Erectile dysfunction is a common problem among men, and it becomes more prevalent with age. While some men can manage their ED symptoms through conservative treatments, others may not find success with these treatments. For such cases, a penile prosthesis implant is a viable long-term solution to severe erection problems. In this article, we’ll provide a comprehensive guide to penile implant surgery, including its benefits, candidacy requirements, and recovery process.

Who is a Suitable Candidate for Penile Implant Surgery?

Persistent erectile dysfunction that affects your sex life can make you a good candidate for penile implant surgery. If you have tried ED medication such as Sildenafil (Viagra), tadalafil (Cialis), Vardenafil (Levitra), avanafil (Stendra), penis pumps, and penile injection medication like TriMix, but haven’t experienced any improvement, you may be a good candidate for this procedure. Also, if you have Peyronie’s disease or prostate cancer, which aren’t treatable with other methods, penile implant surgery can be a viable solution.

However, if there’s a chance that your ED is reversible, emotional issues are causing it, or you lack sexual desire or sensation, you may not be suitable for penile implant surgery. Additionally, if you have a urinary tract infection (UTI) or any inflammation, lesions, or other issues with the skin of your penis or scrotum, this procedure might not be right for you.

Benefits of Penile Implant Surgery

Penile implant surgery has several benefits, including:

a) High Patient Satisfaction Rates: Studies have shown that patients report a 98% satisfaction rate for inflatable penile implants.

b) Increased Treatment Satisfaction: Patients who undergo a penile implant procedure are significantly more satisfied with their treatment than those who use ED medication or other treatment options.

c) Discrete Treatment: A penile prosthesis is not noticeable when your penis is flaccid, and your partner won’t know you’ve had an implant to treat your ED unless you tell them.

d) Quick Recovery Time: The typical recovery time after a penile implant procedure is four to six weeks, and after full recovery, you can resume your sex life.

e) Cost-Effective: Penile implants have been shown to be the most cost-effective ED treatment over a ten-year period.

The Impact of Penile Implant on Your Penis

If you’re considering penile implant surgery, you might wonder how it will affect your penis. The success rate of this procedure is over 95%, and after the surgery, your penis will look and feel the same as before. The latest three-piece inflatable implant design ensures that your partner won’t know about the implant unless you tell them. The only difference is that your erection will be achieved by pressing the button implanted in your testis, which you can do even in the bathroom.

How is the Quality of Erections and Sexual Performance after Penile Implant?

The quality of erections and sexual performance after a penile implant is excellent. Patients often report that their erections with an implant are harder than they were before. A penile implant can significantly improve sexual performance, as you will never lose your erection during sex, and the hardness will remain constant, regardless of how many times you have intercourse. This is something that even younger men with naturally achieved erections may not be able to achieve.

How is the Orgasm, sensation and ejaculation after penile implant?

Orgasm, sensation, and ejaculation after a penile implant are typically unaffected. The implant replaces the damaged erectile tissue without affecting anything else. Patients with an implant can still orgasm and ejaculate normally. In fact, with an implant, you can maintain your erection even after ejaculation, allowing you to experience multiple orgasms without losing erection hardness.

Loss in Penis Size after penile implant?

While most patients do not experience significant penile length loss after implant surgery, some patients may lose some length (0.5 – 1.5 cm). The degree of length loss can depend on several factors, such as the surgeon’s experience in choosing and fitting the implant, the type of implant, and the post-operative follow-up. However, we specialize in minimizing penile length loss after a penile implant. For patients who have already experienced significant length loss due to prostatectomy or Peyronie’s disease or any other size concerns, we can restore or even increase penis size using the AMS 700 LGX implant or other advanced surgical techniques. Additionally, a benefit of a penile implant is that the flaccid penis may be longer after the operation.

Which Penile Implant is the best?

The best penile implant is the three-piece inflatable penile implant. To achieve an erection, you press the implanted pump button in your testicles five to six times. This button is connected to a balloon-shaped reservoir implanted in the lower part of your abdomen. Activating the reservoir sends fluid into your penis, giving you a natural erection. This implant is fully concealed and cannot be seen from the outside. Additionally, if you choose not to disclose the implant, your partner will not be able to tell that you have had a penile implant.

