Penile Implant Surgery
What is Penile Implant surgery?
A penile implant is a device installed inside the penis. The device works to give an erection to men with erectile dysfunction. This is an ideal alternative for men who suffer from erectile dysfunction (ED), and have tried medicinal and other treatment methods with unsuccessful results.
This device has been found to offer immense satisfaction to the patient and their partners as well.
Who can undergo a penile implant surgery?
Erectile dysfunction (ED), or impotence, is one of the most common penile disorders that affect men. In this, the patient is not able to achieve or sustain an erection in the penis. This may prevent conception and intercourse. A penile implant surgery is advised in certain conditions for men suffering from ED.
There are various reasons for a person suffering from erectile dysfunction. It could be the result of anxiety, depression, medications or drugs. In such circumstances, the condition can be treated easily and an implant will not be advised.
When these and other non-invasive treatment methods fail to produce effective results, then this may call for a penile implant surgery.
An ideal candidate for a penile implant surgery is a male with erectile dysfunction caused by:
Blood vessel blockage/leakage
Prior genital surgery
Colon cancer, prostate cancer and bladder cancer
Scarring of penis tissue (Peyronie’s disease)
Prior injury/damage to spinal cord, genitals or pelvis
Chronic/long term diseases – chronic kidney failure, Parkinson’s disease or alcoholism
Vital medications – Chemotherapy for cancer treatment
Congenital (birth) defects in genitals
How is a Penile Implant surgery performed?
The patient gets to choose the type of device to be used once the decision to undergo the surgery has been taken.
Mainly, there are 3 types of penile implants:
Complex Inflatable Devices
A rod implant is one of the most common and affordable types of penile implants. It can be easily implanted and gives a permanent erection. However, the abnormal appearance of the penis may one of the disadvantages of this type of penile implant.
Simple inflatable devices can be used to give erection at will. It has an easy-to-use inflating and deflating pump to help achieve and lose an erection. This is a comparatively more complex and an expensive procedure. One of the disadvantages of this device is that it may not give as much erection as a rod penile implant and may not deflate completely.
Complex inflatable devices are considered to be the best devices for treating erectile dysfunction. However the procedure to implant these is comparatively more complicated than others and the procedure is also more expensive. Risk of complications from this surgery is also very high. The most complex type of this device is composed of three parts, where one is placed in each of three genital parts – the penis, scrotum and the abdomen. This device is highly concealed and gives a natural looking erection, with a larger-sized penis than before. The system of inflating and deflating the device works efficiently to achieve and lose erections.
The exact surgical procedure mainly depends on the type of implant being used. For a rod and simple inflatable device implant, the surgery may be done as an outpatient procedure. However, for implanting complex inflatable device, the surgery is longer and the patient may be required to stay in the hospital for a few days following the surgery.
General anesthesia is usually administered before the implant surgery to prevent pain or discomfort to the patient during the surgery. The incision for implanting the device may be done on the penis, scrotum or the on the skin above or below the penis and scrotum. The device and the individual surgeon’s preferred method will dictate the types and locations of the incisions.
Inflatable implant devices are generally made of a saline reservoir, a pump which is implanted in the scrotum and two tube-like cylinders which are implanted in the penile shaft. As the saline solution is pumped into the penis, it causes an erection. The pump also helps to remove the saline solution and lose the erection.
The non-inflatable penile implant devices normally consist of a set of dual rods that are semi-rigid yet flexible. These are implanted within the erection chambers of the penis which can help to have a permanent erection which can also be easily concealed within the clothes.
Advancement in medical and surgical technology has helped to lower the risks of complications and failure of the devices remarkably. This procedure is even covered by majority of insurance providers all over the world.
What happens following a Penile Implant surgery?
The patient is transferred from the operating room to the recovery room. Vital signs of the patient are monitored constantly to ensure that there is no immediate risk of complications from the surgery. Painkillers are usually prescribed for a short while to cope with any pain. In case of a simple surgical procedure, the patient is discharged from the hospital the same day. In other cases, the patient is normally transferred to another room for a few days.
How safe is Penile Implants surgery?
Penile surgery is meant to cut the ligaments that suspend the front end of the penile shaft. This results in an extended penile shaft after the surgery, giving an illusion of a longer penis size. A major procedure of post-surgical recovery is to extend the penis for some time to prevent the ligaments from healing and becoming shorter than their original size. Without constant stretching, the results may not be successful. The higher expense of the procedure – ranging between $4,000 and $11,000 – is also a significant factor to think about before deciding to undergo the surgery.
