Penile Implants

Three Types Of Penile Implants

When a man has erectile dysfunction (ED), he cannot achieve or maintain a firm erection. Formerly called impotence, about one in every ten men has some degree of ED and most has a physical cause. Diseases such as diabetes or prostate cancer and their treatment, injury, and the side effects of ED drugs can reduce or prevent blood flow and nerve impulses to the penis. Only about 10% of ED has a psychological cause. In addition, COVID has also been causing increases of ED in men.

Penile implants, often called internal penile pumps are one of several ED treatment options. Doctors began doing penile implants in the early 1970s. Since then, nearly 300,000 men have received penile implants. About 20,000 men choose penile implants each year to treat ED.

 

There are three types of penile implants. All are concealed within the body and provide an almost immediate erection to enhance romantic spontaneity.

• 3-piece inflatable implants (about 75% of penile implants.)
  
  
• 2-piece inflatable implants (about 15% of penile implants.)
  
  
• Semi-rigid malleable (positionable) rods (about 10% of penile implants.)

Penile implants often follow after finding that Viagra or another therapy has failed. As with all surgical procedures, there is a slight risk of infection. And although penile implants are highly reliable, malfunctions can occur over time. However, reliability and inflation control have significantly improved over the years. Long-term clinical data shows penile implants to be highly effective and reliable. Studies also find a very high degree of satisfaction between users and their partners.

General Considerations

Penile implants require a simple surgical procedure to place and conceal the prosthesis. An inflatable penile implant is a small, self-contained medical device implanted entirely within the body. It is not visible. Two cylinders are inserted side-by-side into the corpora cavernosa in the shaft of the penis. During a natural erection, the corpora fill with blood. After a penile implant, when a man desires an erection, he uses the device to transfer fluid to the cylinders. The cylinders expand, enlarging or erecting the penis.

For malleable or positionable penile implants, the urologist places bendable rods into the penis. The man then gently bends his penis to achieve an erection. Among other advantages, penile implants are the option for treating physical ED that best preserves romantic spontaneity. Doctors typically recommend starting men with a less-intrusive treatment such as Viagra. If this fails, then penile implants may be the logical next step.

The cost of penile implants (including device, medical procedure, and after-care) usually ranges from $15,000 - $35,000. Most insurance plans, including Medicare, cover penile implants and procedures. There may be some level of co-pay for the patient. However, most men who choose a penile implant have failed previous ED treatment. Most gladly pay a small portion of the cost of the procedure to regain their ability to achieve an erection.

Three-piece Inflatable Penile Implants

Three-piece penile implants are the most technologically advanced device. They are concealed within the body. Urologists consider the 3-piece inflatable implant the gold standard of penile implants.

Placement

During placement of the device, the patient usually is under general anesthesia. A skilled urologist trained in prosthetic urology performs the simple procedure. The procedure generally is on an outpatient basis, commonly called a 23-hour stay. Using a small incision, the urologist positions inflatable cylinders in the corpora cavernosa. A small pump is positioned in the scrotum, and a reservoir is placed deep in the abdomen. The reservoir is filled with saline solution. The device is entirely hidden and discreet.

Recovery Time

It commonly takes about four to six weeks to regain sexual function. Patients can resume sexual activity after a physician consultation.

How It Works

Gently squeeze the concealed pump in your 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, simply press a deflation site on the pump. Deflating the cylinders transfers the fluid back to the reservoir, and the penis becomes flaccid.

Advantages

• It closely resembles the process and feel of a natural erection.
  
  
• Simple, fast inflation preserves sexual spontaneity.
  
  
• Erection feels full.
  
  
• The penis feels soft and flaccid when deflated and appears full and youthful.
  
  
• It is concealed.

Disadvantages

• It requires some manual dexterity to inflate.
  
  
• More mechanical parts than other penile implants.
  
  
• Complications can occur, including infection and device malfunction.

Two-piece Inflatable Penile Implants

Two-piece inflatable penile implants are fluid-filled internal penile pumps. The two-piece system includes cylinders and a small pump. This makes it a slightly more complex device than malleable or positionable penile implants.

Placement

The patient is usually under either local or general anesthesia during the procedure. The procedure generally is on an outpatient basis, commonly called a 23-hour stay. A skilled urologist trained in prosthetic urology performs the procedure usually takes 45 minutes or less. Using a small incision, the urologist positions inflatable cylinders in the corpora cavernosa. A small pump is positioned in the scrotum. The device is completely concealed and unobtrusive. The pump inflates the cylinders by transferring fluid within the system. A simple deflation technique then transfers fluid to return the penis to a flaccid state.

Recovery Time

It takes about four to six weeks to regain sexual function. Patients can resume sexual activity after a physician consultation.

How It Works

Gently squeeze and release the concealed pump in your scrotum several times. This transfers the fluid in each cylinder to the cylinder shaft. Your penis will then become erect. To end the erection, gently bend your penis down for 6-12 seconds. This transfers fluid back into the reservoir.

Advantages

• A small inflation pump provides comfort and ease.
  
  
• Simple, fast inflation preserves sexual spontaneity.
  
  
• Fast and easy one-step deflation.
  
  
• Easier to conceal than a malleable implant.

Disadvantages

• It requires some manual dexterity to inflate.
  
  
• More mechanical parts than malleable penile implants.
  
  
• Complications can occur, including infection and device malfunction.

Malleable (Positionable) Penile Implants

This is the simplest of penile implants.

Placement

Most skilled urologists will do the procedure outpatient, also called a 23-hour stay. The surgeon gently places two bendable, positionable rods into the penis. The rods have an outer coating of silicone and inner stainless steel core or interlocking plastic joints. These enable the man to place the penis in either the erect or flaccid position.

Recovery Time

It takes about four to six weeks to regain sexual function. Patients can resume sexual activity after a physician consultation.

How It Works

For intercourse, the man places his penis in the erect position; the rods inside his penis bend as he does so. To conceal the penile implant, the man bends his penis down. He can bend the device in more than one place to create the desired erection.

Advantages

• Easy to use.
  
  
• Generally the most straightforward surgical procedure for ED.
  
  
• Few mechanical parts mean less chance of malfunction.
  
  
• Least expensive penile implant.

Disadvantages

• The penis always has some degree of rigidity and may be difficult to conceal under tighter-fitting clothes.
  
  
• Complications can occur, including infection and device malfunction.

In Closing

Penile implants aren't for everyone. For example, if you have diabetes that is not well controlled, heart disease, pulmonary or urinary tract infections can be reasons not to get them.

They do not make your penis larger (penis enlargement); in fact, an implant can make your penis a bit shorter than it used to be. Penile implants also don't increase sexual desire or sensation.

For more helpful information for ED, please see: Erectile Dysfunction Guide, Natural Erectile Dysfunction Remedies, and Sex Toys For Erectile Dysfunction.