Our Summary

This research paper discusses the use of inflatable penile prostheses, which were first developed in 1973, as a treatment for erectile dysfunction. Over the years, these devices have been improved upon greatly, increasing their reliability, durability, and the overall success of the surgical procedures in which they are used.

For patients who have not had success with medication treatments for erectile dysfunction, or who would prefer a more permanent solution, the surgical implantation of a penile prosthesis might be a good option. According to 2019 guidelines, this procedure has one of the highest satisfaction rates of all treatments for erectile dysfunction, with 92-100% of patients and 91-95% of partners reporting satisfaction.

The most common surgical method used to implant these devices involves a penoscrotal approach, which is used in more than 80% of cases worldwide. However, there can be problems and dissatisfaction with the procedure, particularly when it comes to technical issues or poor surgical outcomes like the final length of the penis.

The paper emphasizes the need to better inform patients about what to expect from the procedure and the device, and to make sure that the right patients are selected for this kind of treatment.

FAQs

  1. What is a penile prosthesis and how is it used to treat erectile dysfunction?
  2. What is the satisfaction rate for penile implant surgery according to the 2019 guidelines?
  3. What are some potential problems or dissatisfaction that may arise from penile implant surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about penile implant surgery is to follow all post-operative care instructions carefully. This may include avoiding strenuous activities, keeping the surgical area clean and dry, and taking prescribed medications as directed. It is important to attend all follow-up appointments with the doctor to ensure proper healing and functioning of the implant. If any concerns or complications arise, it is important to contact the doctor immediately.

Suitable For

Patients who are typically recommended for penile implant surgery are those who have not had success with other treatments for erectile dysfunction, such as oral medications, injections, or vacuum devices. These patients may have severe erectile dysfunction that significantly impacts their quality of life and relationships.

Other factors that may make a patient a good candidate for penile implant surgery include:

  • A willingness to undergo surgery and follow post-operative instructions
  • Good physical health and the ability to undergo surgery
  • Psychological readiness for the procedure and ability to cope with potential complications or changes in sexual function
  • Partner support and involvement in the decision-making process

It is important for patients to have realistic expectations about the outcomes of penile implant surgery, as it may not restore the same level of function as a natural erection. However, for many patients, the benefits of improved erectile function and satisfaction with the device outweigh these considerations.

Overall, penile implant surgery can be a successful treatment option for patients with severe erectile dysfunction who have not responded to other treatments. It is important for patients to discuss their options with a healthcare provider to determine if this procedure is right for them.

Timeline

Before penile implant surgery:

  1. Patient consults with a urologist to discuss treatment options for erectile dysfunction.
  2. Patient undergoes medical evaluation to determine if they are a good candidate for penile implant surgery.
  3. Patient discusses the risks and benefits of the procedure with their healthcare provider.
  4. Patient may undergo psychological evaluation to ensure they are mentally prepared for the surgery.
  5. Patient undergoes pre-operative testing to assess their overall health and readiness for surgery.

After penile implant surgery:

  1. Patient undergoes the surgical procedure to implant the penile prosthesis.
  2. Patient is monitored in the hospital or surgical center for a period of time after surgery.
  3. Patient may experience pain, swelling, and discomfort in the immediate post-operative period.
  4. Patient is given instructions for post-operative care, including wound care and restrictions on physical activity.
  5. Patient returns for follow-up appointments to monitor healing and function of the penile prosthesis.
  6. Patient may need to undergo rehabilitation or therapy to optimize the function of the prosthesis.
  7. Patient and their partner may experience improved sexual function and satisfaction as a result of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about penile implant surgery include:

  1. What are the potential risks and complications associated with the surgery?
  2. How long is the recovery period, and what can I expect during the recovery process?
  3. Will the implant affect the size or appearance of my penis?
  4. Are there any specific lifestyle changes I will need to make after the surgery?
  5. How long can I expect the implant to last, and what is the likelihood of needing a replacement in the future?
  6. Will the implant allow for natural erections and sexual intercourse?
  7. What are the alternatives to penile implant surgery, and why is this option recommended for me?
  8. How experienced is the surgeon in performing penile implant surgeries, and what is their success rate?
  9. Will insurance cover the cost of the procedure, or will I need to pay out of pocket?
  10. Are there any specific pre-operative or post-operative instructions I should follow to ensure the best outcome?

Reference

Authors: Vendeira P. Journal: Actas Urol Esp (Engl Ed). 2020 Jun;44(5):377-381. doi: 10.1016/j.acuro.2020.01.010. Epub 2020 May 31. PMID: 32493599