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Author: Akash Kapadia, MD

Rebuilding Connection: Penile Implants & Quality of Life for Patients and Their Partners

Posted on by Akash Kapadia, MD in ,

Couple embracing outdoors during sunset

Sex isn’t just about sex. It’s about closeness, confidence, desire, and feeling like yourself. When erectile dysfunction (ED) enters the picture, it can take a toll far beyond the bedroom. Patients often describe a quiet erosion of connection, marked by less eye contact, increased distance, and fewer shared moments. Partners feel it too – frustrated, concerned, or unsure how to help.

For couples dealing with ED, the strain is both physical and emotional. Research shows ED can significantly impact mental and emotional well-being, not just for the individual, but for their partner, too. Many patients experience a dip in self-esteem, confidence, and even depression. Partners often report feeling unwanted, rejected, or isolated in response.¹ And when pills or pumps don’t work (or stop working), it’s easy to feel like hope is off the table.

But it’s not.

Inflatable penile prostheses (IPPs), also known as penile implants, are a highly effective, discreet, and long-lasting solution that’s helping men restore their sexual function and reclaim their quality of life. And research shows that both patients and their partners are overwhelmingly satisfied with the results.

Information about the mechanics of penile implants is widely available. But let’s focus on what really matters: how people feel afterward.

What the Numbers Say

Psychological factors such as stress, negative self-talk, or fear of failure in the moment are almost the worst part about ED – what researchers call “cognitive interference.” A penile implant eliminates the need to mentally manage the timing and success of medication, removing a significant source of anxiety.¹

In one study, more than 83% of patients were satisfied with their implant a year or more after surgery and said that they’d recommend it to a friend.² Another review noted satisfaction rates as high as 90%, putting penile implants on par with other life-enhancing surgeries like knee replacements and breast augmentation.³

Why so high? There’s the obvious reason, of course – regaining an erection. But it also brought people back to a place of comfort, connection, and spontaneity. For many couples, the implant removes the performance anxiety and pressure that often comes with ED. Intimacy becomes possible again, without the clock ticking on medication or external devices.

Men, as well as women, just want to be close to their partner again, and 85% of partners reported satisfaction with the results, alongside the men themselves.⁴ The better the partner feels, the more satisfied the patient is, and vice versa. Restoring erectile function helps restore emotional equilibrium for both partners.

Partners play a huge role in recovery, communication, and emotional healing. That’s why more urologists now encourage couples to come to consultations together to ask questions, express concerns, and start rebuilding trust as a team.

More Than an Erection

Sure, regaining sexual function is important. But the benefits of a penile implant often reach well beyond the bedroom. Patients frequently report improved confidence, reduced stress and anxiety, increased relationship satisfaction, and a return to physical closeness that had been absent for months or even years.

And while not every couple discusses these feelings out loud, many describe a quiet shift in their relationship – hand-holding comes back, affectionate jokes return, and emotional intimacy starts to feel easier again.

Some men worry the implant will “feel fake” or that their partner won’t accept it. In reality, most partners are grateful to regain intimacy and connection. Many couples report that once they adjust, the experience feels natural and emotionally freeing. And while the idea of surgery can seem daunting, the procedure itself is straightforward. Most patients return to light activity within a few days, and sexual activity within 4 to 6 weeks – just a brief recovery when you consider the months or even years of frustration that came before. Even better? Most implants last 10 to 15 years or more, making them a long-lasting solution to a long-standing challenge.

Most implants today are inflatable, discreet, and completely concealed within the body. Once healed, there’s no visible sign, and the function is entirely under your control. That means no waiting for pills to kick in or worrying about timing. It’s there when you want it, and completely undetectable when you don’t.

And with satisfaction rates this high, you’re investing in so much more than a medical device – you’re investing in quality of life, for yourself, and your partner.

Penile implants offer men and their partners a chance to reclaim something deeper. Whether ED has been a lingering issue or a recent frustration, you deserve to know your options and to have a partner in that conversation.