What is the duration of the Penile Implant Surgery?

The penile implant surgery can be performed under spinal anesthesia or general anesthesia. Before surgery, the area is shaved, and a catheter is inserted to collect urine. An IV line is also placed for antibiotics or other medications. The surgeon makes an incision in your lower abdomen, the base of your penis, or just below the head of your penis. Then, the tissue in your penis, which normally fills with blood during an erection, is stretched, and the two inflatable cylinders are inserted. If you have chosen a two-piece implant, the saline reservoir, valve, and pump are placed inside your scrotum. If you have chosen a three-piece implant, the pump goes in your scrotum, and the reservoir is inserted under the abdominal wall. Finally, the incisions are closed. The procedure is usually done on an outpatient basis and generally takes 45 to 90 minutes, but the duration may vary.

How many days do I need to stay in the hospital for penile implant surgery?

After the surgery, you will be given instructions on how to take care of the surgical site and how to use the pump. You may need pain relievers for a few days or weeks. Your doctor will probably prescribe antibiotics to cut down on the chances of infection. You may be able to return to work within a few days, but it may take several weeks to fully recover. You should be able to resume sexual activity in about four to six weeks.

How long do I need to stay in India if I am coming from abroad for Penile implant?

For patients traveling to India for penile implant surgery, the duration of stay depends on the type of penile implant chosen. For a malleable penile implant like the Indian implant, the patient can choose to go back in 3 to 4 days. For an inflatable penile implant, you need to stay around for at least 4 weeks.

How should I prepare for penile implant surgery?

Here are some critical things you should take care of to prepare for the surgery:

• Choose the type of implant, malleable or 2-piece or 3-piece, with your surgeon.
• One week before surgery – We will perform a pre-surgical urine test and blood test for you. Medical or cardiac clearances will also be required before surgery. Medications like aspirin that thin the blood will be stopped, but if you are taking aspirin therapy for your heart condition, we will either reduce your dose or continue it until one day before surgery.
• Three days before surgery – You cannot drive home after surgery, so make transportation arrangements beforehand.
• Two days before surgery – You cannot consume alcoholic beverages until you recover.
• After midnight before surgery – You should not eat or drink anything, including tea or coffee, after 12 am on the day of surgery. If you need to take any medications, you may do so.
• On the day of surgery – Wear comfortable clothing and make sure your underwear provides support to your scrotum. Bring your ID card. Leave the rest to us.

How much does penile implant surgery cost?

The Indian malleable implant or Shah implant costs approximately 1.75 lakhs. The 2-piece implant, such as AMS Ambicor, costs about 5.5 lakhs. The 3-piece implant, such as AMS 700, costs approximately 8.5 lakhs and comes with a 10-year global warranty. The Coloplast titan touch implant costs 8 lakhs 15 thousand but does not have any warranty.

What is the success rate of penile implant surgery?

As with all medical procedures, there is a small risk of complications. The two most severe complications are mechanical failure (less than 5%) and infection of the prosthesis (2-3%). In both cases, complications can be resolved with revision surgery and/or replacement of the prosthesis. Revision surgery has a success rate of 93%, bringing the total success rate of our penile prosthesis surgery to over 99%.

We believe that a very important element that results in such high success rates, beyond surgical skill, is the correct patient selection in terms of surgical technique and extensive post-surgical follow-up with our patients.

What should I do after penile implant surgery?

You can resume normal activities one week after surgery, and complete recovery takes 4-6 weeks. During this time, we will advise you to inflate your implant daily so that you become accustomed to using it. After recovery, you can start having sexual intercourse with your partner in 4-6 weeks.

How many days of leave should one take from work after penile implant surgery?

The recovery time after penile implant surgery is generally 4-6 weeks, although it can vary from patient to patient. You can return to work or business within 2-3 days after surgery, and resume sexual activity within 4-6 weeks.