To increase the girth of the penis, the surgeon mostly relies on fat cells that are sourced from the patient’s abdomen. These are processed and injected into the patient’s penis. This fat transfer procedure simply helps to increase the width of the penis overall. The girth can effectively be increased anywhere between 1 and 3 inches. A potential risk in this procedure is that the transferred fat cells feel abnormally soft. Also, the additional girth may also decrease if the fat cells are re-absorbed into the body eventually. At times, this re-absorption process is not uniform all over the penis and results in a lumpy and an abnormal-looking penis.
To combat this complication, an advanced technique called the ‘dermal transfer’ method is useful. This requires transferring thin strips of skin along with fat cells into the penis. The skin strips prevent the fat from being re-absorbed into the body. The grafting procedure involved with this technique makes this a slightly more complex surgical procedure. There is also a greater risk of penis disfigurement.
Penis lengthening procedures are significantly different than those used to increase the girth of the penis. The corpora cavernosa is the tube of tissue inside the penile shaft which fills with blood and results in an erection. At times, a significant portion of this tube may be concealed within the body. The penis lengthening procedure relies on releasing the concealed portion of tissue to give the entire length to the penis. The concealed portion of the corpora cavernosa is cut to release the stricture. This adds noticeable length to the penile shaft.
The fact that the surgery removes the supportive ligament of the penile shaft from the pubic bone may result in a ‘soft’ base of the penis. This may result it in slipping and shifting while having sexual intercourse. Advances in surgical techniques have remedied this problem to a large extent today.
What are the risks associated with Penile Surgery?
According to the AUA (American Urological Association) there has not been any proof of the surgery being completely safe and effective. The decision to undergo this surgery should be made after weighing the benefits against potential risks involved in it. It becomes important to discuss your individual condition with an experienced physician or urologist to ensure that the penile surgery is best-suited in your case.
What are the types of Penile Implants?
There are basically two types of penis implants in use:
Malleable Penile Prosthesis
A malleable penile prosthesis is of a fixed length. The best-fitting size according to the individual’s normal penis size is inserted through small incisions at the base of the penis, in the junction between the penis and scrotum.
The rod is bent downwards to conceal it efficiently. The malleable rods can be bent accordingly when sexual intercourse is desired.
The implant procedure is simple, usually requiring surgery for 1 to 1 ½ hours, and performed as an outpatient procedure.
Inflatable Penile Prosthesis
Inflatable penile prosthesis use saline fluid to achieve rigidity. A reservoir needs to be placed next to the bladder in dual cylinder system. A pump is used to regulate the movement of the fluid, which is placed inside the scrotum, to the side of one of the testis.
A major advantage of inflatable penile prosthesis is it can give complete flaccidity to the penis and helps in better concealment. Apart from this, at its inflated point, the device also helps in increasing the girth of the penis, along with complete rigidity.
However, as the head of the penis is not supported by the device it might not become completely rigid.
This implant takes around 2 to 2 ½ hours of surgery. Patients are normally required to stay in the hospital overnight with a drainage tube attached. The tube is removed the day following the surgery.
How to prepare for a Penile Implant surgery?
A thorough checkup will usually be done prior to the surgery, to determine the need for a penile implant surgery. Once the decision to undergo the surgery has been made, the surgeon will discuss all benefits, risks and results with you.
The doctor will advise on the medications that are allowed and those which should be refrained from. Blood thinning medications are usually advised to be stopped at least 2 weeks before the surgery.
The surgery might be simple and you can leave the hospital on the same day or you might be required to stay overnight in the hospital. Arrange for someone to drive you home from the hospital or surgery center.
What is recovery like after Penile Implants surgery?
Mostly, the patient can go home within 24 hours from the surgery. Antibiotics will be prescribed to prevent infection. Wear loose fitting underwear and clothing after the surgery. The scrotal pump in inflatable devices needs to be ensured is in place when healing.
Are there complications while recovering from a Penile Implant surgery?
As is seen in any type of surgery, there are certain complications from this surgery. In rare circumstances the results of the surgery may not be satisfactory for the patient. This is mostly as there is hope that this procedure will help to treat or cure an additional medical condition which is related to the erectile dysfunction.
Some of the potential complications from the surgical procedure may include:
Infection in incision area
Nerve or tissue damage