If you’re ready to talk about what life after ED could look like, Dr. Kapadia is here to help. He is a Coloplast Titan and Boston Scientific AMS 700 Center of Excellence for penile implants, and one of the few centers in the nation to achieve this dual designation.

He can offer expert guidance to patients and couples exploring treatment options, and has helped many people find their way back to a satisfying, connected life.

The earlier the ED is addressed, the less emotional distance builds between partners. Don’t wait until things feel unmanageable – many couples say they wish they’d explored treatment sooner.

References:

  1. Allen, M. S., Wood, A. M., & Sheffield, D. (2023). The Psychology of Erectile Dysfunction. Current Directions in Psychological Science, 32(6), 487–493. https://doi.org/10.1177/09637214231192269.
  2. Jorissen, C., De Bruyna, H., Baten, E., & Van Renterghem, K. (2019). Clinical Outcome: Patient and Partner Satisfaction after Penile Implant Surgery. Current Urology, 13(2), 94–100. https://doi.org/10.1159/000499286.
  3. Barton, G. J., Carlos, E. C., & Lentz, A. C. (2019). Sexual Quality of Life and Satisfaction With Penile Prostheses. Sexual Medicine Reviews, 7(1), 178–188. https://doi.org/10.1016/j.sxmr.2018.10.003.
  4. Jorissen, C., De Bruyna, H., Baten, E., & Van Renterghem, K. (2019). Clinical Outcome: Patient and Partner Satisfaction after Penile Implant Surgery. Current Urology, 13(2), 94–100. https://doi.org/10.1159/000499286.

What Causes BPH, and Can It Become a Medical Emergency?

Posted on by Akash Kapadia, MD in

Outdoorsy man pondering while sitting against tree

Benign prostatic hypertrophy, or BPH for short, is a non-malignant condition in which the prostate enlarges. This is quite common, especially as men get older. Although it isn’t fully understood, scientists do know that an excess of certain male hormones encourages parts of the prostate to grow more than usual. Causes of BPH have garnered significant interest in the research community, and we’ll go over some of the theories shortly.

Symptoms

BPH typically presents with changes in urinary habits. Common symptoms are often referred to as “voiding symptoms” because they involve the process of urination or emptying the bladder. This includes a weak or slow urine stream, an uptick in frequency, difficulty urinating or starting to urinate, and waking up at night to urinate more than usual. Another set, called “storage symptoms,” includes sudden urges to go and occasional leakage. Sometimes they can be part of the BPH pattern, but they can also indicate other urinary-related conditions.

Globally, studies have shown that about one in four men will experience these symptoms at some point in their lives, and this rate has remained relatively stable over the past two decades. Though BPH is common, it can still interfere with quality of life, disrupting sleep, increasing bathroom trips, hampering social and work activities, and sometimes affecting sexual and emotional health.

Causative Theories

Forewarning: this part gets super scientific, but don’t worry, it’ll be over soon.

As researchers continue to uncover the mechanisms behind BPH, one recurring theme is the role of chronic inflammation. Other theories include age-related hormonal changes, altered signaling between various cells, and imbalances in growth factor activity. Together, these factors may create an environment that supports abnormal, yet noncancerous, tissue growth.

Another area of growing interest is the idea that BPH may represent a kind of “reawakening” of embryonic growth patterns in the prostate. This theory, first proposed in the 1970s, suggests that aging-related factors can trigger stem cells (cells that develop into other cell types) to become active again. These cells may originate in the prostate itself or be recruited from the bone marrow. Once they arrive, they respond to inflammatory signals and growth factors, leading to abnormal but benign growth of prostate tissue. In particular, mesenchymal stem cells (which can form connective and smooth muscle tissue) seem to play a key role by altering the local environment and encouraging further proliferation of prostate cells.

Untreated BPH

If BPH isn’t treated, the problems can get worse than just annoying bathroom trips. The complications go from uncomfortable to serious. These include impaired bladder emptying, where the bladder fails to fully drain, which increases the risk of urinary tract infections and bladder stones. Sometimes, gross hematuria (visible blood in the urine) can occur, signaling the need for medical attention.

