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A Reboot in the Bedroom: Penile Implants for Gay Men

Posted on by Akash Kapadia, MD in

Gay men couple walking, laughing, holding coffee

If you’ve experienced erectile dysfunction (ED), you’ve probably already tried the usual suspects – pills, pumps, injections. When those stop working or never quite do the job, a penile implant (also called a penile prosthesis) moves from “someday” to “maybe.”

Penile implants are researched and time-tested with high satisfaction rates for the right candidates. What the current medical literature doesn’t do brilliantly – at least not yet – is speak directly to the experiences and outcomes of gay men. Most studies lump everybody together, so specific data by sexual orientation are sparse. Still, we can combine what the evidence shows about implants overall with the practical realities of gay men’s sexual practices to help you make a confident, informed decision.

(A quick note on language: we’ll say “gay men” for readability throughout this article, but we mean that to include any men who have sex with men.)

Penile Implant Basics (The 60-Second Version)

A penile implant is a device placed inside the penis to create a dependable erection on demand. There are two main types:

  • Inflatable implants (most popular): Two cylinders are placed in the penis, a fluid reservoir sits internally (usually in the lower abdomen), and a small pump hides in the scrotum. Squeeze the pump for an erection; press the release to deflate. These offer the most natural aesthetic and rigidity or flaccidity when you want it.
  • Malleable (semi-rigid) implants: Bendable rods keep the penis firm at baseline; you position it up or down manually. They’re simpler, but less discreet under clothing and less “natural” in appearance.

Across studies, patient satisfaction is typically high – often in the 80 to 90% range for inflatable devices, with partners also reporting improved quality of life. The risk of infection for first-time inflatable implants is low (approximately 1–3%), thanks to antibiotic coatings and modern surgical techniques. Device reliability is strong, with eventual wear-and-tear addressed via revision surgery if needed.¹

There is a small but growing body of work looking specifically at men who have sex with men and penile prostheses, suggesting overall satisfaction as well, though the samples are small and not yet definitive.²

Why Talk About Orientation at All?

Because sexual goals, positions, and expectations can vary – and those details matter when you’re choosing a device, sizing cylinders, and planning recovery. For example, anal intercourse can place higher axial (straight-line) forces on the penis than vaginal intercourse, so rigidity and stability are central to comfort and performance.³ That doesn’t mean you need a different kind of implant; it means your surgeon should customize device choice and sizing with these realities in mind. ⁴

Who’s a Good Candidate?

You’re typically a candidate if:

  • ED has been persistent (often 6–12+ months) and medical therapies (pills/injections/vacuum) aren’t working or are not tolerated.
    You’re medically optimized for surgery (e.g., diabetes reasonably controlled, smoking addressed, any active infections treated).
    You want a dependable erection, value spontaneity, and understand that the implant replaces natural erectile function.

Men with scarring (as in conditions like Peyronie’s disease), post-prostatectomy ED, or long-standing diabetes-related ED routinely do well with implants, though the surgical plan may be slightly altered from a straightforward surgery.

Choosing Your Implant: What Matters for Gay Men?

Rigidity and angle control. Anal intercourse, especially in positions that create higher leverage, requires strong axial rigidity from an implant to prevent “buckling.” Three-piece inflatable devices generally provide the best blend of firmness for penetration and a natural, comfortable flaccid state for daily life and concealment. Device design and cylinder materials differ slightly across brands; some offer greater maximal girth or perceived rigidity at a given length. Your surgeon will match device characteristics to your goals and anatomy. ⁵

Girth vs. length expectations. Implants don’t increase natural penile length; in fact, men can sometimes perceive a slight decrease in size due to long-standing ED and tissue remodeling. The priority is functional length and reliable rigidity. Sizing is individualized during surgery to maximize usable length safely and effectively. Over-lengthening risks erosion; under-lengthening compromises performance.

Glans support and curvature. If you have Peyronie’s disease, your surgeon may correct the curvature at the same time. Some men benefit from techniques that improve glans (head of the penis) support when indicated.

Concealment and day-to-day comfort. Inflatable devices are designed to deflate completely when not in use, allowing the penis to hang naturally and remain discreet under clothing. When you want an erection, the pump in the scrotum allows you to inflate the cylinders on demand, providing rigidity only when needed.

The Operation and Recovery

Surgery is typically performed on an outpatient basis, and the procedure usually takes approximately one hour. You’ll go home the same day with pain control instructions, antibiotics as indicated, and a scrotal support.

Pain and swelling peak in the first few days, then steadily improve. Most men are back to light desk work in about a week, and more physical jobs in two to three weeks (per your surgeon’s guidance).

