What is a Penile Prosthesis and Who is it Suitable For?

A penile prosthesis (penis implant) is a device surgically placed in the penis to achieve an erection for men experiencing erectile dysfunction who do not respond to medication treatments and other methods. It helps to achieve the erection necessary for sexual intercourse through a mechanical or hydraulic system. Penile prostheses are generally a last-resort treatment option and provide successful results.

What is a Penile Prosthesis?

A penile prosthesis is a device surgically inserted into the penis designed for men with erectile dysfunction. These prostheses enable the penis to become erect, facilitating the necessary erection for sexual intercourse. Penile prostheses are divided into two main categories: malleable (bendable) and inflatable prostheses. They provide an effective and permanent solution for men who cannot achieve a natural erection with sexual arousal.

Once a penile prosthesis is implanted, it allows complete control over the erection process. The use of a prosthesis generally enables a satisfying sexual life with a partner.

Types of Penile Prostheses

Penile prostheses are produced in two fundamental types: malleable (bendable) and inflatable prostheses. Both types are used in the treatment of erectile dysfunction, but they differ in functionality and ease of use.

1. Malleable (Bendable) Prostheses

Malleable prostheses are the simplest and most cost-effective type of penile prosthesis. The prosthesis consists of two flexible rods inserted into the penis. These rods remain in a semi-rigid state continuously but can be manually bent to position the penis upright when needed.

Advantages:

• Easy to use.
• No risk of mechanical failure due to its simple structure.
• The placement procedure is quicker and easier compared to inflatable prostheses.

Disadvantages:

• May be uncomfortable for some men as the penis remains continuously rigid.
• Does not provide a natural appearance of an erection aesthetically.
• May be noticeable during urination or daily activities.
• Inflatable Prostheses

Inflatable prostheses have a more complex structure and provide results that closely resemble a natural erection. These prostheses consist of two inflatable cylinders placed in the penis, a reservoir (placed in the abdomen), and a pump system. The pump is usually placed in the scrotum. The user squeezes this pump before sexual intercourse to allow fluid from the reservoir to fill the cylinders, resulting in an erection. After intercourse, the fluid is withdrawn, and the penis returns to its flaccid state.

Advantages:

• Provides the most natural appearance of an erection.
• The penis remains in a natural and soft state outside of sexual intercourse.
• The usage is not apparent from the outside.

Disadvantages:

• There is a risk of mechanical failure, and the device may need to be replaced over time.
• The placement procedure requires more complex and longer surgical intervention.
• Generally more expensive than other prostheses.

Who is Suitable for Penile Prostheses?

Penile prostheses are suitable for men experiencing erectile dysfunction who do not respond to other treatment options (medications, vacuum devices, injections, etc.). They are usually preferred in the following situations:

• Men Who Do Not Respond to Other Treatments: In men who do not respond to PDE5 inhibitors such as Viagra and Cialis or other medication treatments, prosthesis surgery may be considered.
• Men Unable to Achieve an Erection Due to Physical Reasons: In cases where achieving an erection is physically impossible due to conditions such as diabetes, vascular diseases, post-prostate cancer surgery, or spinal cord injury, a prosthesis is an effective solution.
• Failed Treatments Due to Psychological or Psychogenic Reasons: In cases of erectile dysfunction related to psychological reasons, penile prosthesis can be used when psychotherapy or other treatment methods do not yield results.
• Erectile Dysfunction Accompanied by Peyronie’s Disease: For men with Peyronie’s disease who cannot achieve an erection due to curvature, penile prosthesis surgery can also be an option.

Penile Prosthesis Surgery and Recovery Process

Penile Prosthesis Surgery

Penile prosthesis surgery is a surgical intervention performed under general anesthesia and typically lasts 1-2 hours. During the surgery, the surgeon makes a small incision at the base of the penis to place the prosthesis. Depending on the chosen prosthesis type, either a malleable or inflatable prosthesis is inserted. For inflatable prostheses, a reservoir is placed inside the abdomen, and a pump is placed in the scrotum.

Patients may generally stay in the hospital for the same day or one night and are discharged within 1-2 days. Antibiotic treatment is administered during and after the surgery to mitigate any risk of infection.

Recovery Process

The recovery process after penile prosthesis surgery typically lasts several weeks. The following points are important during the recovery period:

• First Few Days: Mild pain, swelling, and bruising may occur for a few days post-surgery. These symptoms are normal and decrease over time. Pain relievers prescribed by the doctor are used.
• Daily Activities: Heavy lifting, sexual intercourse, and physical activities should be avoided during the first week after surgery. Normal daily activities and sexual intercourse can resume approximately 4-6 weeks after the surgery.
• Using the Prosthesis: If an inflatable prosthesis is placed, the doctor will provide training on how to use it a few weeks post-surgery. Learning to use the prosthesis correctly may take some time, but most patients can use it comfortably after a few attempts.

Post-Surgery Success and Satisfaction

The satisfaction rate after penile prosthesis surgery is quite high. The success rate in patients who do not respond to erectile dysfunction treatment is over 90%. However, post-surgery sexual satisfaction often depends on the type of prosthesis and the individual’s sexual life expectations. While the prosthesis does not provide a natural feeling of erection during sexual intercourse, it offers a mechanically satisfying solution.

Penile prostheses provide a permanent solution for men with erectile dysfunction who do not achieve results with other treatment methods. When choosing between malleable and inflatable prostheses, factors such as the individual’s lifestyle, expectations, and the doctor’s recommendations should be considered. The recovery process after surgical intervention should be closely monitored, and proper usage of the prosthesis is crucial for long-term success.