implant be inserted?
What are the possible complications?
How long will the implant last?
