A penile prosthesis is one of the therapeutic alternatives available for men with erectile dysfunction, especially when less invasive treatments do not provide a satisfactory response.
Although it has been used for several decades, not all men understand what is a penile prosthesis and what its effects on sexual life may be.
It is a device designed essentially to provide the rigidity necessary for sexual activity and is not intended to increase penis size, contrary to what many imagine.
In this article, learn what a penile prosthesis is used for, in which situations it may be considered, what the main types of implant are and which aspects should be evaluated before surgery.
What is a penile prosthesis and what is it used for?
A penile prosthesis is a device surgically implanted inside the corpora cavernosa of the penis.
The main function of the penile prosthesis is to allow the man to obtain sufficient rigidity for penetration during sexual intercourse. Therefore, its indication is fundamentally functional – and not aesthetic.
The prosthesis may be considered in patients with erectile dysfunction who do not respond adequately to less invasive treatments, when these are not tolerated or are contraindicated, and in some cases associated with Peyronie’s disease. The decision must be individualized, based on clinical assessment and the characteristics of each patient.
Does a penile prosthesis increase penis size?
A penile prosthesis does not increase the size of the penis, and this is one of the main misconceptions related to this type of surgery.
The implant is not intended to increase the dimensions of the penis. In men with penile deformity associated with fibrosis, reconstructive surgery may be considered in the same procedure, according to clinical assessment. That approach can modify anatomical conditions, but it does not allow predicting or guaranteeing a specific increase in length.
It is important that expectations are discussed realistically with the surgeon before the intervention.
Penile prosthesis and erectile dysfunction
Erectile dysfunction corresponds to persistent difficulty in obtaining or maintaining an erection with sufficient rigidity for satisfactory sexual activity.
An occasional episode of difficulty achieving an erection does not necessarily mean there is a disease. Stress, anxiety, fatigue or excessive alcohol consumption, for example, can temporarily interfere with the sexual response.
When the difficulty becomes frequent or persistent, it deserves medical evaluation. Erectile dysfunction may be associated with cardiovascular diseases, arterial hypertension, diabetes, hormonal changes, neurological diseases, medications, pelvic surgeries, priapism, smoking and psychological factors.
In cases where other approaches do not provide a satisfactory response or are not indicated, a penile prosthesis may be considered one of the options for treatment of erectile dysfunction.
What types of penile prosthesis are there?
There are different types of penile prosthesis on the market. When understanding what a penile prosthesis is, it is also useful to know the most commonly used models: malleable or semirigid prostheses and inflatable prostheses.
Malleable or semirigid prosthesis
The malleable prosthesis is composed of two metal rods coated in silicone, placed inside the corpora cavernosa. These rods maintain some degree of permanent rigidity and can be positioned manually according to need.
It is a system with fewer mechanical components than an inflatable prosthesis. Permanent rigidity, on the other hand, can make the implant less discreet in daily life, although the experience varies depending on each patient’s anatomy and adaptation.
Inflatable penile prosthesis
The inflatable prosthesis allows alternating between a more flaccid state and a rigid state.
In the most commonly used systems, besides the cylinders, there is a saline reservoir and a small pump in the scrotum. When the man wants to obtain an erection, he operates that pump to transfer fluid to the cylinders, which increase in volume and confer rigidity to the penis.
The main advantage of these devices is that they provide a flaccid appearance closer to the natural when not activated. On the other hand, they are more complex systems and, over the years, a component may fail, making a new intervention necessary.
Which is the best penile prosthesis?
There is no single model that is best for all men.
Understanding what is a penile prosthesis and how it works is essential when choosing between options.
The choice depends on several factors, such as anatomy, manual dexterity, age, comorbidities, previous surgeries, presence of penile fibrosis, personal priorities, device availability and costs.
The most important thing is that the choice is made after clearly understanding how each device works and what its advantages and limitations are.
What are the advantages and disadvantages of implanting a prosthesis? — what is a penile prosthesis
Penile prosthesis implantation can have an impact on physical and psychological aspects, depending on the clinical indication, the technique used and the course of each patient.
Possible attainment of penile rigidity for sexual activity
A prosthesis may be indicated for men with erectile dysfunction and can provide rigidity for sexual activity when medications do not produce a satisfactory response or are not recommended.
Restoration of self-confidence
Erection problems can be associated with anxiety and loss of confidence. In such cases, implanting a prosthesis can help restore the rigidity necessary for sexual activity, but effects on confidence and satisfaction vary by patient.
Peyronie’s disease
When Peyronie’s disease is associated with erectile dysfunction, a prosthesis may be considered as part of the therapeutic approach, depending on the deformity, erectile function and other clinical characteristics. Correction of the curvature may require additional procedures.
Costs
Costs may vary according to the type of prosthesis, the institution and charges associated with the surgery. Inflatable prostheses tend to be more expensive.
Health insurance coverage
Coverage varies according to the insurance or health subsystem. Not all costs of the prosthesis and surgery are always included.
Surgical risks
Surgery may involve risks such as infection, pain, bleeding, wound-healing problems or device failure, and a reoperation may be necessary.
Recovery
After surgery, there may be pain, swelling and temporary limitation of physical and sexual activity. Resumption of intercourse depends on recovery and the surgeon’s recommendation.
Does the prosthesis interfere with orgasm or ejaculation?
The prosthesis acts on penile rigidity and is not intended to directly alter orgasm or ejaculation. However, these functions may already be altered due to prior conditions.
Achieving adequate rigidity may allow sexual activity in some patients. The potential influence on sexual sexual life, confidence and satisfaction with relationships varies according to clinical conditions, expectations and individual experience.
How is recovery after penile prosthesis surgery? (what is a penile prosthesis)
In the first days after surgery some degree of pain, swelling and ecchymosis of the penis and scrotum is expected. These symptoms can be managed and tend to decrease progressively.
The timing to begin manipulating the prosthesis depends on the technique used and the postoperative course. Sexual activity is often resumed around six weeks, but this can vary according to each case.
Fever, progressive redness, wound discharge, severe pain or sudden worsening of the swelling are warning signs and justify contact with the medical team.
When to seek medical evaluation? (what is a penile prosthesis)
Occasional difficulties achieving an erection are common. However, when the problem repeats, interferes with sexual life or causes concern, medical evaluation is advisable.
The man should also seek specialized medical assessment in Portugal if he notices changes in the anatomy of the penis, such as curvature, shortening or loss of girth.
An individualized consultation can help assess the causes, discuss whether a penile prosthesis is appropriate for the case and explain what outcomes can realistically be expected, as well as the limitations and risks of the procedure.
If you have symptoms, request a medical evaluation.
