Penile implant surgery

A penile implant or prosthesis is a device that is inserted into the erectile cylinders of the penis. These erectile cylinders enable men to obtain and maintain an erection. If you are suffering from erectile dysfunction, a penile implant allows you to maintain a rigid penis for any length of time.

What is erectile dysfunction?

Impotence, known as erectile dysfunction, describes the inability to maintain an erection that is sufficient for penetration and the sexual satisfaction of both partners. It can affect men of any age.

However, erectile dysfunction mostly impacts men over the age of 50. The NHS estimates 50% of men aged between 40 and 70 in the UK will experience erectile dysfunction.

In the future, the number of men affected by erectile dysfunction is likely to increase. Consultant urological surgeon and andrologist, Mr Vaibhav Modgil predicts the rate of erectile dysfunction will have doubled, from 152 million men in 1995, to 322 million men in 2025. 

What are the common causes of erectile dysfunction? 

The most common causes of erectile dysfunction include:  

• Type 1 or Type 2 diabetes;
• Cardiovascular disease;
• Psychological disorders such as depression, anxiety and body dysmorphia;
• Pelvic surgery or trauma, and 
• Hormonal problems such as low testosterone or high prolactin levels. High prolactin levels can interfere with hormonal secretions and lead to a decrease in testosterone.   

What is a penile implant? 

There are two types of penile prosthesis or implants — a malleable penile implant and an inflatable penile implant.

Malleable penile implant 

Inflatable implant 

A three-piece inflatable penile implant comprises two paired cylinders inserted in the penis, a pump in the scrotum and a fluid-filled reservoir in the abdomen. When activated, the pump in the scrotum fills the cylinders in the penis with fluid,  allowing it to become rigid. The inflatable implant’s release button returns the penis to a flaccid state.

The second type of inflatable penile implant is a two-piece inflatable. The two-piece inflatable implant includes two pre-filled cylinders in the penis and a scrotal pump. But, unlike the three-piece inflatable, it does not use a fluid reservoir. The two-piece inflatable implant does not become flaccid when deflated.

Who can receive penile implant surgery?

If you’re suffering from erectile dysfunction, you could be a potential fit for a penile implant or prosthesis surgery. This decision is made after confirming the underlying cause of your erectile dysfunction, an assessment and a careful conversation between yourself and a urological surgeon about the risks and benefits of surgery.     

If you decide to proceed with penile implant surgery, you will be given a spinal or general anaesthetic. A small incision will be made below or above your penis and you will be required to stay overnight in the hospital. The surgery should take no more than 75 to 90 minutes.

Can penile implants increase size?

A penile implant cannot increase the size or width of your penis like a natural erection would.  Moreover, with a penile implant the head of your penis might not be as a rigid as it would be with a natural erection.

What should you do after your penile implant surgery?

After you’ve recovered, you will need to visit your surgeon for a post-surgery appointment. This will take place two weeks following your surgery. At your appointment, your surgeon will ensure the device is working efficiently. They will also teach you how to inflate and deflate the implant.

You will be provided with patient leaflets and shown instructional videos to put you at ease when using the implant. Your surgeon will see you again at six weeks post-surgery to evaluate how the implant is functioning. If you are given the all-clear by your surgeon, you can resume being sexually active.    

How long does a penile implant last?  

A penile implant will last at least 10 to 15 years before it needs to be replaced. Moreover, penile implant surgery holds one of the highest patient satisfaction rates. More than 90% of penile implant patients report that they are satisfied with the results of their surgery.  

What medications are available for erectile dysfunction?

Lifestyle changes such as lowering your alcohol intake, consuming a healthy diet, weight loss and being more active can significantly improve erectile dysfunction. Weight loss and exercise can reduce the risk of developing erectile dysfunction by 70%.

The first line of treatment for erectile dysfunction includes oral medications such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Spedra). These medications work by relaxing the blood vessels in the penis and encouraging blood flow to allow an erection to occur.

Penile creams are another treatment option you can use for erectile dysfunction. Alprostadil 3 mg/g cream is prescribed to patients with erectile dysfunction, who have an intolerance or cannot take oral medication for other health reasons.   

What alternative treatments are available for erectile dysfunction?

Other treatment options include self-administered penile injections. This will involve the injection of a drug such as alprostadil into the side of the penis to produce an erection. The urologist will administer your first penile injection. Your urologist will explain how injection therapy works and will teach you how to administer these injections independently.

Vacuum erection assistance devices (VEDs) are another alternative treatment for erectile dysfunction. The treatment works by placing your penis into a plastic cylinder. The air is then removed from this cylinder using a pump. This generates a vacuum within the cylinder that promotes blood flow to the penis and results in an erection. VEDs allow you to sustain an erection for up to 30 to 45 minutes.

If a blockage in the artery supplying blood flow to the pelvis or penis is found, microsurgical reconstruction of the arteries may be recommended. An artery blockage to the pelvis is caused by traumatic injuries to the pelvic area.

How can we help?

Our dedicated team of specialists in urologic health can provide you with convenient and accelerated access to an appointment. Our Consultants can talk to you about your experience, perform a patient assessment and guide you through your different treatment options.

Don’t let erectile dysfunction get in your way of having a healthy sexual relationship with your partner. If you would like to speak to a Consultant and learn more, please contact our team by calling us on 0808 101 0337 or through our online enquiry form.