There may be a bit of a learning curve when it comes to activation. With an inflatable implant, you’ll be taught to cycle the device (inflate/deflate) to get comfortable using it and to keep tissues supple. Many surgeons start gentle cycling around two to four weeks after surgery.

Sexual activity will have to be put on hold for a while as the anatomy heals. Penetrative sex is usually cleared at around six weeks, once tenderness subsides and you’ve mastered cycling, though your exact timeline may vary.

Sex After an Implant

Positions and comfort. Early on, choose positions that let you control depth and angle. High-leverage positions (where the partner’s body weight or angles create greater force) may be more comfortable after you’ve had a few weeks of practice with the device. Remember, anal intercourse can require higher axial forces; that’s normal, and your implant is built for function, but your body and soft tissues are still recovering.

Lubrication and condoms. Use plenty of lube to reduce friction and pressure on soft tissue. Condoms are still a viable recommendation for STI prevention; implants don’t change STI risk. Choose higher-quality condoms that fit your girth comfortably.

Communication. If you’re the insertive partner, communicate about pace and angle. Let your partner know you’re getting used to a new device and may need a gentler start the first few times of resuming sexual activity.

Ejaculation and orgasm. An implant restores erection, not sensation, libido, or the ability to orgasm – those depend on nerves, hormones, and overall health. Many men report stable or improved sexual satisfaction once the anxiety about ED is gone.

Risks, Complications, and How Surgeons Reduce Them

All surgery carries risk. For implants, the big three are infection, erosion, and mechanical failure over time.

  • Infection: Modern infection rates for first-time, three-piece inflatable implants are approximately 1–3%, which is reduced by meticulous sterile technique and the use of antibiotic-coated devices. Risk is higher with poorly controlled diabetes and other underlying health conditions. If an infection occurs, the device may need to be removed and later replaced. ⁶
  • Erosion or tissue injury: This is rare, but the risk increases if a device is oversized or if tissues are too fragile. This is why careful sizing and experienced surgical technique are imperative.
  • Mechanical issues: All devices can eventually wear out, and revision rates naturally increase after many years of use. Your erection is dependable for as long as the device works, and devices can be replaced when needed.

Your surgeon will screen for modifiable risk factors (optimizing blood sugar, encouraging smoking cessation, treating skin infections), choose the right device for your anatomy and goals, and use infection-prevention protocols to reduce complications. ⁷

What About Satisfaction, Specifically in Gay Men?

Research is limited but encouraging. In a study of MSM undergoing inflatable penile prosthesis, men reported a renewed sense of vitality and overall greater satisfaction in daily life. We need larger studies that correspond with sexual orientation, but the available signal aligns with what many patients report in the clinic: once healed and comfortable with the device, sexual function becomes consistent, and confidence returns. ⁸

A penile implant is a durable, on-demand solution for ED with high satisfaction and low infection risk in well-selected patients. For gay men, the key is personalization: choose a surgeon who will talk candidly about your sexual goals, optimize device selection and sizing for strong axial rigidity and comfort, and guide you through recovery so you can return to the sex life you want, safely and confidently.

As a fellowship-trained urologist in men’s sexual health, Dr. Kapadia prioritizes respectful, individualized care. He has been designated as a Coloplast Titan and Boston Scientific AMS 700 Center of Excellence surgeon for penile implants. If you’re considering an implant or just want to understand your options, schedule a confidential consultation. Bring your questions, your goals, and your partner if you’d like. We’ll talk through candidacy, device choices, recovery, and what sex can look like afterward so you can make an informed decision that truly fits you.

Notes on evidence: Research specifically focused on gay men with penile implants is limited but growing; early studies suggest high satisfaction, consistent with broader implant literature. Anal intercourse can involve higher axial forces, which is relevant for device selection/sizing and return-to-sex recommendations.

References:

