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What is a penile prosthesis?

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A penile prosthesis is an artificial support for the penis. For men who have problems getting an erection (erectile dysfunction) and are not able to have sexual intercourse, the solution may be to have a prosthesis implanted inside the penis. However, no one should consider this procedure until other methods have been exhausted. Indeed, there are numerous other treatments for erectile dysfunction and more are being developed all the time. It is also advisable to consult first with a doctor to investigate the possible underlying cause of impotence.

How do penis prostheses work?

Patients should understand that these devices are only a mechanical way of providing an erection to allow them to have sexual intercourse and not to enhance libido (sexual drive). In both types of prostheses, sensation will be reduced and ejaculation may be absent. There are two main types of penile prostheses:

Semi-Rigid: This consists of two rods of silicone rubber that are fitted into the length of the penis through a small operation. This provides some rigidity as well as a certain amount of flexibility so that the penis can either be curved downwards in the normal position or put into an erect position for intercourse.

Inflatable: This consists of two cylinders, a pump and a reservoir. The cylinders, which are placed inside the penis, can be inflated with fluid to produce an erection and deflated after intercourse. All parts of this ‘hydraulic’ system have to be implanted inside the penis and scrotum. When an erection is required, squeezing a device placed in the scrotum activates the pump. In doing so, fluid is drawn from the reservoir to the cylinders, making the penis hard. Following intercourse, a valve is pressed and the fluid runs back into the reservoir.The main advantage of this method is that it looks more natural. There are, however, also a few disadvantages. For instance, the inflatable prosthesis is quite expensive and it is unlikely that the operation will be available on the NHS in your local hospital. Also, this type of surgery is more complex and involves more parts which can go wrong. Lastly, this option requires more manual dexterity, which might not be suitable for everyone.

Which patients are suitable for a penile prosthesis?

Usually, patients who have had a physical injury to the erectile tissue within the penis are suitable for penile prostheses. Possible causes of such injury may include:

  • Damage caused by repeated injection treatment
  • Damage caused by previous surgery
  • Peyronie’s disease, which causes fibrosis within the erectile tissue
  • Patients who have unsuccessfully tried all other treatments for loss of erection, such as oral drug treatment and injections

What if you do not want a penile prosthesis operation?

Assuming that all other available treatments have been exhausted, it is important to remember that there are other ways to enrich your sex life to make it exciting and enjoyable. Endless sexual intercourse may be the fantasy of someone who cannot get an erection; however, vast numbers of men and women are satisfied by other kinds of lovemaking such as oral sex and touching. Although you will obviously miss being able to have intercourse yourself, it is possible to derive considerable satisfaction from knowing that you can still love and satisfy your partner.

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