1. What is a penile implant?
For an erection to happen in men, the erection chambers in the penis need to be filled with blood. When there is insufficient blood flow to the penis or if the blood cannot be kept stored in the penis during erection, the penile implant is the perfect solution. A penile implant (penile prosthesis) is placed inside corpora cavernosa (the tubes that are filled with blood to create rigidity during intercourse). The erection provided by the implant gives rigidity whenever you want and as long as you want. It does not affect your satisfaction or ejaculation.
2. Who needs penile implant?
Anyone who has erectile dysfunction may benefit from a penile implant. This treatment option gives more than a 95% satisfaction rate. It is permanent and life-long. People are encouraged to use all non-invasive treatment options before proceeding to penile implant surgery since it is an irreversible procedure. Some of the most common indications are:
- Insufficient or no response to oral medications or injection therapies
- Contraindications to medical therapy due to side effects or medical conditions
- When there are both vascular and neuronal reasons for ED (complex cases)
- Diabetic patients who are prone to less response to other options
- Patients who have undergone prostate or rectal oncological surgeries.
- Neurological diseases where there is a problem with the electrical supply of erection
- Traumatic patients who have injury to the penile nerves or spinal cord
- Patients who want a definitive solution
- Patients undergoing penile reconstructive or corrective surgeries which will increase and exacerbate the existing ED
3. What kind of surgery is implant placement?
It is an overnight surgery which requires general or spinal anesthesia. Depending on the type of implant preferred, there will be a 3-5 cm incision at the scrotum or an extra incision near your inguinal canal. You can be mobilized and walk back home the next day. You will be given some detailed information about how to take care of yourself and you should give yourself at least 10 days for a proper healing period. You will feel the implanted device for a while but you will get used to it very easily and it will be a part of you. You will be asked to apply cold packs especially for the first couple of days to avoid excessive swelling. An antibiotic will be prescribed for you to protect from implant infection.
4. Are there different types of penile implant?
Majorly penile implants are classified into 2 categories:
The type that is most suitable for you depends on the couple factors and of course your choice. Malleable implants are very reliable since they do not have any mechanical parts and carry much less risk of infection. They are also the choice of an implant if there is too much scarring in the penis tissues such as in Peyronie’s Disease. However, they do not have the aesthetic flaccid and rigid states and are always have the same hardness, but allows hiding only with bending.
Inflatable implants are aesthetically more attractive since you only have a hard penis once you activate it and return to a soft penile state once you are done with your activities. It is the most natural-looking device. They contain different components which slightly increases the infection risk and mechanical malfunction risk ( but recent advances made these differences almost negligible). This device type requires dexterity, that means the person must be able to function a pump and deflation mechanism.
Whatever your choice is, implant surgery has the highest patient and partner satisfaction among all the ED treatments. Once you get to the stage where you decide on the implant you would like to have you will be given full information about what is best for you.
5. How to choose the device for penile implant?
There are some factors that need to be considered before making a decision. The main goal in suggesting a particular implant is to preserve as much length and girth as possible with maximum hardness for satisfactory intercourse.
- Patient and partner age
- Penis and scrotum size and shape
- Previous surgeries (especially those involving the penis testicles and the abdomen)
- Pathologies that affect the penis structure (Peyronie’s disease, penile curvature, penile tissue scarring)
- Chronic kidney failure that might require kidney transplantation in the long run
- Dexterity of the patient
- The patient choice
- Financial issues
6. Why Penile Implant at AACSH?
Surgical Specialization and Experience
Penile implant surgery is a sub-specialty of urology, where there is limited training during a standard urology residency. Due to its tricks of the trade and possible risks, the success rate is directly related to the experience and the training of the surgical team. Prof.Dr. Haluk Kulaksizoglu, is a member of the Urological Prosthetic Surgeons Society and has been one of the most experienced surgeons internationally. He had his “Sexual Dysfunction” fellowship training at the Boston University Department of Urology, which is one of the Centers of Excellence in the USA. He has been a tutor and mentor of penile implant surgery in Turkey. He has trained many urologists, given lectures and published papers on the topic. Before joining AACSH, Dr. Kulaksizoglu has been the Chairman of a tertiary academic medical center in Turkey which got referrals from all over Turkey, Middle-East and Europe as well as Asia.
At AACSH, our motto for all our patients is “ Discretion and Professionalism”. All your information is kept safe and confidential. Anyone walking through our door every bit of information is stored and kept most ethically.
Frequently Asked Questions (FAQ)
- Is the implant visible on the outside?
- Penile prosthesis is totally implanted inside the tissues and is not visible from outside.
- Do implants affect my libido or satisfaction?
- No. Satisfaction is actually felt through an area of the brain behind our ears (the temporal lobes). The electric signals from the penis reach this area for a satisfying feeling. The nerves that generate these signals are located at the glans (the head) of the penis and are not touched during implant surgery. Actually, with the self-esteem gained from a guaranteed erection cause most patients to feel more satisfactory intercourse.
- Will there be any alteration in ejaculation?
- No. Erection and ejaculation are in fact two different systems. Ejaculation is not affected by implants. On the contrary, especially in those patients who experience premature ejaculation alongside ED feel much safer since the hardness of the penis is not affected with ejaculation and may continue the act as long as he or his partner prefers.
- How do I know if I need one?
- If you are having ED, you should always consult a specialist. Your doctor will give options about your treatment and then you can decide what and when to do. Always keep in mind that as long as you want to pursue your sexual activities there is a solution. Take the first step and ask your doctor.
- Is there a guarantee period?
- Penile implants have a lifelong guarantee but some implants may need to be replaced in 10-15 years. If there is a mechanical malfunction the device company provides the faulty parts for free. On the other hand, infection and other complications due to surgery are not under warranty. You should choose the device and your surgeon wisely.
- How long after the surgery can I start using the device?
- During intercourse, there is a substantial force applied to the penis shaft. To ensure that tissues are properly and totally healed, six-week sexual abstinence is recommended. Early usage may result in damages to the inner tissues.