  1. Levine, L. A. (2024, April 25). AUA2024 PREVIEW Prevention and Treatment of Inflatable Penile Prosthesis Infection, and Placement Following Explant – American Urological Association. American Urological Association News. https://auanews.net/issues/articles/2024/april-2024/aua2024-preview-prevention-and-treatment-of-inflatable-penile-prosthesis-infection-and-placement-following-explant.
  2. La, J., Loeb, C. A., Barham, D. W., Miller, J., Chung, E., Gross, M. S., Hatzichristodoulou, G., Park, S. H., Perito, P. E., Suarez-Sarmiento, A., Van Renterghem, K., & Yafi, F. A. (2023). Satisfaction rates of inflatable penile prosthesis in men who have sex with men are high. International journal of impotence research, 35(6), 564–568. https://doi.org/10.1038/s41443-022-00603-2.
  3. Miller, J. A., Loeb, C. A., La, J., El Khatib, F., & Yafi, F. A. (2023). Penetrative anal intercourse may require high axial loading forces. The journal of sexual medicine, 21(1), 40–43. https://doi.org/10.1093/jsxmed/qdad156.
  4. Thirumavalavan, N., Cordon, B. H., Gross, M. S., Taylor, J., & Eid, J.-F. (2018). Rear Tip Extenders and Penile Prosthesis Rigidity: A Laboratory Study of Coloplast Prostheses. The Journal of Sexual Medicine, 15(7), 1030–1033. https://doi.org/10.1016/j.jsxm.2018.05.001.
  5. Chung, E., Bettocchi, C., Egydio, P. H., Love, C., Osmonov, D., Park, S. S., Ralph, D., Xin, Z. C., & Brock, G. (2022). The International Penile Prosthesis Implant Consensus Forum: clinical recommendations and surgical principles on the inflatable 3-piece penile prosthesis implant. Nature Reviews Urology, 19, 534–546. https://doi.org/10.1038/s41585-022-00607-z.
  6. Baird, B. A., Parikh, K., & Broderick, G. (2021). Penile implant infection factors: a contemporary narrative review of literature. Translational andrology and urology, 10(10), 3873–3884. https://doi.org/10.21037/tau-21-568.
  7. Moukhtar Hammad, M. A., Barham, D. W., Sanford, D. I., Amini, E., Jenkins, L., & Yafi, F. A. (2023). Maximizing outcomes in penile prosthetic surgery: exploring strategies to prevent and manage infectious and non-infectious complications. International Journal of Impotence Research, 35, 613–619. https://doi.org/10.1038/s41443-023-00773-7.
  8. La, J., Loeb, C. A., Barham, D. W., Miller, J., Chung, E., Gross, M. S., Hatzichristodoulou, G., Park, S. H., Perito, P. E., Suarez-Sarmiento, A., Van Renterghem, K., & Yafi, F. A. (2023). Satisfaction rates of inflatable penile prosthesis in men who have sex with men are high. International journal of impotence research, 35(6), 564–568. https://doi.org/10.1038/s41443-022-00603-2.

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.

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” →

Comparing Coloplast Titan and Boston Scientific AMS 700 Penile Implants

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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.

Continue reading “Comparing Coloplast Titan and Boston Scientific AMS 700 Penile Implants” →

Malleable Versus Inflatable Penile Prosthesis

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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

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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.

Comparing Viagra/Sildenafil to Cialis/Tadalafil

Posted on by Akash Kapadia, MD in ,

When patients find that they need erectile dysfunction/ED medication, their mind often goes straight to which medication is best. This decision can be challenging with all of the marketing swirling around ED treatment. Ultimately, however, the two most commonly known medications on the market are Sildenafil, the generic version of Viagra, and Tadalafil, the generic version of Cialis. Other than the dosages – 100 mg maximum for sildenafil and 20 mg maximum for Tadalafil, the two drugs have similarities and differences that every patient should know and understand.

For one, both are PDE5 inhibitors, which relax and widen blood vessels to allow for increased blood flow. This is the primary mechanism of their effectiveness, and it’s why they are so good for mild to moderate ED.

Continue reading “Comparing Viagra/Sildenafil to Cialis/Tadalafil” →

When to Consider a Penile Implant for Erectile Dysfunction

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Man and wife walking down path holding hands

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for sexual satisfaction. It is a prevalent condition affecting up to 30 million men in the United States and 150 million worldwide. ED can significantly impact a man’s quality of life and intimate relationships. Luckily, numerous treatment options exist for ED, which range in invasiveness and cost. These include oral phosphodiesterase type 5 (PDE5) inhibitors (e.g., sildenafil, tadalafil), intraurethral alprostadil, penile injections, and vacuum devices. However, if these methods fail to provide satisfactory results or are contraindicated due to medical conditions, a penile implant may be worth considering. However, it can also be regarded as a first-line treatment through shared decision-making. This article explores the circumstances under which patients could contemplate a penile implant as a treatment option for ED, discussing the procedure, benefits, and potential risks involved.

