Although the medical treatments of ED (pills, injections, suppositories, VED) [link to all four sections] may provide satisfying erections, they unfortunately do not provide a long-term “cure” to the problem. They are, after all, “bandaids” for the symptoms but not a total solution.
Most men and their partners want, ultimately:
Because of all of these factors, penile implants offer a very compelling alternative to treating ED.
There are several types of implants. In each case, the implant goes into the “erection bodies” of the penis and converts the non-functioning penis into a functioning penis.
Most insurances companies, including Medicare, cover the device and surgery although the patient needs to check with their individual insurer.
For those without insurance or who have insurers who do not cover these services, we have specialists who can work with the patient on costs and payment [link to costs]
No, sensation of the penis or sensation of orgasm is not affected by having an implant.
As with any surgical procedure, there are potential risks. The most significant is infection. Just like having a knee or hip prosthesis, having a penile implant means there is a “foreign body” in place and an infection can be quite serious (just like with a hip or knee).
Implants are safe for getting an MRI if needed.
It is important to tell other health care providers that you have an implant. For example if you are having a dental procedure you will likely need additional antibiotics.
Infection rates with modern implants are quite low, around 1%.
There are certain conditions that do increase the risk of infection:
One of the great advances of modern implants is the use of coating that hold in antibiotics to prevent bacteria from getting on the device.
We use many techniques to minimize infection in patients, both before the operation and during the operation. It is critical that surgeons are very meticulous in technique and are aware of the many things that can be done to prevent infections.
When a man has had ED for a long time, the penis shrinks and scars. This is similar to a weightlifter who stops working out and the muscles shrink. For this reason, the penis is often shorter than it was when he was younger. Sometimes this is made worse by “bad memory” (i.e. a man thinks he was larger in the past when he actually was), gaining weight, having pelvic surgery such as a radical prostatectomy, etc. This loss of length is the most common cause for dissatisfaction. We have been working on techniques to maximize your penile length while still performing safe surgery. These include things the patient does before the operation and afterwards.
Depending on the patient’s individual situation, there are two “expandable” devices that are available that will allow the penis to stretch to its full potential.
The devices are typically put in through a very small incision on the upper part of the scrotum. This takes about an hour. Usually, this is the only incision that is necessary.
The procedure may be done as an outpatient or with an overnight stay. If done as an outpatient, the patient needs to return to clinic the next day to have dressings etc removed.
The procedure is done in the operating room, either in the hospital or at a surgery center.
These devices are mechanical and so eventually they will fail. With modern devices, they usually last 10-15 years and may last even more than 20 years. When they fail, an additional surgery is required to replace the device (very similar to the original surgery).
As with other specialized surgeries, the patient should be careful about who they choose to perform it. With implants, surgeons often do 1-10 per year and may not have specialty training in implant and penile surgery. As with most things, the patient should enquire about the experience of the surgeons performing these cases and only go to someone who is comfortable with all aspects of these cases.
You will need to meet with the physician to make sure that you are a suitable candidate for this procedure.
Most patients require only a short workup, including cystoscopy (look inside bladder with a small camera) and urine flow studies. These can be done on the day of the consultation.
We must make sure that laboratory studies, including urine culture, are normal. If there are abnormalities or something in your health history that may compromise your ability to receive anesthesia, you may need to visit your regular doctor or a specialist (cardiologist, anesthesiologist) to make sure your health is optimized so you get the best possible outcome.
You will need to shower with a special antibiotic soap for several days before the operation and we can provide this in clinic or have you pick it up locally.