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Erectile Dysfunction
Penile Prosthesis
A penile
prosthesis is another treatment option for men with erectile
dysfunction. The simplest type of prosthesis consists of a
pair of malleable rods surgically implanted within the erection
chambers of the penis. Today, many men choose a hydraulic,
inflatable prosthesis, which allows a man to have an erection
whenever he chooses.
A penile
implant is usually used when there is a clear medical cause
for ED and when the problem is unlikely to resolve or improve
naturally or with other medical treatments. Sometimes a penile
prosthesis is implanted during surgery to reconstruct the
penis when scarring has caused erections to curve.
How
Does the Penile Prosthesis Work?
The inflatable
penile prosthesis consists of two cylinders -- a reservoir
and a pump -- which are placed surgically in the body. The
two cylinders are inserted in the penis and connected by tubing
to a separate reservoir of fluid. The reservoir is implanted
under the groin muscles. A pump is also connected to the system
and sits under the loose skin of the scrotal sac, between
the testicles.
To inflate
the prosthesis, the man presses on the pump. The pump transfers
fluid from the reservoir to the cylinders in the penis, inflating
them. Pressing on a deflation valve at the base of the pump
returns the fluid to the reservoir, deflating the penis.
Is
the Prosthesis Noticeable?
While
men who have had the prosthesis surgery can see the small
surgical scar where the bottom of the penis meets the scrotal
sac, other people probably will be unable to tell that a man
has an inflatable penile prosthesis. Most men would not be
embarrassed in a locker room or public restroom, for example.
What
Is Sex Like With the Prosthesis?
When the
penis is inflated, the prosthesis makes the penis stiff and
thick, similar to a natural erection. Most men rate the erection
as shorter than their normal erection; however, newer models
have cylinders that may increase the length, thickness, and
stiffness of the penis.
A penile
prosthesis does not change sensation on the skin of the penis
or a man's ability to reach orgasm. Ejaculation is not affected.
Once a penile prosthesis is put in, however, it may destroy
the natural erection reflex. Men usually cannot get an erection
without inflating the implant. If the implant is removed,
the man may never again have natural erections.
How
Effective Are the Implants?
About
90%-95% of inflatable prosthesis implants produce erections
suitable for intercourse. Satisfaction rates with the prosthesis
are very high, and typically 80%-90% of men are satisfied
with the results and say they would choose the surgery again.
Is
the Implant Safe?
No surgery
is totally free of possible complications. Complications associated
with penile implants include:
Uncontrolled
bleeding after the surgery possibly leading to re-operation
Infection
Scar tissue formation
Erosion (tissue around the implant may break down)
Mechanical failure
Will Insurance Cover the Cost of the Penis Prosthesis Implant?
Insurance
coverage for these operations is often good, as long as a
medical cause of ED is established. Medicare covers the surgery,
but Medicaid does not.
Reviewed
by the doctors at the Glickman Urological Institute at The
Cleveland Clinic.
Edited
by Charlotte Grayson, MD, WebMD, May 2004
Portions of this page © The Cleveland Clinic 2000-2004
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