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A penile prosthesis is another treatment option for men with erectile
dysfunction. These devices are either malleable or inflatable. The simplest
type of prosthesis consists of a pair of malleable (bendable) rods surgically
implanted within the erection chambers of the penis. With this type of implant
the penis is always semi-rigid and merely needs to be lifted or adjusted into
the erect position to initiate sex. Today, many men choose a hydraulic,
inflatable prosthesis, which allows a man to have an erection whenever he
chooses and is much easier to conceal. It is also more natural.
A penile implant is usually used when there is a clear medical cause for ED
and when the problem is unlikely to resolve or improve naturally or with other
medical treatments. Sometimes a penile prosthesis is implanted during surgery
to reconstruct the penis when scarring has caused erections to curve
(Peyronie’s disease).
How Does the Penile Prosthesis Work?
The inflatable penile prosthesis consists of two cylinders — a
reservoir and a pump — which are placed surgically in the body. The two
cylinders are inserted in the penis and connected by tubing to a separate
reservoir of fluid. The reservoir is implanted under the groin muscles. A pump
is also connected to the system and sits under the loose skin of the scrotal
sac, between the testicles.
To inflate the prosthesis, the man presses on the pump. The
pump transfers fluid from the reservoir to the cylinders in the penis,
inflating them and causing an erection. Pressing on a deflation valve at the
base of the pump returns the fluid to the reservoir, deflating the penis and
returning it to the normal flaccid state.
While men who have had the prosthesis surgery can see the small surgical
scar where the bottom of the penis meets the scrotal sac, other people probably
will be unable to tell that a man has an inflatable penile prosthesis. Most men
would not be embarrassed in a locker room or public restroom, for example.
What Is Sex Like With the Prosthesis?
When the penis is inflated, the prosthesis makes the penis
stiff and thick, similar to a natural erection. Most men rate the erection as
shorter than their normal erection; however, newer models have cylinders that
may increase the length, thickness, and stiffness of the penis.
A penile prosthesis does not change sensation on the skin of
the penis or a man’s ability to reach orgasm. Ejaculation is not affected. Once
a penile prosthesis is put in, however, it may destroy the natural erection
reflex. Men usually cannot get an erection without inflating the implant. If
the implant is removed, the man may never again have natural erections.
How Effective Are the Implants?
About 90%-95% of inflatable prosthesis implants produce erections suitable
for natural remedy for erectile dysfunction. Satisfaction rates with the prosthesis are very high, and
typically 80%-90% of men are satisfied with the results and say they would
choose the surgery again.
Is the Implant Safe?
No surgery is totally free of possible complications.
Erectile symptom
associated with penile implants include:
- Uncontrolled bleeding after the surgery possibly leading to
re-operation
- Infection
- Scar tissue formation
- Erosion (tissue around the implant may break down) requiring removal
- Mechanical failure leading to re-operation and removal
Will Insurance Cover the Cost of the Penis Prosthesis Implant?
Insurance coverage for these operations is often good, as long as a medical
cause of ED is established. Medicare covers the surgery, but Medicaid does
not.
Reviewed by the doctors at the Glickman Urological
Institute at The Cleveland Clinic.
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