More severe complications include acute urinary retention, a sudden and painful inability to urinate that requires emergency care. In the worst cases, urine can back up into the kidneys, leading to kidney failure, which can cause permanent damage.

Beyond the urinary system, untreated BPH can lead to chronic sleep loss that affects energy, mood, and concentration. In older adults, sleep disruption increases the risk of falls, which can lead to fractures or head injuries.

When Is It an Emergency?

BPH becomes an emergency mainly when it causes acute urinary retention (AUR) – a sudden inability to urinate that’s painful and needs immediate medical attention. If you can’t urinate at all, it’s important to get help right away to avoid serious complications.

When urine builds up suddenly and can’t be released, it puts extreme pressure on the bladder, potentially damaging the bladder muscle and reducing its ability to function correctly over time. Urine trapped in the bladder can also become a breeding ground for bacteria, increasing the risk of urinary tract infections (UTIs). If these infections spread into the bloodstream, they can cause sepsis, a serious medical emergency.

Because the kidneys filter waste from the blood, any blockage that causes urine to flow backward can impact kidney function. The effects on other body systems further afield are often related to the complications that arise from infections or the body’s response to severe pain and stress.

Treatment Options

Treatment for BPH depends on the extent to which the symptoms are impacting daily life. For men with mild or stable symptoms, active monitoring with regular check-ins with a healthcare provider may be sufficient. However, if the symptoms are more severe, many treatment options become available.

In situations where procedures or surgery aren’t possible due to other health conditions, catheter-based management may be used. This involves placing a tube (catheter) into the bladder to allow urine to drain, either as a temporary solution or for longer-term management. The goal of each of these treatments is the same: to relieve obstruction, improve bladder emptying, and alleviate symptoms. However, they differ in terms of their invasiveness, speed of action, and alignment with a person’s overall health and preferences.

The Bottom Line

Importantly, there’s no reason to suffer and just put up with urinary symptoms. If your urinary function is at all bothersome or if something feels off, talk to a urologist. At the very least, you deserve less stress and better sleep. And who knows? A simple conversation could spare you a lot of trouble down the road.

Dr. Kapadia Achieves Center of Excellence Status for AMS 700 Penile Implant

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Dr. kapadia standing next to center of excellence recognition at ceremony

One of Dr. Kapadia’s most gratifying treatments for erectile dysfunction is known as a penile implant or inflatable penile prosthesis. These implants offer qualifying patients with severe erectile dysfunction an option for achieving an erection and enjoying a normal sex life with their partners when other options like medications and injections have failed. For some, this can even restore fertility and the ability to conceive without external procedural intervention.

Continue reading “Dr. Kapadia Achieves Center of Excellence Status for AMS 700 Penile Implant” →

Prostate Cancer Screening – Should You Do It?

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Man sitting on doctor's physical table folding hands in lap white provider takes notes with pen on clipboard

Prostate cancer screening has been a mixed bag over the past several decades. In the late 1970s and early 1980s, we were excited to find a marker in the blood specific to the prostate known as PSA – prostate-specific antigen. This was a watershed moment in the diagnosis and, ultimately, treatment of prostate cancer, but not in the way we all thought back then. Without the benefit of hindsight, the initial reaction to PSA was to set a cutoff (of about 4), at which point a prostate biopsy would be ordered.

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Comparing Coloplast Titan and Boston Scientific AMS 700 Penile Implants

Posted on by Akash Kapadia, MD in ,

Operating room scene with doctor at the operating table performing penile implant on patient
With his recent designation as an AMS 700 Penile Implant Center of Excellence surgeon, Dr. Kapadia is now a COE-designated doctor for both major inflatable implantable penile prostheses on the market. As such, there might be no better time to compare the two devices to see which is better for any given patient.

Hint: Each penile implant device has pros and cons and may suit different anatomies. Both devices have size and rigidity options depending on the patient’s needs. As such, Dr. Kapadia chooses the best device for his patients without regard to loyalty to one device maker or the other.

That said, let’s dig deeper into the differences between the two.

