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A penile implant is a device placed inside the penis. The device allows men with erectile dysfunction to have an erection.
Who is a candidate for the procedure?
Erectile dysfunction, sometimes known as impotence, is a condition in which a man is not able to achieve or sustain an erection. As a result, he cannot have intercourse or impregnate a woman. A penile implant, which requires surgery, is one of the treatments used for some men with erectile dysfunction.
Different treatments are used for erectile dysfunction, depending on the cause. For example, depression, anxiety, and drugs or medications can cause erectile dysfunction. In these cases, the cause can often be treated and an implant would not be used.
Other causes of erectile dysfunction cannot be treated directly. In these cases, an implant may be useful if other treatments do not work. Possible candidates for an implant include men with erectile dysfunction due to:
How is the procedure performed?
- blood vessel blockage or leakage
- previous surgery in the genital area
- prostate cancer, bladder cancer, or bowel cancer
- Peyronie's disease, which is scarring inside the penis that occurs for unknown reasons
- previous injury or damage to the pelvis, genitals, or spinal cord
- long-term or chronic disease, such as chronic renal failure, alcoholism, or Parkinson's disease
- medications that cannot be stopped, such as chemotherapy for cancer
- congenital defects of the genitals, or abnormalities present at birth
Once the decision is made to have a penile implant, the type of device must be chosen. There are three main types of implants. The three types are called rods, simple inflatable devices, and complex inflatable devices.
When rods are inserted into the penis, a permanent erection occurs. The penis can be bent down so that it is not noticed under the clothing. The penis can be straightened for sex easily. Advantages include low cost, ease of use, and the lowest risk of problems from the surgery or the device itself. The main disadvantages are the constant erection, which may show through tight clothing, and the unnatural appearance of the penis.
Simple inflatable implants allow the man to control his erections by inflating and deflating the device. The surgery is more complicated than it is for a rod device. The implant is also more expensive. This implant doesn't make the penis get as erect as the rod does. It also doesn't deflate as much as the complex inflatable devices.
The complex inflatable implants are thought to be the best devices, but they are more expensive and complicated. They also have the highest risk of malfunction or problems from the surgery. The most complex of these devices has three parts, with one in the penis, one in the scrotum, and one in the abdomen. This device provides the most natural appearance of an erection, with an increase in length and width of the penis. Inflating and deflating the implant controls erections.
The type of surgery depends on the device and the surgeon. The rod and simple inflatable devices may be done in a same day surgery setting. This means that the person can go home the same day as the surgery. The complex inflatable devices may require a few days in the hospital.
Surgery may be done with general anaesthesia, which means that the man is put to sleep with medications. Other types of pain control may also be used. The doctor will discuss the options for pain control before surgery.
The incisions in the skin used to insert the device may be on the penis, the scrotum, or the skin above or below the penis and scrotum. This depends on the device and the surgeon's preferred method.
What happens right after the procedure?
The man will be taken from the operating room to the surgery recovery room. His blood pressure, pulse, respirations and incision will be monitored by the staff. Analgesics will be given as needed. If the man is having same day surgery, he will be sent home from the surgery recovery room. Otherwise, he will be taken to the surgery inpatient unit for a brief hospital stay.
What happens later at home?
After surgery, pain is common. Pain medications are given to control pain. Ice packs and elevating the penis and scrotum may also be advised. Antibiotics may be given during and after the surgery.
Total healing time is usually three to four weeks, and it may take a month or two before the body gets used to the implant. Normally, the implant cannot be used until at least 4 to 6 weeks after the surgery. This is when healing is usually complete. Home care instructions should be followed closely to help avoid problems.
What are the potential complications after the procedure?
Penile implants do not normally affect sexual desire, sensation in the penis, or the ability to have children. However, the implant will affect the tissues inside the penis. Future erections will often depend on the implant device. Removal of the implant device will likely leave a man unable to have an erection.
Complications of penile implants can result from the surgery or from the device. Surgery can cause bleeding, infection, or allergic reaction to the anaesthesia. The device itself can malfunction or become damaged. This is most common with the complex inflatable implants. Further surgery may be needed if the device becomes damaged.
Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request