Do you know when to think about penis prosthesis?
The penile implant is indicated for individuals affected by conditions that affect the functioning of the male sexual organ, but many patients, when they arrive at the office, have not even thought about the possibility of placing a penile prosthesis, some even reveal a certain aversion to broaching the subject.
We can say that a large part of this behavior is misinformation about the functioning of this device that can return a quality sex life to men.
For this reason, in this content, learn everything about penile prosthesis, we will discuss its advantages and disadvantages. Let's demystify the theme, understand when to place it and which model is ideal for each case. Good reading!
What is a penile prosthesis?
The penile prosthesis consists of a device placed inside the penis that promotes sufficient rigidity for vaginal and anal penetration.
This device, the implants, goes inside the penis and maintains the natural appearance of your penis. The partner, most of the time, does not notice when a man has an inflatable penile prosthesis.
Currently, penile prostheses can be semi-rigid or inflatable. We will address the differences later in the text.
The penile prosthesis is among the best alternatives for men who suffer from a problem with the functionality of the penis, such as lack of erection or deformities, which can hinder or prevent sexual intercourse.
O penile implant It is a procedure indicated when less invasive treatments, such as the use of oral and injectable medications, penile rehabilitation or low-intensity shock wave therapy, do not have the expected effects.
Therefore, this method can be recommended for patients of different age groups, ranging from men aged 25 to 90 years, who can undergo surgery to implant a penile prosthesis.
For which individuals is the penile prosthesis implant indicated?
The penile prosthesis is recommended in several situations, being considered a safe, effective procedure with a high rate of satisfaction. There are different cases in which the implant can be recommended. Some situations include:
• Have you tried treatments for erectile dysfunction with drugs such as pills, formulas and injections, without satisfactory results;
• The dose of medication has been increased and there are more and more side effects, such as nasal obstruction, headache, facial flushing;
• Takes some heart medication (nitrates) and cannot use erection medication;
• Doesn't have good results with medicine or formulas and doesn't want to use penile injections to improve erection;
• He has already had penile injections that, at first, worked, but ended up having many side effects, such as pain or formation of fibrosis inside the penis (which cause deformities such as loss of size, curvature, thinning);
• He had surgery on his prostate and has refractory impotence;
• You have Peyronie's disease (bent penis), associated with sexual impotence.
About penile prosthesis implant surgery
It is a safe and efficient procedure, with a high level of satisfaction for the couple. It can be performed with local anesthesia + sedation or sedation + spinal anesthesia, or general anesthesia depending on the case. In this way, the patient will not feel any pain during the procedure.
Recovery is fast, with an average hospital stay of 12 to 24 hours. See when the return to normal activities occurs:
- Working and studying (home office), in general, happens after 48 hours;
- Working face-to-face, depending on the activity, generally 7 to 10 days;
- Physical activities, in general, can be resumed in about 1 month;
- Return to sexual activities 4 to 6 weeks.
The implantation of the penile prosthesis is done internally, with nothing exposed. No tissue is removed to place the cylinders. The cylinders just occupy the spaces that were previously filled with blood, when the patient was potent.
There is no change in libido (sexual desire), ejaculation, orgasm or urine flow. The function of the penile prosthesis is only to provide adequate rigidity for carrying out sexual activity. The patient can have orgasms and continue sexual intercourse if he so desires.
What are the types of penile prostheses?
There are currently 2 types of penile prostheses: the malleable or semi-rigid and the inflatable 3-piece (reservoir, cylinder and pump).
Each penis implant will be adapted to the body, it will have a type of operation and can be indicated according to certain situations. The andrologist is responsible for investigating each case and suggesting the best model. Learn more about each of them:
Malleable or semi-rigid penile prostheses
Malleable or semi-rigid penile prostheses are made up of filaments of a metallic alloy surrounded by biocompatible silicone, allowing a satisfactory rigidity and malleability of the penis, so that the penis can remain downwards or to the side (in the “normal” position) or in the opposite position. proper position for the sexual act (forward).
It requires less manual skill and is good for very elderly patients or those with loss of hand dexterity. It has a much lower cost than inflatable ones. Unlike the inflatable penile implant, no pump is needed to initiate an erection.
3-volume inflatable penile prostheses
The inflatable penile prostheses available on the Brazilian market are the most recognized in the world, from the American companies AMS and Coloplast, manufactured in the United States under strict quality control:
- Coloplast Titan OTR (Standard);
- Coloplast Titan OTR Narrow-Base;
- AMS 700 CX with Inhibizone (Standard);
- AMS 700 CXR with Inhibizone;
- AMS 700 LGX with Inhibizone.
- They are the ones that make the penis closer to the natural one, being the least noticeable of all the prostheses. Provides excellent rigidity and penile caliber.