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The Decision to Treat Peyronie’s Disease

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Older man staring out window holding cup of coffee in right hand, leaning on glass

It’s essential to shed light on a condition that affects about 5% of men both psychologically and physically, known as Peyronie’s Disease or PD – a condition that involves the abnormal presentation, often curvature, of the penis. Peyronie’s can manifest in several ways, and while the most common curvature is upward, the penis can also curve to the side or downward. How the penis curves and the degree of curvature is related to plaque accumulation. This plaque pulls on the penile structures, causing the penis to curve during erection. The most common cause of Peyronie’s Disease involves micro tears in the penis that, over time, create an exaggerated inflammatory reaction with resultant penile plaque accumulation.

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Kidney Stones This Summer & Fall – What You Need to Know

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Man putting hand on back struggling with kidney stone pain

While the end of summer may be filled with enjoying friends and family, barbecues, and getting some last-minute hot weather, it also represents the time we are most at risk for kidney stones. And if you live in or around Atlanta, you have the dubious distinction of being part of the Stone Belt – an area encompassing the Southeast United States where patients are particularly prone to develop kidney stones. Why is that? The combination of outdoor activity, hot weather, and many of us being chronically dehydrated can increase stone development during these hot months.

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Malleable Versus Inflatable Penile Prosthesis

Posted on by Akash Kapadia, MD in

Man working at desk in at home office space, pondering about options for penile implants
If you’ve been considering a penile prosthesis for erectile dysfunction that has not responded to medication like Viagra/Sildenafil or Cialis/Tadalafil, or Trimix injections, you have likely come across the three-piece inflatable penile prosthesis. This is, after all, the gold standard in penile plants and by far the most employed implant to restore erectile function in qualifying patients. However, it’s important that patients understand the full breadth of severe ED treatment options before they choose, even if one option is dominant.

In this case, patients looking for a penile implant may have the option of a malleable implant versus the three-piece inflatable type. In this article, we will talk about the benefits of each, and which may be best for you.

What Is a Malleable Penile Prosthesis, and What Are Its Benefits?

A malleable penile prosthesis is simply a semi-rigid metal core rod that is placed within the penis, replacing the corpora cavernosa that are no longer receiving enough blood to create or sustain an erection. The surgery is straightforward, with the surgeon hollowing part of the penile shaft, sizing the rod, and ultimately implanting it. To achieve an erection, patients lift the penis upward. To eliminate the erection, they put it back down. Everything is performed by hand and on demand.

The Benefits of the Malleable Penile Prosthesis Include

  • A single piece implant within the penis. This very straightforward implant reduces how extensive the surgery will be.
  • No inflatable parts mean that the prosthesis has little chance of malfunctioning even many years later and with significant usage.
  • The nature of simply repositioning the penis to create an erection means that the motion to get an erection is discreet.

What Is an Inflatable Penile Prosthesis, and What Are Its Benefits?

An inflatable penile prosthesis is a three-part medical device that includes two pencil-shaped balloon structures that replace the corpora cavernosa in the penis, a pump and release valve implanted in the scrotum, and a reservoir placed deep within the pelvis. All three of these components are hidden, and after some adjustment time, the patient will barely realize they’re there. The inflatable penile prosthesis is the most common penile implant in use today. To create an erection, the patient pumps the scrotal device 10 to 15 times. This forces liquid from the reservoir into the implant. A small button on the pump allows water to drain out and back into the reservoir.

The Benefits of the Inflatable Penile Prosthesis Are Severalfold:

  • The IPP creates the most realistic of erections. Unlike a malleable device, this correction is solid and silent to movement.
  • The IPP is very discreet, and many patients can perform the pumping and valve release action without making it obvious to their partner, even if they know about the implant.
  • Unlike a malleable implant, the penis returns to its flaccid state, where it feels relatively natural as well.

Note: There are differences between the two major inflatable penile implant devices, which are discussed in a separate blog.

Bottom Line

As you can see, both malleable and inflatable penile prostheses can make a big difference in a man’s sex life, especially if they have not been able to enjoy their sex life for some time. There is a reason, however, why the inflatable penile implant is so popular, and that is because the nature of the implant mimics normal erectile function very closely. Erections feel very natural, as does the flaccid penis.

