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Penile Implants
- Penile implants involve surgical insertion of
malleable or inflatable rods or tubes into the penis. A
semi-rigid prosthesis is a silicon-covered flexible metal rod.
Once inserted, it provides the rigidity necessary for
intercourse and can be curved slightly for concealment. It
requires the simplest surgical procedure of all the prostheses.
Its main disadvantage is that concealment can be difficult with
certain types of clothing.
- An inflatable penile prosthesis consists of two soft silicone or
bioflex (plastic) tubes inserted in the penis, a small reservoir
implanted in the abdomen, and a small pump implanted in the
scrotum. To produce an erection, a man pumps sterile liquid from
the reservoir into the tubes by squeezing the pump in the
scrotum. The tubes act as erectile tissue and expand to form an
erection. When the erection is no longer desired, a valve allows
the fluid to return to the reservoir. Inflatable prostheses are
the most natural feeling of the penile implants and they allow
for control of rigidity and size.
- The surgical procedure to implant the inflatable prosthesis is
slightly more complicated than for a semi-rigid implant. Also,
because there are more mechanical parts, there is a higher risk
for mechanical failure requiring repair or adjustment.
- A self-contained inflatable prosthesis is similar but has fewer
parts. It consists of a pair of inflatable tubes in the penis
with a pump attached directly to the end of the implant. The
reservoir is also located in the shaft of the penis. Its compact
design allows for simpler implantation, but because it takes up
more space in the penis, there is less room for expansion.
Types of Penile Implants: Vascular Reconstructive Surgery
- A small
percentage of men undergo vascular reconstructive surgery to
improve blood flow to the penis. Revascularization involves
bypassing blocked veins or arteries by transferring a vein from
the leg and attaching it so that it creates a path to the penis
that bypasses the area of blockage. Young men with only local
arterial blockage are the best candidates for this procedure. It
may restore function in 50% to 75% of men.
Venous ligation
- is performed to prevent venous leak. Problematic
veins are bound (ligated) or removed, which allows an adequate
amount of blood to remain in the penis. It may improve function
in 40% to 50% of men, but some men may experience problems over
the long term.
- Vascular surgery for erectile dysfunction is rarely performed
and is generally considered experimental. Risks include nerve
damage and the creation of scar tissue, both of which are causes
of impotence. Surgeons experienced with these procedures may be
difficult to find.
Erectile Dysfunction:
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