Mention a penile implant to a man with erectile dysfunction (ED), and you might get a squeamish look. The idea of having surgery on his private parts is likely to make any man squirm. And, naturally, there are questions. Will the implant work? Will there be complications? Will sex feel the same? What do partners think?
These are all valid concerns. However, research over the years has found that implants have high satisfaction rates from men and their partners.
What is a penile implant?
A penile implant (sometimes called a penile prosthesis), is a device that allows a man to get an erection whenever he chooses. The implant is placed inside the body. No part of the implant is visible. Sexual sensations, ejaculation, and orgasm remain the same for most men.
In basic terms, implant surgeons remove the corpora cavernosa – two spongy chambers in the penis. Typically, these chambers fill with blood to form an erection. The tissue is replaced with implant materials, which form erections differently, depending on the type:
- Malleable (semi-rigid, bendable) implants are rods placed in the shaft of the penis. When a man wants to have an erection, he simply lifts the penis into position. When he is done with sexual activity, he places it downward again.
- Inflatable penile implants are a bit more complex. Instead of bendable rods, surgeons place two cylinders inside the penis shaft. These cylinders are connected to a pump that is surgically placed in the scrotum. To have an erection, the man activates the pump, which fills the cylinders with fluid, making the penis erect. After sex, he deactivates the pump, and the penis returns to its flaccid (not erect) state. Inflatable implants come in two varieties. Three-piece units include the pair of cylinders, the pump, and a fluid-containing reservoir. With two-piece units, the pump and reservoir are in the same unit.
Why get an implant?
While less-invasive treatments for ED, such as pills, injections, and suppositories, help lots of men, they aren’t appropriate for everyone. Some men just don’t have success with these options. And others can’t use them. For example, men who take medications containing nitrates cannot take ED pills because drug interactions could cause a dangerous drop in blood pressure.
Are men satisfied?
Experts say yes, for the most part. Here is a brief summary of research conducted over the last two years:
- In June 2018, BJU International published a study of 142 Italian men with implants. Men tended to be satisfied with their implants one year after surgery. More experienced surgeons were more likely to have satisfied patients.
- A July 2018 Journal of Sexual Medicine study of 902 men with implants reported that 93% were highly satisfied six months after implantation. Those who experienced major complications were less satisfied.
- A November 2018 paper in Sexual Medicine Reviews reported that patient and partner satisfaction rates were over 85%.
- Research published in the Journal of Sexual Medicine in May 2019 analyzed couples’ satisfaction with implants in a group of 883 men and their partners. About 90% of those with malleable implants said they were “somewhat” or “very” satisfied. Rates for these categories were 96% for men with two-piece inflatable implants and 99% for men with three-piece inflatable devices.Most of the couples said the implant met their expectations and that the device was easy to use. In addition, most said they felt confidence in their ability to engage in sexual activity.
Implant advantages
Many men enjoy the spontaneity that implants offer. Instead of waiting for other treatments to take effect, they can create their erection in the moment. Some feel more masculine having their erectile function restored and more confident being able to please their partner.
Implant disadvantages
On the other hand, implants can have some drawbacks. As with any surgical procedure, there is a risk for infection. Device malfunctions are rare, but possible. There could be some shortening of the penis (although some men don’t notice). And some men don’t like the “artificial” aspect of a prosthesis.
A big decision
While most men and their partners are satisfied with their implants, only you and your partner can decide what is best for your personal situation. It’s important to be prepared and have realistic expectations. Also, keep in mind that implant procedures are not reversable. Once the corpora cavernosa are replaced, they cannot be restored.
Be sure to let your urologist know if you or your partner have any questions or concerns.
Resources
BJU International
Capogrosso, Paolo, et al.
“Satisfaction rate at 1‐year follow‐up in patients treated with penile implants: data from the multicentre prospective registry INSIST‐ED”
(Abstract. First published: June 29, 2018)
https://onlinelibrary.wiley.com/doi/abs/10.1111/bju.14462
International Society for Sexual Medicine
“What if I don’t like the implant? Can the operation be reversed?”
https://www.issm.info/sexual-health-qa/what-if-i-dont-like-the-implant-can-the-operation-be-reversed/?ref_condition=penile-prosthesis
“Will sex still feel the same with a prosthesis?”
https://www.issm.info/sexual-health-qa/will-sex-still-feel-the-same-with-a-prosthesis/?ref_condition=penile-prosthesis
Journal of Sexual Medicine
Carvalheira, Ana, PhD, et al.
“Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation”
(Full-text. December 2015)
http://www.jsm.jsexmed.org/article/S1743-6095(16)30020-0/fulltext
Çayan, Selahittin, MD, FECSM, et al.
“Comparison of Long-Term Results and Couples’ Satisfaction with Penile Implant Types and Brands: Lessons Learned From 883 Patients With Erectile Dysfunction Who Underwent Penile Prosthesis Implantation”
(Full-text. Published: May 30, 2019)
https://www.jsm.jsexmed.org/article/S1743-6095(19)31140-3/fulltext
Habous, Mohamad, MD, FEBU, FECSM, et al.
“Predictors of Satisfaction in Men After Penile Implant Surgery”
(Full-text. Published online: July 15, 2018)
https://www.jsm.jsexmed.org/article/S1743-6095(18)31002-6/fulltext
Mayo Clinic
“Two-piece penile implant”
https://www.mayoclinic.org/tests-procedures/penile-implants/multimedia/two-piece-penile-implant/img-20008851
Sexual Medicine Reviews
Barton, Gregory J., et al.
“Sexual Quality of Life and Satisfaction With Penile Prostheses”
(Full-text. Published online: November 29, 2018)
https://www.smr.jsexmed.org/article/S2050-0521(18)30113-6/fulltext
Urology Care Foundation
“What is Erectile Dysfunction?”
(Updated: June 2018)
https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction#Treatment
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