When we talk about surgery for erectile dysfunction, then we have probably
already exhausted many of the other treatment options that are available.
As a last resort, then, we will discuss with patients the option of
surgical intervention.
What this requires is implantation of a penile prosthetic device.
Penile prostheses have been used for hundreds of years, historically.
Many, many, many years ago, people actually implanted
fragments of bones into the penile tissues.
This allowed patients to have a firm penis.
Penile implantation therapy has come a long way.
We no longer implant bones.
But we have prosthetic devices that can be used.
These come in many shapes and forms.
We have something called a semi-rigid penile prosthesis where the erectile
bodies are identified, the tissue within the erectile bodies are cored out
and we insert malleable rods directly into the penis.
These rods are firm all of the time.
They can be manipulated to different shapes and angles.
This is the simplest form of a penile prosthetic and requires insertion of
two rods within the penile tissues.
There is also something called an inflatable penile prosthesis.
These also come in several different types.
The principles are the same.
These generally have anywhere from two to three
components, depending on the type of prosthetic you are using.
They have cylinders that go into the penile tissues.
In their natural state, they are deflated and soft.
However, there is a system whereby fluid can be pumped into
these cylinders to make them firm and rigid.
There are various different pump mechanisms and things like
that.
There is a device that is a two-piece unit, which is comprised of the
cylinders as well as a reservoir and a pump, all contained in one, and
usually, that reservoir and pump is contained within the scrotal area.
The three-piece unit has two cylinders.
The cylinders are connected on one end to a reservoir, which is a sac that is filled
with fluid, and then on the other end to a pump mechanism, or an activation
mechanism, that is then implanted into the scrotal area.
Again, in the natural state, these cylinders are flaccid.
When you're ready for sexual activity, you would
activate the activation, or pump, mechanism that will then trigger the
cycling of fluid into the penile bodies, into the penile cylinders.
A couple of important things to note with surgical therapies.
It is not a way of increasing penile length.
In fact, in many cases, the length will actually shorten slightly.
It does require a surgical procedure, where there are incisions.
Also, these are mechanical devices, which are prone to
all of the potential consequences or side effects that we can see with
mechanical devices.
This includes things such as infections.
Infections can be a serious complication when talking about
penile prosthetic devices.
If there is an infection, then these commonly
have to be removed.
Also, you should note that once you have this procedure done, you can no
longer ever have normal erections or even the ability to have normal
erections.
Because during the procedure the normal erectile tissues are
completely cored out and they will no longer function normally.
So, it is a procedure, which can benefit many patients
in the appropriate circumstances.
But you should seriously consider some of the potential
risks and long-term potential side effects to these types of products.
This should be discussed extensively with your
surgeon or with your urologist prior to undergoing this procedure.
You should also talk to them about the potential alternative treatments that are
available prior to undergoing surgical intervention.