Category: Penile Implants

Comparing Viagra/Sildenafil to Cialis/Tadalafil

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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When to Consider a Penile Implant for Erectile Dysfunction

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)

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.

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Improve Blood Flow to Treat Erectile Dysfunction

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.

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How Much Does a Penile Implant Cost?

Medical form for health insurance submission for penile implant costs

Foremost in the minds of many men we treat is the cost of a penile implant. Indeed, price is one of the most significant barriers to correcting severe ED. This article will discuss how to navigate the financial aspects of getting a penile prosthesis. Of course, we encourage you to contact our office and speak to our patient navigators as you may find that a penile prosthesis is within reach.

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Dr. Kapadia Named Coloplast Center of Excellence in Penile Implantation

Dr. Kapadia standing in operating room ready to help patients after being named a Coloplast Center of Excellence in Penile Implantation in Atlanta

All of us at Dr. Kapadia’s practice are excited to have been named a Coloplast Center of Excellence for penile implantation. This is a designation awarded to very few centers across the United States. Dr. Kapadia is one of the foremost implantation specialists in the southeast United States, now recognized with this new designation. Coloplast chooses its Centers of Excellence very carefully. Not only do COE men’s health specialists have to perform a significant number of penile implants, but they must also be leaders in the field, promoting the advancement of patient care, safety, and effectiveness in penile implantation. Further, Coloplast only offers its COE designation to physicians who are leaders in their respective urologic professional associations.

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Will I Maintain Length & Girth After a Penile Implant?

Tape measure around a banana represents changes in girth and length a man might experiences after penile implant

The primary goal of a penile implant procedure is to restore sexual function in the form of a solid and lasting erection. For many patients, the ability to have a normal sex life is all they want and expect after surgery. However, some patients, rightly, worry about the size and girth of their penis after a penile prosthesis. While this does not change the outcome of the surgery, nor is it a medical consideration, Dr. Kapadia and our entire team are very aware of the psychological impact these changes can have. And as such, we go to great lengths to explain to our patients that they should expect penile length and girth to be very similar to what they had before the procedure.

To make our patients feel more comfortable, we often measure the length and girth of the penis both before and after surgery, so there is an objective measurement to put the mind at ease. You can also rest assured that we select the size of our implant based upon the patient’s anatomy both for this reason and to ensure comfort and compatibility with its natural size.

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Three of Our Patients’ Most Pressing Questions on Penile Implants

Men's health urologist discusses the questions his patient has about a penile implant

The thought of surgery may be concerning and scary. And this fear can be heightened when you haven’t been armed with the right information. Thousands of men have understood and realized the benefits of a highly successful implantable penile device in treating severe erectile dysfunction, allowing patients to continue an enjoyable sexual life well into their later years. Penile implants offer some of the highest satisfaction rates of any procedure our practice provides. This article will discuss some of the most common questions patients and their partners ask us.

1.     How Successful Is a Penile Implant?

The short answer is that a penile implant is very successful in qualified patients who have severe erectile dysfunction and have not received, or no longer receive, a benefit from erectile dysfunction pills or injections. The procedure is also very safe, especially in the hands of a very experienced urologic surgeon like Dr. Kapadia. In fact, Dr. Kapadia is one of the leading providers of penile implants in Atlanta and the southeast United States, considering this procedure one of the core specialties of his practice. Whether due to aging, penile conditions such as Peyronie’s disease, or post-prostatectomy impotence, penile implants are truly a life-changing procedure. Within just a few weeks after surgery, patients can return to normal sexual function and all of the psychological and emotional benefits that go along with it.

2.     Will I Be Able to Enjoy Sex?

The answer to this is a resounding – yes. Maintaining the ability to enjoy sex is one of the key benefits of these advanced penile implants. During the procedure, the nerves that control the pleasure senses in the penis are not affected whatsoever. Instead, we only replace the mechanism for achieving an erection with the prosthesis. Further, patients do not need to worry about timing their medication or whether the erectile process is obvious. The penile implant allows for discreet erection on demand.

3.     Will the Recovery Process Be Difficult?

To be sure, there is some sacrifice for such a transformative procedure, which comes in the form of some pain and soreness for a couple of weeks after surgery. However, the recovery is by no means brutal. First, the procedure is performed as minimally invasively as possible, meaning that pain, blood loss, and recovery time, in general, are minimized. Second, you will not be kept in discomfort and will be prescribed appropriate pain medication to stay comfortable after surgery. It is important to mention that your recovery can be sped up by following post-op instructions closely. You will be required to perform simple activities after surgery to ensure that healing and implant function continues appropriately.

We encourage any patients considering a penile implant to schedule a consultation with Dr. Kapadia to learn more about the pros and cons of surgery and if they are a candidate for the procedure. Dr. Kapadia offers similar procedures from two different medical device manufacturers, and during a consultation, we will discuss which is best for you. In the meantime, you can watch the webinar on each of these devices by clicking on the links below.