Ultimately, the most important takeaway from this article is that any man who is not able to achieve an erection after having tried medications and injections should know that they do have an option in the form of a penile implant.

Secondly, Dr. Kapadia is one of the region’s leaders in penile implant procedures and is a Center of Excellence for both the Coloplast Titan and the Boston Scientific AMS 700 devices. Schedule an appointment with Dr. Kapadia to learn more and take the next steps towards restoring the erectile function you want.

Deciding To Tell Your Partner About a Penile Implant

Posted on by Akash Kapadia, MD in

Couple having discussion on couch about penile implant options, man has arm around woman's shoulders

It’s hard enough to decide to get a penile implant to treat severe erectile dysfunction, even knowing that the alternative may be an inability ever to achieve an erection again. After all, the idea of removing the natural corpora from your penis and replacing them with an implant seems, well, drastic. However, while it may be a difficult decision for you, there is also a consideration about your partner and how to break it to them, if at all.

Before getting into a discussion about this very delicate topic, you must understand a few things.

First, if you are in a committed, long-term relationship, you will most likely want your partner to participate in the decision-making process. It’s unlikely that you can sweep significant surgery under the rug. Not only is there the surgery itself but also the recovery, during which time you will not have any sexual interaction. Secondly, having a partner to support you during recovery and even in the initial decision-making process is very important for your physical and emotional well-being.

Older patients who are not in committed relationships and who are dating older partners may find the conversation to be slightly more straightforward as well. After all, as we get older, we usually understand the physical limitations that come with age. Whether it’s taking erectile function pills like Viagra or Cialis, needing injections, or even a penile implant, the concerns become less concerning. Most importantly, the function is there.

So, in the end, this discussion primarily concerns younger and middle-aged patients whose partners would not expect them to have or need a penile implant.

Why Not Just Hide It?

Many patients, especially those on the dating scene, choose to hide the fact that they have a penile implant. It is a decision that every patient must make individually. However, there is some degree of fear and trepidation that comes with keeping this kind of secret that can preclude a patient from enjoying their sex life. Also, no matter how discreet the penile implant may be, and it most certainly is, being entirely contained within the body, it remains somewhat difficult, especially when a man is having regular sexual relations with the same person, to hide the motions needed to inflate and deflate the prosthesis.

So, let’s get into what you can say or do to alleviate concerns associated with a penile implant and reduce the possibility of misunderstandings by a partner.

Explain what a penile implant is and isn’t. When someone discusses a penile implant, the first thought is toward male enhancement. However, these implants are purely functional and have nothing to do with increasing a man’s length or girth. This must be explained clearly to avoid confusion or thoughts that the implant may be for aesthetic purposes.

When discussing the penile implant, it may also be helpful to explain the need for it. Whether it was a traumatic event or vascular issues that caused the inability to achieve an erection, having your partner understand that it was a medical issue that necessitated the penile implant can take some of the shock from the announcement.

There may also be some concern on the part of the partner that sex will somehow feel different. This is another misconception that should be discussed, and you have the equipment to prove it. This is especially true with the AMS 700 implant, which feels natural when the penis is flaccid and erect. This part of the discussion must, of course, be approached very carefully and tactfully.

If you have an upcoming visit on the books with Dr. Kapadia or your local penile implant specialist, it may be good to invite your partner along to hear directly from the surgeon about the device. Your partner can even understand the composition of the implant by looking at and feeling a demo device.

Lastly is understanding the problematic truth that can occur in some relationships. While we would all hope that our personalities and other attributes would be enough to enjoy a committed relationship, some people fixate on a problem that, in this case, has no bearing on sexual function.

The Bottom Line

While we praise the virtues of modern three-piece penile implants (and they are technological marvels) and how discreet and natural they are, most patients will want to tell their partner about their implant to be fully candid with someone they care about. This conversation can go one of two ways…but hopefully very well, with an understanding partner. Most importantly, be sure to do and say what you feel is best for your needs and the needs of your budding or mature relationship.