PENILE PROSTHESES OR PENILE IMPLANTS
We prefer to call penile prosthesis as penile implants because the term prosthesis would be the replacement of a part of the body, and is not what happens to implants that are placed inside the penis, getting completely internal and being highly aesthetic. Implants are an excellent treatment option for patients with erectile dysfunction due to organic causes and who have failed to clinical treatments (oral medications, vacuum pump and self-application). The prosthesis gives back to man a new "skeleton" to the penis, causing it to go back to having sex with ejaculation and normal orgasms. The psychological evaluation of the patient must be careful, avoiding creating false expectations about the outcome. Patients with high levels of anxiety, depression or those who have low self-esteem may not have the implant recommended. The ideal is to the partner participate and collaborate with the surgery, but this requires the consent of the patient.
The penile implant involves the replacement of the natural mechanism of erection of the body by an artificial erection system. There was a progress in this area in the last years and today there are several types of prostheses available. There are prostheses which are formed by a semi-flexible silicone tube and an inner rod platinum or silver and which retains given voltage to the penis, there are pivotal implants as implants that are formed by an inflatable system in which the penis becomes erect or lose his erection controlled by a hydraulic pressure transmission device.
Comparative studies show that the implants have satisfaction rates above other treatments (*)
- 93% of the patients with implants are moderated or fully satisfied
- 51% os the patients that uses oral treatments are moderated or fully satisfied
- 40% of the patients with self-application are moderated or fully satisfied
- (*) A Rajpurkar, C Dhabuwala, Comparison of Satisfaction Rates and Erectile Function J.Urol 2003 July 170: 159-163
Benefits of the implant:
Allows the return to a sexual life;
It offers a long-term solution;
Allows an erection and relation whenever desired;
It offers a lasting erection;
Eliminates the expense of oral or injectable drugs;
It does not interfere in the ejaculation or orgasm.
Types of prostheses
a) Soft, half-hard type – This type of implant has been used by clinicians for over twenty years. During these two decades, many different designs have been developed. This type of implant creates a permanent semi-erection and is technically easy to deploy, and less expensive as well as having a very low complication rate.
The use does not require any special skills by the patient or partner.
b) Articulable – This type of prosthesis is more of a man's disposition type which seeks a solution for the erectile dysfunction, but requires a type of prosthesis more simple than the inflatable ones. It is very recommended to men who have some difficulty on dealing with inflatable prostheses, but at the same time want a good rigidity. The segmented body allows to put the prosthesis in any position while maintain enough erection for the sexual intercourse.
c) Inflatable with Two Volume – This prosthesis combines the standard cylinder of a volume graft with a tiny scrotal pump which makes it easier to inflate the prosthesis to pump the ends of the inflatable cylinder of a volume. Emptying is achieved flexed to prosthesis 10 to 15 seconds. Although it requires a certain skill on the part of man to handle it, it is quite simple and when deflated is more natural than the soft.
d) Inflatable with Three Volumes – This inflatable implant with multivolume achieves a good erection: a truly rigid, thick and natural erection. It is imperceptible to the eye when soft, and generally cannot be noticed by touching the penis. It is also available the same implant only antibiotic coating which can be highly recommended in some specific cases, in order to avoid infections.