Category: Penile Implants

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.

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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:

• Will I Maintain Length & Girth After a Penile Implant?
• Three of Our Patients’ Most Pressing Questions on Penile Implants
• The Different Causes and Treatments for Erectile Dysfunction (ED)

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.

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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.

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