Tag: penile prosthes

Bill took a deep breath, looked at his wife Judy, and finally told his urologist, “Okay. I’ll get the implant.”

It wasn’t something he necessarily wanted to do. But he had been dealing with erectile dysfunction (ED) for a few years now and no other treatments seemed to be working out. Because he took heart medication, he couldn’t take the pills he saw advertised on TV. And the vacuum device, which was far from romantic, didn’t seem right for him either.

He didn’t like the word “prosthesis” when it referred to his manhood. It made him think of artificial limbs. But he knew that an implant was just that – a device designed to give him an erection when he wanted.

He and Judy were in their fifties - still young - and still had a long sex life in front of them. He wanted to be more spontaneous with their lovemaking. He wanted to feel confident, like he did early in their marriage. And he wanted to keep Judy satisfied. She was patient, but he knew he was disappointing her every time.

Bill had heard that penile implants had a high satisfaction rate. He’d also heard that sex would probably still feel the same as it did before he had ED. But he was nervous. He knew that after getting the implant, there was no turning back. So he wanted to make sure he was doing the right thing.

Many men getting implants share Bill’s concerns. Penile implantation is a big decision. Today, we’ll talk about men’s experiences with implants and some things to keep in mind if you’re considering one.

What kind of implant?

Bill’s urologist recommended a 3-piece inflatable implant, which is currently the most common type. These implants have three components:

• Cylinders that are surgically implanted into the shaft of the penis. These cylinders replace the corpora cavernosa – the spongy tissue that typically fills with blood and gives an erection its firmness.

• A reservoir filled with saline fluid. This fluid fills the cylinders on demand, similar to the way blood once filled the corpora cavernosa.

• A pump placed in the scrotum. When a man wants an erection, he can activate the pump by squeezing it, sending the saline fluid into the cylinders. Similarly, when he no longer desires an erection, he can deactivate the pump, returning the saline fluid to the reservoir until next time.

Another type of implant, but less commonly used, involves malleable rods placed in the shaft. The man can move his penis to an erect position as he chooses.

Why do men like their implants?

In December 2015, The Journal of Sexual Medicine published a study on men’s satisfaction and dissatisfaction with penile implants. The researchers interviewed 47 men with an average age of 61 years and asked them to share their thoughts.

Overall, 79% of the men were “fairly” or “very” satisfied. The main reasons they gave were:

• Improved sexual performance. Men could get erections, penetrate their partners, and feel sexually satisfied.

• Improved self-esteem, confidence, and male identity. “It was a giant step I took in my life, and I'm glad I took it,” one man said.

• Improved relationships. One participant remarked, “My general relationship with my wife is much better now.” Others said they were happy that they could please their partners.

• Improved urination. Some men said their urinary function was better with the implant.

Why are men dissatisfied?

While the majority of men were satisfied, there were some who were not. Here are some of their reasons

• Unmet expectations. Some men found that the implant did not “feel” the way they thought it would.

• Shortening of the penis. In some cases, the penis was shorter than it was before. Two men were not able to have intercourse. [Note: A small 2014 study of penile shortening showed that 70% of men experience some degree of shortening after penile implantation, usually in the range of 0.5 centimeters to 1.5 centimeters. However, over half the men in the study didn’t notice.]

• Feeling “artificial.” One man said, “It is always artificial. It takes time to inflate, it always disturbs.”

Malfunction. After a while, some men with inflatable implants had trouble activating their devices. It is possible for pumps to malfunction, although this is rare. A urologist should give instructions on how to keep the device in good working order.

Should you get an implant?

That’s a question only you, your partner, and your doctor can answer. As the study suggests, the majority of men are satisfied with their choice. But men should be prepared – and have realistic expectations – before surgery. If you have any questions or concerns, be sure to let your andrologist know.