Erectile dysfunction (ED) is the inability of a man to attain and/or maintain an erection sufficient for sexual activity. Fortunately, most men who have ED only lose the ability to have satisfactory erections.
In other words, for most of these men, penile sensation is normal and the ability to have an orgasm and ejaculate remains. Today, there are several treatment options available to men suffering from this disorder. Lifestyle changes are the first line of treatment with weight loss, smoking cessation and exercise associated with improved erections. For most men, the initial medical treatment will be an oral medication such as sildenafil citrate. If this treatment is unsuccessful, second-line treatment options are ordinarily considered. These include using a vacuum erection device, intraurethral medication or penile injection therapy. If these second-line treatments fail or if the patient and his partner reject them, then the third-line treatment option, penile prosthesis implantation, is considered.
Penile Prosthesis Information
What are penile prostheses?
What are the different types of penile prostheses?
The inflatable devices have fluid-filled cylinders that are implanted within the erection chambers. Tubing connects these cylinders to a pump that is implanted inside the scrotum, the sac that contains the testicles. In the simplest of these inflatable devices, the pump transfers a small amount of fluid into the cylinders for erection, which then transfers out of the cylinders when erection is no longer needed. These devices are often referred to as two-component penile prostheses. One component is the paired cylinders and the second component is the scrotal pump.
Three-component inflatable penile prostheses have paired cylinders, a scrotal pump and an abdominal fluid reservoir. With these three-component devices, a larger volume of fluid is pumped into the cylinders for erection and out of the cylinders when erection is no longer needed.
What does penile prosthesis implantation involve?
Most men have pain after penile prosthesis implantation for about four weeks. Initially, oral narcotic pain medication is required and driving is prohibited. If men limit their physical activity while pain is present, it usually resolves sooner. Men can often be instructed in using the prosthesis for sexual activity one month after surgery, but if pain and tenderness are still present, this is sometimes delayed for another month.
What are the complications of penile prosthesis surgery?
Mechanical failure is more likely to occur with inflatable than with a malleable or semi-rigid prostheses. The fluid present inside the inflatable prosthesis leaks into the body; however, these prostheses contain normal saline that is absorbed without harm. After mechanical failure, another operation for prosthesis replacement or repair is necessary if the man wants to remain sexually active. Today’s three-component inflatable penile prostheses have about a 10 to 15 percent likelihood of failure in the first five years following their implantation.
Is penile prosthesis implantation covered by insurance?
Will a penile prosthesis interfere with urination?
Where can I get more information?
- Erectile Dysfunction: Causes, Risks & Talking To Your Doctor
- Erectile Dysfunction: Primary Treatment Options
- Erectile Dysfunction: Secondary Treatment Options
AUA Foundation Fact Sheets: