What are penile prostheses?
Penile prostheses are devices that are implanted inside the corpora cavernosa of the penis. In this mock-up you can see a penis perfectly. The penis, cut transversely, has two corpora cavernosa and it is inside these corpora cavernosa where the penile prostheses are implanted. What these devices do is to restore erectile function. That is to say, they allow the penis to achieve a good rigidity and allow an adequate sexual intercourse in the face of the individual’s impotence problem.
Is the prosthesis a good option for erectile dysfunction?
The penile prosthesis, in many occasions, is the best option and we will see that in many occasions, it is also the only option. It is the best option because when pharmacological treatments have really failed, physical treatments such as vacuum or intracavernous injections have also been used for this pathology. There are patients, perhaps 15% of individuals who suffer from erectile dysfunction due to a major disease such as diabetes, hypertension, cardiorespiratory insufficiency, etcetera. For these individuals it is the only option, and it is the first option, so it is not the last option. It is a truly spectacular solution because erectile dysfunction is restored.
What does the operation consist of and how does a penile prosthesis work?
The operation is a complex operation. In our center we have a lot of experience and therefore it is a routine surgery. It consists of previously making an incision in the penioscrotal angle and, through a small incision of three centimeters (usually enough), allows us to place a prosthetic system like the one I have in my hand, which is a last generation prosthesis. It allows us to activate this small pumping system that is placed inside the individual’s scrotum and when activated by pressing on the skin with a pressure of 200 grams, an erection of optimum rigidity is achieved. Until the patient finishes his sexual intercourse and when he has finished, by pressing on a deactivation system for two seconds, as I am doing now, the penis by its own weight goes down immediately and remains completely flaccid.
The surgery lasts about 50 minutes, 60 minutes at the most, with locoregional anesthesia from the middle of the body down, and they are usually only in the clinic for one night, if we operate in the afternoon, or they leave in the afternoon, if we operate in the morning. Four or five weeks after the operation, except for some complication that may occur, infection or not, but which are very low, the patient is able to have sexual relations.
How to know which prosthesis is the most suitable?
To know which prosthesis is the most suitable, without a doubt, it is necessary to start from the complete clinical history of the patient, to know the typology of the patient, to know his concomitant diseases… Once we know all these details we can choose between malleable or hydraulic prostheses of last generation. What is the difference? The malleable ones are prostheses that are not activated but can only be bent or straightened like the one I am showing now and that would be indicated for an obese person, diabetic, who cannot reach or cannot handle the prosthesis at the level of the scrotum. Or who, for example, has a disease such as arthrosis of the hands, of the fingers and would not be able to handle a pumping system as I have shown before.
Once this is known, the prosthesis is chosen and complications must always be avoided in the future. The most important are the preoperative complications, that is to say, to avoid false expectations. What I can say, in conclusion, is that the prosthesis is the best solution to an erectile dysfunction problem that cannot be solved with other methods and it is highly gratifying for the patient himself, for his partner and for the doctor.