Penile Prosthesis to Treat Erectile Dysfunction
For most men, the initial medical treatment will be an oral medication such as sildenafil citrate. If this treatment is unsuccessful, second-line treatment options are ordinarily considered.
If these second-line treatments fail or if the patient and his partner reject them, then the third-line treatment option, penile prosthesis implantation, is considered.
Penile prostheses are devices that are implanted completely within the body. They produce an erection-like state that enables the man who has one of these implants to have normal sexual intercourse.
There are two erection areas in the penis. All penile prostheses have a pair of components that are implanted within both of these erection areas.
The simplest penile prostheses consist simply of paired flexible rods that are usually made of medical-grade silicone, and produce a degree of permanent penile rigidity or firmness that enables the man to have sexual intercourse. These devices are either flexible or inflatable.
The flexible prosthesis can be bent downward for urination or upward for intercourse. Inflatable penile prostheses are gizmos that can be inflated for erection..
The inflatable devices consist of a pump which is placed inside the scrotum (the sac that contains the testicles) and the inflatable part which is implanted inside the penis (the part called the corpora cavernosa)
Three-component inflatable penile prostheses have paired cylinders, a scrotal pump and an abdominal fluid reservoir. With these three-component devices, a larger volume of fluid is pumped into the cylinders for erection and out of the cylinders when erection is no longer needed.
Penile prostheses are implanted by making an incision above or below the penis. This procedure requires anesthesia. After the procedure pain medications are used while waiting for the surgical wound to heal.
After about a month the patient is able to resume sexual activity. Infection is a potential complication of penile implants, and if that happens the prosthesis has to be removed from the body.
Mechanical failure is more likely to occur with inflatable than with rod prostheses. The inflatable prosthesis contains saline , which is salt water , this may leak into the body. If there is mechanical failure re-implantation may be necessary. The mechanical failure rate may be as high as 10 to 15 %.