When can one have sex after penile implant surgery?

You should avoid sexual activity immediately after surgery and not activate or deactivate the penile implant for the first two weeks. You can gently pump the implant into place, but it’s important to wait for 2 weeks before starting to compress the pump. After 4-6 weeks, sexual intercourse can resume. Your surgeon will activate the pump in their chamber, and provide you with a sample pump for practice. Regular practice will also help to increase penis size during erections.

Does having sex with a penile implant cause pain?

No, penile implants are designed to provide a natural sexual experience and satisfaction, and should not cause pain during intercourse. In fact, having a penile implant can improve self-confidence and enhance pleasure for both partners.

How long does a penile implant last?

The life expectancy of a penile implant varies from 5 to 20 years, with an estimated lifespan of 10 to 15 years for implants placed today. However, the frequency of use can affect its durability, with an average use of one to two times per week. Larger cylinders require more pump squeezes, which can decrease the lifespan of the pump and tubing. In case of failure, replacement surgery is less painful than the initial procedure.

Factors that affect the lifespan of penile implants

Like any mechanical device, the more you use a penile implant, the sooner it will wear out. Therefore, the average use of a penile implant is considered to be one to two times per week. Patients with larger cylinders may require more squeezes of the pump to obtain an erection, which can decrease the life expectancy of the pump and tubing connecting the penile pump to the implant cylinders.

Type of penile implant

There is no appreciable difference between the life expectancies of different manufacturers. However, there are differences between the types of cylinders. For instance, AMS silicone cylinders are more fragile than the Bioflex Coloplast cylinders and are the most likely cause of failure of the AMS brand of implant. Failure occurs because of repeated bending of the deflated cylinders at the location of folds and not at the point where the cylinders are connected to the non-inflatable proximal portion.

On the other hand, the Coloplast tubing that connects the cylinders to the pump is the Achilles heel of this penile device brand. The tubing is outsourced and not manufactured in-house, is not as good as the AMS tubing, and is prone to fracture after 10 to 15 years of use.

Penile pump malfunction

Penile pump malfunction is rare. Both AMS MS (momentary squeeze) pump and the Coloplast “Touch” pump are extremely reliable, and on rare occasions, the pumps will jam in the deflation mode and will require a very, very forceful squeeze to activate the device. This has occurred more often with the Coloplast pump than with the AMS pump. The reservoirs almost never fail. The Coloplast reservoir has a built-in lockout valve, which prevents backflow into the cylinders, preventing auto-inflation.

What are the potential complications of penile implant surgery?

While penile implant surgery is generally safe and successful, there are some possible complications, including infection and malfunction. Infection is rare, occurring in only 0.5% of patients, and can be treated with antibiotics if caught early. If it is deeper, the implant may need to be removed and replaced. Malfunction is also rare, with less than 5% of patients experiencing issues after five years. However, the implant will wear out eventually and need to be replaced. Your doctor can provide further guidance on potential complications.

Myths About Penile Implants

Fiction: Penile Implants Are Too Invasive and Take Too Long

Fact: This is a common myth about penile implants, but it’s not true. Modern penile implant surgery only requires a small incision near the penis, and the entire procedure usually takes less than an hour.

Fiction: Penile Implants Have a Very Long Recovery Time

Fact: After the surgery, patients typically spend one night in the hospital and experience minor pain for the first week, which can be managed with oral medication. Most patients can resume sexual activity within four to six weeks, making penile implants one of the least invasive urology procedures with a short recovery time.

Fiction: Penile Implants Are Just Novelty Procedures

Fact: Penile implants are a last resort treatment for erectile dysfunction when other forms of medication or treatment have failed. They are not a novelty, but a serious medical option for men who need them.

Fiction: Penile Implants Are Very Unnatural and Stand Out

Fact: Modern penile implants are designed to be concealed within the penis, making them almost unnoticeable when the penis is flaccid. While there may be a slight bulge when the penis is erect, most partners report being satisfied with the natural look and feel of the implant.

