Penile Implants: A Personal Decision

We can provide you with thorough information about the types of penile implants available at our Houston office. Choosing the penile prosthesis that is best for you is a very personal decision. Because each type of prosthesis offers unique features, you will want to discuss the choices with your doctor in order to choose the option that is right for you.

Penile prostheses may be malleable (bendable) or inflatable and are manufactured by two different companies. We prefer the multi-component inflatable penile prostheses made by American Medical Systems (AMS) and the Mentor Corporation, because of high levels of patient satisfaction. Unlike malleable prostheses, the inflatable prostheses may increase in length and girth. To learn more about the types of penile prosthesis, contact our Houston office today. 

One-Piece Positionable Prosthesis (Malleable)

One-piece positionable prostheses are the simplest types of penile prostheses. The prosthesis consists of a pair of cylinders that are surgically inserted into the penis. The prosthesis is positioned up for intercourse or down for everyday activities.

Advantages	Disadvantages
Totally concealed in body Easy for you and your partner to use Good option for men with limited dexterity Generally the simplest surgical procedure Simply bend prosthesis to conceal 91% patient satisfaction rate	Remains firm when not being used Less appropriate for patients requiring repeated cystoscopy

Two-Piece Inflatable Prosthesis

The two-piece inflatable prosthesis also provides excellent results and may be more appropriate in some men with extensive abdominal surgery. Using models available in the clinic, Dr. Lipshultz will demonstrate the use of the prostheses. A penile implant is entirely concealed within the body and is designed to be simple and discrete to operate. It may offer a permanent, long-term solution to ED, and can help you return to an active, satisfying sex life.

The two-piece inflatable prosthesis consists of a fluid-filled pair of cylinders implanted in the penis and a small pump implanted in the scrotum. To get an erection, you simply squeeze and release the pump several times. When the fluid is pumped into the cylinders, it creates an erection that provides rigidity.

Advantages	Disadvantages
Totally concealed in body Simple to use One-step deflation Device is inflated to provide rigidity and deflated for concealment 90% of partners would recommend it to other couples	Requires some manual dexterity Cylinders remain partially filled with fluid when deflated

Three-Piece Inflatable Prosthesis

The three-piece, fluid-filled inflatable prosthesis features a pair of cylinders implanted in the penis, a pump implanted in the scrotum, and a reservoir implanted in the lower abdomen. When the fluid is pumped into the cylinders, it creates an erection that provides rigidity and girth expansion.

Advantages

Disadvantages

Totally concealed in body Like a natural erection Device is inflated to provide rigidity and deflated for concealment Expands in girth (all AMS 700® cylinders) and length (AMS 700 LGX®) When deflated, the cylinders are soft and flaccid AMS 700 with InhibiZone® is the only inflatable penile prosthesis with clinical evidence showing a significant reduction in the rate of revision due to infection. Parylene coating increases durability 92% patient satisfaction

Requires some manual dexterity

About The Procedure

Dr. Lipshultz prefers the penoscrotal approach. A 3 cm incision is made horizontally between the penis and the scrotum on the underside of the penis and leaves no visible scar. This approach also provides excellent surgical exposure and avoids any possible injury to the nerves of the penis. The operative time for surgery is usually less than 2 hours. We prefer a general anesthetic, although an epidural anesthetic may be used. You will typically spend one night in the hospital. A urethral catheter positioned in your bladder will be removed in the morning the day after surgery. An ice pack is placed over the genitalia to minimize swelling. All skin sutures are absorbable and do not need to be removed.

Complications, as with any other surgery, may include bleeding and infection. These problems are rare and are minimized with meticulous intraoperative hemostasis and by the use of intravenous antibiotics prior to and after surgery. Even rarer complications include prosthesis malfunction and damage to the corporeal bodies. Although the penile prosthesis contains silicone, no case of proved immunologic disease (similar to breast implants) has ever been reported.

The length of the penis is not changed with this procedure. The corporeal bodies within the penis are of a fixed, measurable length and cannot be changed. The largest possible cylinders are always placed, maximizing the individual’s penile size.

The first follow-up visit is at approximately 2 weeks after surgery. At this visit, the prosthesis will be tested. The second follow-up visit is at approximately 6 weeks after surgery. After this visit, the penile prosthesis may be used.

Contact our Houston office to learn more about the types of penile prosthesis.