Penile Implants: Procedure, Benefits, Cost, and Recovery

Erectile dysfunction (ED) is a quite common condition affecting many men, more frequently found in older men. Temporary inability to get an erection is quite normal, but chronic erectile dysfunction can cause difficulties in sexual relationships, problems with psychological state and confidence. Nevertheless, there are a variety of ways to resolve this problem, including lifestyle changes, medications, and/or surgery for penile implants.

In cases when pills, injections, or vacuum pumps do not give the desired effect, then a penile implant can be an alternative. Penile implants have been used for more than a few decades already and can be considered one of the most efficient solutions for men with severe erectile dysfunction. Understanding the nature of the procedure, its advantages, the healing process, and the cost of a penile implant can be very useful for patients.

What Is a Penile Implant?

A penile implant, also known as a penile prosthesis, is a medical device surgically placed inside the penis to help a man achieve an erection suitable for sexual intercourse. Whereas oral medications rely on the improvement of circulation, the penile implant allows for a mechanical erection whenever it is needed.

It is worth noting that penile implants do not increase sexual drive, increase fertility, or affect testosterone levels. The main aim of penile implants is to enable erections for men who have not been helped by any other treatment for erectile dysfunction.

Who May Need a Penile Implant?

Penile implants are generally recommended only after conservative treatments have failed or are unsuitable. A urologist conducts an extensive assessment to determine whether surgery is appropriate.

A penile prosthesis would be recommended for those who have:

• Persistent erectile dysfunction that is unaffected by medication.

• Failed to get satisfactory outcomes using injection and vacuum therapy techniques.

• Failed to achieve success using penile injections or vacuum erection devices.

• Developed erectile dysfunction after prostate cancer surgery or pelvic injury.

• Diabetes-related erectile dysfunction that is resistant to treatment.

• Peyronie's disease is associated with severe erectile dysfunction.

It can also be considered by individuals who are medically fit for surgery and have realistic expectations about the outcome.

Types of Penile Implants

There are two main types of penile implants.

• Inflatable Penile Implant

This is the most commonly used model because of its resemblance to a natural erection. It has inflatable cylinders that are inserted into the penis; a fluid-filled reservoir that sits in the lower abdomen; and a small pump, which is fitted inside the scrotum. An erection is achieved when the pump is squeezed, causing the fluid to fill the cylinders, leading to an erection. Pressing the release valve returns the fluid to the reservoir, allowing the penis to become flaccid again.

• Malleable Penile Implant

A malleable implant consists of flexible rods placed inside the penis. The penis remains firm but can be positioned upward for sexual activity and downward for comfort or concealment. This option has a simpler design and may be suitable for selected patients.

How Is the Procedure Performed?

The penile implantation procedure is normally carried out using either general or spinal anaesthesia and typically takes about one to two hours on average.

The surgeon cuts a small opening in the region of the base of the penis or in the scrotum. Then the device is installed in the erectile chambers of the penis. In the case of using an inflatable implant, the pump and fluid reservoir are put through the same or another small opening. Finally, before closing the opening, the surgeon ensures that the device works properly.

Most patients are discharged from the clinic on the same day, although sometimes a hospital stay is needed.

Benefits of Penile Implant Surgery

For appropriately selected patients, penile implants offer several important advantages.

• Provides dependable erections whenever desired.

• No requirement for repeated medication or shots.

• More spontaneity in intimate moments.

• Very high satisfaction level for patients and their partners.

• Modern generation devices are meant to work efficiently for many years.

One of the common questions asked is how the sensation during intercourse changes after the operation. Usually, the sensation, orgasm, and ejaculation stay the same since the related nerves are not involved in the procedure. However, sexual function may still depend on underlying medical conditions.

Recovery After Surgery

The recovery process is generally slow and straightforward if the post-operative recovery guidelines are followed closely after surgery.

In the initial days after surgery, there is a chance of mild pain, swelling, and bruising. These problems are addressed by using prescribed medicines and getting enough rest. The patient is asked to move about slowly after surgery, but he/she should not indulge in heavy physical work for a few weeks.

Usually, men can resume their work at the office within one or two weeks, depending on the nature of their job and its requirements. In the case of inflatable implants, the procedure for inflating the device is demonstrated by the surgeon once the healing process is complete. Sexual intercourse can start after four to six weeks.

Possible Risks and Complications

All surgeries have inherent risks, and penile implant surgery is no different, although complications are relatively rare.

Complications can include the following:

• Infection

• Bleeding

• Pain/Inflammation

• Malfunction of the implant

• Device erosion or displacement, which is a very rare problem

It is necessary to visit a qualified urologist and follow all of the doctor's instructions after the operation.

What Does Penile Implant Surgery Cost?

In India, the cost of penile implant surgery ranges from INR 1.5 lakhs to INR 8.5 lakhs (ref.), depending on the type of penile implant used and the hospital where the surgery is performed. The semirigid implants are comparatively cheaper than the inflatable implants due to advanced technology.

Several factors affect the cost of treatment, such as:

• Type of penile implant.

• Brand and technology of the implant.

• Facilities available in the hospital.

• Surgeon’s expertise.

• Pre-operative investigations.

• Post-operative care.

• Location of the hospital.

Since the treatment is tailor-made for each patient, the total cost must be discussed during the initial consultation.

Conclusion

A penile implant is a proven and effective way of treating men with ED who haven't responded to conservative therapy. The implant provides reliable erections, high levels of satisfaction, and a chance to recover self-confidence and intimacy. Having knowledge of the procedure itself, potential complications, recovery period, and treatment costs will help you make a decision. In cases when other treatments failed to cure erectile dysfunction, a visit to a urologist may help to find out if a penile prosthesis is the best solution for you.