Fiction: Penile Implants Are Not Reliable and Are the Least Desirable Treatment

Fact: Studies have shown that penile implants have a 97% reliability rate over five years, making them a highly reliable option for treating erectile dysfunction. In addition, 94% of men with penile implants report being satisfied with the results, making them a desirable treatment option for those who need them.

Causes of Erectile Dysfunction:

Erectile dysfunction can have many underlying causes, including:

• Cardiovascular disease
• High blood pressure
• Diabetes
• Obesity
• Tobacco use
• Alcoholism
• Certain medications
• Psychological factors, such as stress, anxiety, and depression.

Symptoms of Erectile Dysfunction:

The primary symptom of erectile dysfunction is the inability to get or maintain an erection firm enough for sexual activity. Other symptoms may include:

• Reduced sexual desire
• Premature ejaculation
• Delayed ejaculation
• Anorgasmia (inability to achieve orgasm).

Diagnosis of Erectile Dysfunction:

If you experience symptoms of erectile dysfunction, your doctor will likely perform a physical exam and ask you about your medical history. They may also conduct additional tests, such as:

• Blood tests to check for underlying health conditions
• Urine tests to screen for diabetes
• Psychological evaluation to check for underlying mental health conditions.

Types of Penile Implants:

There are three main types of penile implants: inflatable, semi-rigid, and malleable. Each type has its own advantages and disadvantages.

Inflatable Penile Implants:

Inflatable penile implants consist of two cylinders that are placed inside the penis. These cylinders are connected to a fluid-filled reservoir and a pump that is implanted in the scrotum. When the pump is squeezed, the fluid is transferred from the reservoir to the cylinders, causing the penis to become erect.

Advantages:

• Offers the most natural-looking and feeling erection
• Can be inflated and deflated as needed, allowing for spontaneous sexual activity
• Generally lasts longer than other types of penile implants

Disadvantages:

• More complex surgery than other types of penile implants
• Higher risk of complications, such as infection or mechanical failure

Semi-Rigid Penile Implants:

Semi-rigid penile implants consist of two bendable rods that are placed inside the penis. These rods keep the penis firm but can be bent into a more comfortable position when not in use.

Advantages:

• Easier to use than inflatable penile implants
• Lower risk of mechanical failure

Disadvantages:

• Does not offer a natural-looking or feeling erection
• Not as easy to conceal as other types of penile implants

Malleable Penile Implants:

Malleable penile implants consist of two bendable rods that are placed inside the penis. These rods can be bent into a more comfortable position when not in use.

Advantages:

• Easier to use than inflatable penile implants
• Lower risk of mechanical failure
• Offers a more natural-looking and feeling erection than semi-rigid penile implants

Disadvantages:

• Does not allow for spontaneous sexual activity
• Not as easy to conceal as other types of penile implants

Procedure:

The procedure for implanting a penile implant typically takes 1-2 hours and is performed under general anesthesia. Recovery time varies depending on the type of implant, but most men can resume sexual activity within 4-6 weeks after surgery.

Our centre specializes in the diagnosis and treatment of erectile dysfunction (ED) using penile implants. We understand that ED can be a sensitive and difficult issue for men to discuss, which is why our team of healthcare professionals is dedicated to providing compassionate and discreet care to our patients.

Our centre offers a range of penile implant options, including inflatable and malleable implants, to provide the best possible outcomes for our patients. We work closely with each patient to determine the most appropriate implant option based on their individual needs and preferences.

Our team of experts is experienced in the latest medical technology and techniques, including minimally invasive surgery, to ensure that our patients receive the best possible care and outcomes. We understand that the decision to undergo penile implant surgery is a significant one, and we provide thorough education and support to our patients throughout the entire process.

At our centre, we understand that every patient is unique, and we provide personalized care tailored to each patient’s individual needs. Our goal is to provide our patients with the best possible care and support to help them regain their sexual confidence and improve their quality of life.

If you are experiencing ED and are interested in learning more about penile implant surgery, please don’t hesitate to contact us to schedule a consultation with one of our experts. We are here to help you every step of the way.