During penile implant insertion a prosthesis is placed in the penis to allow the production of an erection-like state which will aid the male in sexual intercourse. Indications supporting the need for an implant include an unresponsiveness to other treatment options, diabetes or vascular disease, spinal cord injury and certain previous operations.
Types
According to the University of Southern California, inflatable prosthetics are available in two-piece or three-piece versions. Both options contain two cylinders, a pump, a reservoir and tubing.
The three-piece prosthetic consists of cylinders that are inserted into the penis, a pump that is placed in the scrotum, and a reservoir that holds the fluid for inflation that is implanted into the abdomen.
A two piece option allows the cylinders to go into the penis and the pump reservoir combination is inserted into the scrotum.
Reservoir Positioning
Reservoir positioning might be the most complicated part of the implantation procedure. If the bladder is not completely empty, there is a risk of bladder perforation. If the reservoir is incorrectly positioned over the fascia, mechanical complications can occur.
Implanting the Reservoir and Cylinders
The implantation surgery is usually performed by an urologist who will first obtain a complete medical and sexual history. He might order additional testing such as blood tests, urine tests and a psychological analysis.
The genitals will be shaved before the surgery to reduce the chance of infection. The surgery can be performed under general anesthesia or with an epidural or spinal block. The surgery for an inflatable system with the reservoir can last between 1 to 2 hours (twice as long as surgery for the non-reservoir types).
The device in implanted through two small incisions made on the top side of the scrotum. Pain may be experienced for about 4 weeks after the prosthesis is implanted. A prescription pain reliever is given to make recovery more comfortable.
The skin sensation, ability to reach orgasm and the ability to ejaculate is unchanged by a prosthetic implantation. The success rate for penile implantations is about 90 to 95 percent . Five years following insertion, 90 to 95 men out of 100 report their prosthetic as functional.
How Does the Reservoir System Work?
According to the Cleveland Clinic Urology Department, the penile implant with reservoir works by pressing on the pump (which is in the scrotum just behind testicles). This action transfers fluid from the reservoir and to the cylinders located in the penis. The presence of fluid causes the cylinders to fill out, and an erection is achieved. There is a deflation valve at the base of the pump, and when pressed, the erection deflates.
Considerations
The procedure can be complicated by patient obesity, smoking, heart disease, poor nutrition, illness, alcoholism, drug use, diabetes and chronic lung disease. Herniation is rare but can occur in inflatable penile prosthesis surgery. Tissue erosion around the implant is possible, as well, and mechanical failure is possible.
Other options to implantation surgery includes oral and injectable medications, suppositories and vacuum devices.
