There are many treatments for erectile dysfunction, The best treatment will vary, depending on the underlying cause and the severity of the problem. Most men are not entirely satisfied with the treatment of their ED; there are drawbacks to each treatment. Moreover, many men find that their ED worsens as they age; medications that work well initially might not work well after a few years.
There is one treatment that stands out among all the others: the penile implant, also called a penile prosthesis.
Inflatable penile implants have the highest rate of patient satisfaction of any form of ED treatment. In a study of men who have had implant procedures, the patient and partner satisfaction rates were 97% and 91%, respectively1 2. Another study, conduction in 2002, found patient satisfaction of 85%3 (though the devices and surgical procedures have improved significantly since then).
Implants require no planning or preparation before engaging in sex. They allow men to have erections as often and as long as they wish. They allow men to experience sexual pleasure, to have orgasms, to ejaculate, and even father children, just as they did prior to the implant. (Of course, if you cannot ejaculate due to a prostatectomy, the implant will not restore that ability.)
The procedure is performed by a surgeon who specializes in implants. It may be an outpatient surgery, or it may require a couple of night’s stay in the hospital. Recovery typically takes 4 to 8 weeks, depending on the patient’s age and general health. Patients cannot have intercourse until their surgeon advises them that they are fully recovered from the surgery.
Many men find the recovery painful. Patients using inflatable implants may also experience pain the first few times the implant is inflated.
How Implants Work
There are three basic types of implant: semi-rigid, two-piece inflatable, and three-piece inflatable. With all implants, the “parts” are totally concealed within the body.
Semi-Rigid (Malleable) Penile Implants
Two flexible rods are inserted in the penis, replacing the corpora cavernosa. This has the effect of giving the patient a permanent erection. The penis can be bent down when not in use, and bent up prior to intercourse.
Considerations
- Easiest type of implant to use – good for men with limited dexterity.
- Simplest surgery.
- Least expensive.
- Some men find the permanent erection to be inconvenient or uncomfortable.
- Two-piece Inflatable Penile Implants
Two-piece Inflatable Penile Implants
Two inflatable chambers are inserted in the penis, replacing the corpora cavernosa. A small pump and fluid reservoir are inserted in the scrotum. Prior to intercourse, the man uses the pump in the scrotum to inflate the chambers, producing an erection. After intercourse, the man squeezes the pump again, while at the same time squeezing the penis to deflate the erection.
Considerations
- Easy to use.
- May produce “soft” erections, because the reservoir in the scrotum holds only a small amount of fluid.
- The devices are very reliable, but there is a possibility of mechanical failure, which requires additional surgery to correct.
Three-piece Inflatable Penile Implants
Two inflatable chambers are inserted in the penis, replacing the corpora cavernosa. A fluid reservoir is inserted in the abdomen, and a pump is placed in the scrotum. Prior to intercourse, the man uses the pump in the scrotum to inflate the chambers, producing an erection. After intercourse, the man squeezes the pump again, while at the same time squeezing the penis to deflate the erection.
Considerations
- Easy to use. It has a larger, softer pump than two-piece inflatables.
- The large fluid reservoir produces the most natural erection.
- The most complicated surgical procedure; requires an experienced surgeon. Some patients report that their partners do not know they have an implant.
- The devices are very reliable, but there is a possibility of mechanical failure, which requires additional surgery to correct. Because it is more complex, a three-piece implant may be more likely to fail than a two-piece implant.
Loss of Length
Many men report that their erection is shorter after an implant. It’s important to realize that this loss of length is due to long term, severe ED – which limits blood flow to the penis and causes tissues to shrink – rather than the surgery itself.
To avoid this problem, many doctors will have patients uses a penis pump for a month prior to the surgery. This helps to increase blood flow and stretch the tissues and restore the length. Stretching the tissues can also make the surgery and subsequent recovery easier. This is an important thing to talk to the surgeon about.
With preparation prior to surgery, and a properly sized implant, most men experience little if any loss of length.
Brands of Penile Implants
There are several brands and models of implant available. You can find out more about them by visiting the manufacturers websites, but you will need to discuss the best choices with your surgeon.
- American Medical Systems (Boston Scientific)
- Coloplast
- Promedon
- Rigicon
- Zephr Surgical Implants (not available in US?)
Cost of a Penile Implant
The total cost for the implant procedure may range from $10,000 to $20,000. Implants are prescribed by a doctor, and are covered by most insurance policies, including Medicare.
Recommended Reading
Everything You Never Wanted to Know about Erectile Dysfunction and Penile Implants, by Rick Redner MSW and Brenda Redner RN. Lulu Publishing Services, 2016.
For anyone facing severe Erectile Dysfunction, or considering a penile implant, this is a must-read book. It is a very personal story of one couple’s struggle with ED. At the same time, it in incredibly fact-filled, with detailed information about the implant process, and dozens of footnotes and references.
TAGS: Erectile Dysfunction, Penile Implants, Relationships
For More Information
Causes of Erectile Dysfunction
Treatments for Erectile Dysfunction
References
- Levine, Laurence A; Estrada, Carlos R; Morgentaler, Abraham. “Mechanical Reliability and Safety of, and Patient Satisfaction with the Ambicor Inflatable Penile Prosthesis: Results of a 2 Center Study.” The Journal of Urology, Sep 2001, Volume 166, Issue 3, pp 932–937. <http://www.jurology.com/article/S0022-5347(05)65867-3/abstract>
- Ji, Yoon Seob; Ko,Young Hwii; Song, Phil Hyun; Moon, Ki Hak. “Long-Term Survival and Patient Satisfaction with Inflatable Penile Prosthesis for the Treatment of Erectile Dysfunction.” Korean Journal of Urology. Jun 2015; 56(6):461-465. <https://synapse.koreamed.org/DOIx.php?id=10.4111/kju.2015.56.6.461>
- Montague, Drogo K. “Nonpharmacologic Treatment of Erectile Dysfunction.” Reviews in Urology. 2002; 4(Suppl 3): S9–S16. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476026/>
