 |
|
|
Frequently Asked Questions about Penile ImplantsClick these links to view other sections of this page:
When is a penile implant indicated?A penile implant may be indicated after an erectile dysfunction specialist has diagnosed the cause of impotence as a vascular, neurogenic or other structural problem that is irreversible, untreatable, or for which other treatment has failed.
How does a penile implant work?An inflatable implant is a small, self-contained prosthesis made of medical grade silicone that is implanted entirely within the body and is not visible. The most technologically advanced implant consists of three parts: two elongated cylinders which are inserted side-by-side into the corpora cavernosa in the shaft of the penis; a small pump which is positioned in the scrotum; and a small reservoir filled with saline, which is tucked deep in the abdominal-groin area. During a natural erection, the corpora fill with blood. After a penile implant, when a man desires an erection, he gently squeezes the concealed pump in the scrotum several times. This moves the saline solution from the reservoir into the cylinders. As the cylinders fill, the penis becomes erect and firm. To end the erection, he simply presses a "deflation site" or relief valve on the scrotal pump. Deflating the cylinders transfers the fluid back to the reservoir and the penis becomes flaccid.
How noticeable is the implant?A penile implant is virtually unnoticeable. In fact, one patient reported feeling confident that if he were in a locker room with three of his closest friends, the friends would never detect anything out of the ordinary. And a urologist stated, "The situation is much the same as wearing a wristwatch. It is something that you are not aware of until you want to use it." The carefree nature of the device appeals to men in practically every walk of life. Users range from construction worker to college professor, and from pro wrestler to postal worker. Men with penile implants participate in all kinds of vigorous sports, including running, tennis, weight lifting, and bicycling. Patients report comments from their partners ranging from "no difference" to "improved" to "he can last longer." In some cases, however, patients report that the head of the penis isn't as firm as with a natural erection and an erect penis isn't quite as long as a result of this. However, of all the generally accepted treatments for erectile dysfunction, a penile implant offers the highest satisfaction rating (95%) among patients and is the most effective long-term treatment. Is a penile implant reversible?Once a penile implant has been done, the procedure is not reversible. The rods inserted into the penis go into the space called the corpora cavernosa, a spongy area of the penis that fills with blood during a normal erection. Inserting rods into this area causes structural changes that are irreversible, even if the rods were later removed. What is the cost of a penile implant?The cost of penile implants varies with the type of implant, the physician, hospital, and location. Costs generally range from $15,000 to $35,000. Most commercial health insurers cover the cost of medically necessary diagnosis and treatment of erectile dysfunction. Insurance co-pays and deductibles apply as stipulated by individual policies. What is the surgical implant procedure?The operation to implant any prostheses is considered major surgery. You may be fully anesthetized or you may be given a local anesthetic to numb the area where the surgery occurs. The three-piece inflatable implant is surgically inserted into the penis through a small incision made slightly above the base of the penis or through an incision on the under surface of the penis where it joins the scrotum. The incision gives access to the corpus cavernosa, which are two spaces in the penis that fill with blood and produce an erection. The synthetic (medical grade silicone) cylinders, which will be properly sized to fit you, are inserted into the corpus cavernosa. The small pump, which you will use to inflate the implant with fluid, is placed in the scrotum and the fluid (saline solution) reservoir is tucked into the abdominal cavity. The surgery typically lasts between 30 minutes to two hours. How painful will the procedure be?Penile implants are usually done under general anesthesia. Patients can expect some post-operative pain and discomfort for the first three to seven days after the procedure - pain which is generally relieved by prescribed pain relievers. Gradually the discomfort goes away and there is steady improvement. Most patients are able to return to work (no heavy lifting) within a week. What happens after surgery?Immediately after surgery, your doctor will deflate the implant and gently tape your penis against the skin for a week or longer to promote healing. A catheter (hollow tube) may be inserted into your penis to drain urine from your bladder. The catheter will be removed before you leave the hospital. In a typical operation, you will be discharged from the hospital after 1 (23 hours) to 3 days. Some pain medication may be necessary and your doctor may place you on antibiotic to prevent infection. Less than 3 percent of patients in a clinical trial reported having an infection. If you notice any redness, swelling and/or heat around the incision area or drainage from the incision, contact your doctor. What can I expect during my recovery following a penile implant?In many cases, an implant can be done as an outpatient procedure, commonly called a "23-hour stay;" although, sometimes a hospital stay of a day or two is required. For two to three days post surgery, the patient should remain flat as much as possible to minimize swelling. Patients can expect pain and discomfort for the first three to seven days after the procedure, pain which is generally relieved by prescribed pain relievers. Gradually the pain goes away and there is definite trend of improvement. Most patients are able to return to work (no heavy lifting) within a week. It takes about 4 to 6 weeks to regain sexual function. The cylinders should remain deflated until the third or fourth week after surgery in order to help prevent autoinflation (inadvertent and unwanted inflation of the device.) Additionally you should avoid wearing tight fitting underwear. This helps to prevent curving of your penis during healing. Anytime you have to void, retape your penis in the same straight position that it was in prior to untaping. Patients can resume sexual activity after physician consultation. Do implants ever need to be replaced?Rarely, because technology has greatly improved reliability and longevity in recent years and most products now carry a lifetime warranty. Most implants last more than 10 years and clinical data show high levels of both long-term device reliability and patient satisfaction. If a replacement is necessary, it is important to note that a re-operation is considerably less complicated than the original surgery and usually requires no more than a correction of a minor hydraulic problem. A nationally known ED specialist, who has performed over 800 implants, reports a malfunction rate of less than 2.5%. Even with the possibility of replacement surgery, the long term success rate of an implant is vastly superior to that of any other remedy for ED. This page revised March 2005 Copyright 2005 Erectile Dysfunction Information Center. All rights reserved. This site contains information about erectile dysfunction (impotence) for men with ED and their partners. Nothing in this site may be reproduced without written authorization from the Erectile Dysfunction Information Center.
| |
||||
|