Some situations that may warrant the consideration of a penile implant include:

  1. Non-Responsiveness to Medications: If oral medications or other ED treatments do not produce the desired results, a penile implant may be a viable alternative.
  2. Anatomical Abnormalities: Certain anatomical abnormalities, such as Peyronie’s disease (scar tissue formation in the penis) or severe congenital penile curvature, can coexist with refractory ED. In such cases, a penile implant can help overcome these physical limitations.
  3. Underlying Medical Conditions: Individuals with medical conditions like diabetes, spinal cord injuries, or prostate cancer treatments (e.g., radical prostatectomy) may experience persistent ED that does not respond well to conservative treatments. A penile implant can offer a solution in these cases.

There are two primary types of penile implants: inflatable and malleable.

  1. Inflatable Implants: This type consists of inflatable cylinders placed in the penis, a fluid-filled reservoir, and a pump. The cylinders fill with fluid by squeezing the pump in the scrotum, creating an erection. After intercourse, the liquid is transferred back to the reservoir, deflating the implant. The reservoir is typically placed within the pelvis through the same incision used to place the implant.
  2. Malleable Implants: Malleable implants, also known as semi-rigid implants, consist of bendable rods inserted into the penis. They allow the individual to position the penis for sexual activity manually. Unlike inflatable implants, malleable implants do not require a pump or reservoir. However, the same level of natural flaccidity is not achieved with a malleable.

Penile implants offer several benefits for individuals with persistent ED:

  1. Reliability: Penile implants provide a reliable and on-demand solution for achieving and maintaining erections.
  2. Spontaneity: Unlike other treatment options that may require planning or timing, penile implants allow for spontaneous sexual activity.
  3. Improved Satisfaction: Across multiple studies, penile implants have been shown to have up to a 90% patient and partner satisfaction rate. This high satisfaction rate makes sense as penile implants can restore sexual function and enhance overall well-being.

However, it is essential to consider the potential risks associated with penile implants, and discussing these factors with a physician is crucial before making a decision:

  1. Infection: While rare, the risk of developing an implant infection is between 1 and 3%. Infection risk is higher in the following situations: replacement or revision of penile implant, immunosuppression, poorly controlled diabetes, and pre-existing infection anywhere else in the body. In case of penile implant infection, the device must be removed, the cavity washed out, and new placement.
  2. Mechanical failure: As with any mechanical device, there is a chance of breakdown of the components over time, requiring reoperation. The risk of mechanical failure is 5% at five years after device placement.
  3. Intraoperative complications: Complications during the operation are exceptionally rare. However, one notable complication is an injury to the urethra, which requires abandoning the surgery and waiting to place the implant when the urethra has healed.

When traditional treatment options for ED prove ineffective or unsuitable, a penile implant can be considered a viable solution. It offers individuals a reliable and on-demand method to regain sexual function, improving quality of life and intimate relationships. However, the decision to pursue a penile implant should be made after carefully considering the individual’s unique circumstances in consultation with Dr. Kapadia.

Related Topics:

The Different Causes and Treatments for Erectile Dysfunction (ED)

Posted on by Akash Kapadia, MD in ,

Man standing covering crotch with both hands crossed

The prospect of erectile dysfunction, or not being able to perform sexually, either due to the inability to achieve an erection or maintain that erection throughout intercourse, strikes fear into the hearts of young and older men alike. And while ED may seem like a concern that would only affect those of advanced age, that’s not necessarily the case. There are different reasons why erectile dysfunction may occur, and each of these has treatment options to address the root cause.

Here at our practice, we have no shortage of younger men – those under the age of 40 – that experience problematic ED. These men can suffer from a variety of issues, both organic (structural) and non-organic such as anxiety, poor past sexual experiences, depression, and more. Regardless, they are often relieved that the cause of their erectile dysfunction can often be treated with medication or talk therapy.

Continue reading “The Different Causes and Treatments for Erectile Dysfunction (ED)” →

Improve Blood Flow to Treat Erectile Dysfunction

Posted on by Akash Kapadia, MD in ,

Blood cells flow in vein

The function of a man’s erection revolves around blood, so it stands to reason that improving blood flow can work wonders to enhance sexual performance and reduce the risk of erectile dysfunction / ED. There are several other potential causes of erectile dysfunction, including medication and even psychological considerations, but those will be discussed separately. Most importantly, early detection and treatment are important. Many men, often out of embarrassment, wait months or even years as their sexual health declines before seeking treatment from a qualified urologist or men’s health specialist. Or they opt for supplements or generic medications without a complete picture of their sexual health. Ultimately, visiting a knowledgeable specialist and urologist like Dr. Kapadia is the best next step.

In the meantime, whether you are suffering from ED or not, here are some tips to improve blood flow and give yourself the best chance at a long and satisfying sex life.

Continue reading “Improve Blood Flow to Treat Erectile Dysfunction” →