Treatment Erectile dysfunction prostate surgery

Treating erectile dysfunction with penile implants

Three-piece inflatable penile implantPenile implants, an option patients with erectile dysfunction probably hear little about, might offer a lasting and satisfying cure. Abraham Morgentaler, M.D., director of Men’s Health Boston, explains how.

Thanks to Viagra’s introduction more than a decade ago, erectile dysfunction has become fodder for comedians, talk shows, and mainstream media. And there’s clearly a market for Viagra (sildenafil) and its cousins, Cialis (tadalafil) and Levitra (vardenafil): the American Urological Association estimates that ED, as it’s become known, affects 25 million American men.

All three medications have helped a significant number of men achieve an erection firm enough for intercourse. A 2001 study of Viagra’s long-term effectiveness reported an overall success rate of 69%. The success rates for Cialis and Levitra were similar — 59% and 69%, respectively. However, the response can depend on what caused the ED in the first place. Men who have vascular problems as a result of diabetes or heart disease find that the drugs work only about half of the time. Response rates are lower — just 30% — for men who’ve had a radical prostatectomy.

Men who cannot take the ED medications or find them ineffective do have other options. For example, injections, penile bands, and vacuum erection devices can help men with ED achieve and sustain an erection. Yet many men and their partners find that using these aids requires planning and eliminates spontaneity, or that they produce less-than-satisfactory results.

For these men, a penile implant, also called a penile prosthesis, may be the best option. Men with an implant can have an erection at any time — and maintain it for as long as they want — without the use of medication or other devices, allowing for greater spontaneity. Broadly speaking, there are two types of implants:

  • Inflatable implants. These may have a two- or three-piece design. Three-piece implants consist of a fluid-filled reservoir in the abdomen, a pump with a release valve in the scrotum, and two inflatable cylinders in the penis (see Figure 1). Squeezing the pump transfers fluid from the reservoir into the cylinders, causing an erection. Pushing the release valve drains the fluid back into the abdominal reservoir. Two-piece implants combine the fluid-filled reservoir and the pump in the scrotum (see Figure 2). Bending the penis returns the fluid to the reservoir.
  • Semirigid, or malleable, rods. As the name implies, this type of implant consists of bendable rods, usually constructed of braided stainless steel wires or articulating plastic disks, covered with silicone (see Figure 3). The rods are bent upward to have sex and pointed down to conceal the device under clothing. This type of implant is always firm.

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by Ukrainianfreak