- The 3-volume inflatable penile prostheses consist of two inflatable cylinders connected to an “inflator” device and a reservoir.. The biocompatible silicone cylinders are inside the penis, the pump is in the scrotum and the reservoir is hidden inside in the pelvic region. The entire system is filled with saline solution;
- Nothing is apparent;
- for erection: the patient just presses the pump that will be located in the scrotum, then the serum from the reservoir is transferred to the cylinders and the penis becomes erect / rigid;
- To make the penis flaccid: the patient presses a button on the inhaler, then it will go down (the serum returns from the cylinders to the reservoir and the penis returns to its resting appearance).
How to choose between a semi-rigid or inflatable prosthesis?
This is a big question for men. Choosing the type of semi-rigid or inflatable prosthesis is an important step towards the final satisfaction of the patient.
Basically, the inflatable penile prosthesis provides more rigidity, caliber and naturalness for the patient.
The semi-rigid penile prosthesis has a lower cost, is simpler to use and has less chance of revisions.
I prepared a detailed video on the subject.
To go deeper into this decision, watch the video below:
What are the advantages and disadvantages of the penile prosthesis?
Advantages of having a penile prosthesis:
- Have penetrative intercourse whenever you feel like it.
- It does not lose rigidity during intercourse.
- You can maintain penetration even after orgasm if you wish.
- It is very discreet and most of the time the partner does not notice that the man has a prosthesis.
- It avoids side effects and unpredictability of the functioning of the pills.
- Avoids side effects and unpredictability of the operation of injections
- Increases the spontaneity of relationships, that is, you will have sex when you feel like it, instead of waiting for the effects of pills or scheduling yourself to apply an intracavernous injection (in the penis)
- It does not affect sensitivity, orgasm or urination (urine).
Disadvantages of having a penile prosthesis:
- It is a surgical and definitive procedure. Thus, when the patient chooses to have a prosthesis, then he cannot go back and remove the prosthesis to keep trying to take pills or injectables.
Note: This is why the penile prosthesis is indicated for patients who do not respond well to medication or who have already used them and did not like the side effects or the fact of having to use medication to have sex.
- If the option was for a semi-rigid prosthesis, you will have to adapt to the fact that the penis is always stretched “hard”.
How does penile prosthesis work?
The device used in the penile prosthesis makes it possible for the man who had no erections or only poor quality erections Satisfy your desire to penetrate during intercourse with your partner.
Besides, the device also serves to return a better quality of life to patients who have erectile dysfunction, Peyronie's disease, traumatic injuries, penile deformities, ischemic priapism, among other conditions.
In the case of inflatable prostheses, the erection mechanism will be provided by the 3 devices of the prosthesis (inflator, reservoir and cylinders), which can make the member rigid or flaccid, depending on the moment desired by the patient. When having sexual intercourse, the man has to press the pump (inflator) that is inside the scrotum (bag) to transfer the liquid (saline solution) from the reservoir to the cylinders.
In this procedure the trained man does it in less than 1 min and in general the partner will not notice. The entire device is internal
In the case of malleable or semi-rigid prostheses, the silicone rod is inserted into the corpora cavernosa and the sexual organ will often be rigid. It will be necessary for the patient to “disguise” the erection, which is taught after implantation of the device. The same occurs with articulated prostheses, which are easier to disguise.
Penile prosthesis: how to optimize size preoperatively?
In fact, there are some methods that can help the penis to grow or at least give an impression of growth. With this, the ideal technique for your case should be recommended by a specialized professional, who is the andrologist.
Some interventions can help to gain size in a natural way (without surgical procedures), such as penile rehabilitation, which includes physiotherapy, vacuotherapy and penile traction, which are made to stretch the shaft of the penis.
Penile rehabilitation is widely used when the patient undergoes prostate removal surgery, spent a lot of time in sexual inactivity (without erections and sexual intercourse) and also before performing a penile prosthesis implant surgery.
traction techniques
- Vacuum therapy (penis pump): improves the size of the penis and a little in the caliber;
- penis extender: improves the size of the penis discreetly.
Penile prosthesis associated with cosmetic surgery
For patients who have had a penile implant and want to correct something in their penis, it is essential to say that there are surgical techniques for aesthetic purposes. Indeed, these aesthetic procedures are aimed at correcting everything from minor defects to an embedded penis. The most common methods are:
Removal of Tyson's Glands
Tyson's Glands are normal structures of the penis, found around the glans (head of the member). It can help with lubrication, even when there is abundant secretion there is formation of "smegma", which resembles a "white mass".
This surgical intervention is purely aesthetic, as many men who have these enlarged glands complain about the visual appearance.
Scrotoplasty / Penoscrotal Synechia Correction
It is the high insertion of the scrotum into the penis, that is, the "bag" goes up to the middle of the penis and significantly covers up the organ, making it look smaller.
This condition can be congenital (born this way) or acquired. In the acquired forms, they generally occur after a circumcision (phimosis surgery), in cases where a lot of skin has been removed. That way, it is a cosmetic procedure that can give the appearance of a penile enlargement.
