Penile Prosthesis Applications: A Permanent Solution for Erectile Dysfunction

Penile prosthesis applications are a surgical treatment option for men experiencing erectile dysfunction (ED). Erectile dysfunction is the inability of a man to achieve or maintain sufficient erection for sexual intercourse, and it can result from both physical and psychological causes. In cases where other treatment methods (such as medications, injections, or vacuum devices) have failed or are ineffective, penile prosthesis surgery offers a permanent and effective solution.

A penile prosthesis is an artificial device implanted into the penis, designed to provide the necessary rigidity during sexual intercourse. This procedure is considered an effective treatment option, especially for men with severe erectile problems.

What is a Penile Prosthesis?

A penile prosthesis is a medical device surgically implanted inside the penis to provide an erection. These prostheses mimic the natural structure and function of the penis, allowing for sufficient rigidity for sexual intercourse. Penile prostheses typically come in two main types: inflatable (hydraulic) prostheses and malleable (semi-rigid) prostheses. Both types are placed inside the erectile chambers of the penis (corpora cavernosa) and are not noticeable from the outside.

Penile prostheses do not change or enlarge the penis size, but they enable men with erectile dysfunction to engage in sexual intercourse. The prostheses have no effect on sexual desire or ejaculation; they only provide mechanical erection.

Types of Penile Prostheses

Penile prostheses are produced in different types based on ease of use and technological features. The two main types of penile prostheses are:

1. Inflatable Penile Prostheses (Hydraulic Prostheses)

Inflatable prostheses are one of the most common and advanced types of penile prostheses. These prostheses allow the user to switch between erection and a normal state. An inflatable prosthesis typically consists of three parts:

1. Cylinders: These cylinders are placed inside the penis and inflated during sexual intercourse to provide an erection.
   1. Pump: A pump placed inside the scrotum (testicle sac) inflates and deflates the prosthesis to achieve an erection.
   1. Reservoir: A liquid reservoir placed in the abdominal cavity stores the fluid needed to inflate the cylinders.

These prostheses provide rigidity when pumped during sexual intercourse and return to a normal state once the function is no longer needed. They are the most preferred type of prosthesis because they offer the experience closest to natural erection.

• Malleable (Semi-Rigid) Penile Prostheses

Malleable prostheses have a structure that remains semi-rigid but is not easily noticeable from the outside. These two-piece prostheses consist of two flexible rods implanted in the penis. These rods allow the penis to be bent manually upward or downward.

The advantage of malleable prostheses is that they do not require any additional procedures such as inflation or deflation. The user can be ready for sexual intercourse whenever they want. However, since the penis is always semi-rigid, some patients may find this condition uncomfortable.

Who is Suitable for Penile Prosthesis?

Penile prosthesis surgery is suitable for men whose other erectile treatment methods have failed or are ineffective. Suitable candidates for penile prosthesis applications include:

• Those with Severe Erectile Dysfunction: Especially men who do not respond to treatment methods such as medications, injections, or vacuum devices.
• Those with Erectile Dysfunction Due to Non-Psychological Factors: Men who cannot achieve an erection due to physical causes such as neurological disorders, diabetes, or loss of erection following prostate cancer surgery.
• Those Who Wish to Continue Sexual Activity: Men whose sexual lives are negatively affected by erectile problems and wish to correct this situation.
• Those Unsuitable for Other Treatment Methods: Patients who are sensitive to the side effects of other treatment methods or do not benefit from these treatments.

While penile prosthesis surgery offers a permanent solution to erectile problems, it can significantly improve a person’s sexual life. However, since this surgical procedure is irreversible, a thorough evaluation and specialist consultation before surgery is important.

How is Penile Prosthesis Surgery Performed?

Penile prosthesis surgery is usually performed under general anesthesia. The surgical process may vary based on the type of prosthesis and the patient’s condition, but it generally proceeds with the following steps:

• Preparation and Anesthesia: In the pre-operative period, the patient’s medical history is reviewed, and necessary tests are conducted. During the surgery performed under general anesthesia, the patient is completely asleep.
• Placement of the Prosthesis: The surgeon makes a small incision at the base of the penis to insert the cylinders of the prosthesis into the penis. If an inflatable prosthesis is used, the pump is placed in the scrotum, and the reservoir is placed in the abdominal area.
• Closure of the Incision: After the prosthesis is placed, the incision is closed with cosmetic stitches, and a dressing is applied for wound healing.
• Post-Operative Care: The patient may stay in the hospital for a few days after surgery. It is important to pay attention to the doctor’s recommendations during the recovery process. It may take several weeks for the prosthesis to regain its full function, and the doctor will determine when sexual activity can be resumed.

Recovery Process and Results

The recovery process after penile prosthesis surgery generally lasts from 4 to 6 weeks. In the post-operative period, swelling and mild pain may occur; however, this condition will gradually decrease and completely disappear. Medications and care recommended by the doctor during the recovery process should be strictly followed.

Once full recovery is achieved, the use of the prosthesis is quite simple and comfortable. Patients using inflatable prostheses can achieve an erection by pumping the prosthesis and can return to a normal state when not in use. Patients using malleable prostheses can engage in sexual intercourse by manually lifting the penis.

Risks and Complications of Penile Prosthesis Surgery

As with any surgical procedure, penile prosthesis surgery has certain risks and complications. The risks of surgery include:

• Infection: There is a risk of infection in the area where the prosthesis is placed. In case of infection, removal of the prosthesis may be necessary.
• Prosthesis Malfunction: Although rare, mechanical failures may occur in the prosthesis, which may require replacement of the prosthesis.
• Pain and Discomfort: Pain and discomfort may occur during the post-operative period, but this is usually short-lived.

Although the risks of surgery are low, a personal evaluation should be made for each patient to determine whether surgical intervention is appropriate.

Penile prosthesis applications are a permanent and reliable treatment method for men experiencing erectile dysfunction. These prostheses offer an effective solution, especially for patients who do not achieve results from other treatment methods, providing the experience closest to natural erection and significantly improving the quality of sexual life. If you are considering penile prosthesis surgery, you can learn about the most suitable treatment option by consulting a specialized doctor.