During surgery, this synechia is corrected using zetaplasty methods, or a transverse incision with longitudinal synthesis, or even resection of the synechia in cases where excess scrotal skin occurs. The best technique is evaluated on a case-by-case basis.
pubic liposuction
Pubic fat in some patients may be deposited disproportionately to the percentage of body fat distribution.
It is common for these patients to arrive at the office with a complaint of a small penis, when in fact they are immersed in a large pubic fat pad.
Therefore, in this procedure, the surgeon performs a liposuction of the pubic region with removal of excess fat in the region.
penile bioplasties
Bioplasties are procedures that aim to promote penile thickening with various techniques, including fat grafts, hyaluronic acid and collagen stimulators.
They can be done before or after penile prosthesis implantation, but it is highly recommended that they be performed by an andrologist urologist with experience in penile prosthesis and fillings.
Section of the suspensory ligament of the penis
This surgery aims to loosen the suspensory ligament of the penis in order to expose part of the member that is internal, called the crura (root of the penis), giving it a larger external appearance.
Results are variable and inconsistent. In general, it can give an increase of 1,5 to 2 cm in the best scenario, which in most cases does not meet the expectations of patients who seek this procedure.
Due to the results presented in a literature review, the Instituto Cavalcanti does not indicate this surgery for aesthetic purposes, but for exceptional cases, such as micropenis, very acute pubopenic angle, short ligament or postoperative period of partial penectomy with embedded penile stump.
Penile prosthesis associated with penile enlargement surgeries
Egydio's Technique
This technique is mainly used in patients who have Peyronie's disease and have suffered from organ shortening due to scarring plaques, but also for patients who have congenitally curved penis.
In the case of Peyronie's disease, with this technique, multiple incisions are made in the fibrotic plaques, forming a mesh, to stretch the penis at the limit of the nerve and the urethra with the placement of the penile prosthesis.
In order to expand the tunica albuginea of the penis and gain an average of 2 to 3 cm, it is necessary to place a penile prosthesis. Therefore, this technique is not used exclusively for aesthetic purposes, but to recover the lost size in patients with penile fibrosis.
Penile prosthesis and the Urofill™ technique
After performing a penile implant surgery, the patient can also choose to apply the technique urofill™.
Applied in the office itself, offers men a noticeable increase in the circumference of the penis, using hyaluronic acid fillers. Generally, the amount of acid applied to each patient varies around 10 ml to 30 ml, changing from man to man.
For every 6 ml of hyaluronic acid, the penis gains about ¼ inch, that is, around 0,65 cm. In practice, after the process, the patient has an average gain of 3 cm in circumference. Gain in caliber is temporary and requires reapplication every 1 to 2 years.
Injectable procedures and fillers (grow penis caliber only)
- Hyaluronic acid: this is a promising treatment and is already available at the Cavalcanti Institute. You can expect to gain flaccid caliber and size;
- Fat grafting.
In cases of penile enlargement surgeries, the most used techniques are:
Section of the suspensory ligament of the penis + VY flap/flap
With this technique, the surgeon makes an incision in the suspensory ligament, which connects the penis to the pubis, and allows for a gain of up to 3 cm, associated with traction techniques.
The function of this structure is to maintain the pubo-penile angle upwards, stabilize the penis and protect the vasculo-nervous bundle of the sexual organ. The surgery can be performed in two ways: infrapubic or subcoronal. When making an incision on the site, there is the impression that the penis got a little bigger.
dermolipectomy
Pubic dermolipectomy consists of the removal of skin and fat from the pubis of men in order to improve this view of the penis.
This surgery can be performed on men who want to improve the aesthetics of their penis. In some cases, these layers are so large that they leave the penis embedded.
Correction of the penoscrotal synechia
Lowers the scrotum, giving the appearance of a larger penis in some patients.
Read more:
Conclusion
The semi-rigid or inflatable penile prosthesis is a definitive and curative solution for erectile dysfunction and Peyronie's disease with severe penetrative difficulties.
In addition to being, at first, an exclusively functional procedure, we perform all the safe techniques to return the largest possible size and caliber for your case.
By the way, there are solutions for your case. Therefore, look for a doctor who is a reference in the matter, who has experience and knowledge about when to consider a penile prosthesis.
Penile prosthesis implantation with Dr. Marco Túlio Cavalcanti
Now that you know when to think about penile prostheses, it is worth mentioning that Dr. Marco Túlio Cavalcanti is also a specialist in these treatments for increasing the caliber and circumference of the penis and other conditions related to male sexuality.
Your case will be studied thoroughly and the best solution will be suggested. There are several options that can adjust to your case and need, such as the procedures described in this text.
Schedule an appointment right now and learn about all available treatments.
Dr. Marco Túlio Cavalcanti Urologist and Andrologist. Erectile dysfunction and sexual impotence: put an end to this torment. Penile Prosthesis: the resumption of your sex life. Peyronie disease: correction of the curvature, recovery of the size and caliber of the penis. Hormonal Replacement: resume your performance.
Instagram: @dr.mtcavalcanti
Youtube: Dr. Marco Tulio Cavalcanti