Penile prosthesis

Penile prosthesis or penile implants have the function of achieving and maintaining an erection, and their implantation is a permanent solution to erectile dysfunction (impotence), of any cause. The penis firmness after the insertion of the penile prosthesis allows for normal sexual intercourse.

The most common reason for implantation of penile prosthesis is impotence, which can be caused by various causes: due to the damage to the blood vessels (e.g. in diabetes, vascular diseases, etc.), then to nerve damage (after prostate surgery, injuries and neurological diseases), or due to diseases of the penis itself (Peyronie's disease, penile trauma, congenital anomalies). Read more about erectile dysfunction here and read about Peyronie's disease here

Penile prosthesis are also implanted in the "neophalus" after "sex confirmation" operations to achieve erection and allow penetration.

Due to the complexity of the procedure, it is necessary that the decision on the implantation of the prosthesis, prosthesis model, and surgical approach is made exclusively by the surgeon-urologist, narrowly specialized in the field of urological reconstructive surgery, who will perform the above said surgery, in consultation with the patient.

What kind of penile prosthesis are there?

There are two basic types of penile implants (penile implants):

• Semi-rigid
• Inflatable

Semi-rigid penile prostheses

How does the semi-rigid prosthesis look like?

Semi-rigid penile prosthesis consist of two semi-rigid rods of varying length, which are inserted into the body of the penis.

The Genesis® model (manufacturer: Coloplast) and the AMS Spectra® model (manufacturer: Boston Scientific) have shown excellent clinical results.

How are these implants fitted?

• The surgery for the implantation of semi-rigid dentures is performed under general or spinal anesthesia.
• The surgery itself takes about an hour.
• Patient stays in the hospital 1 day after the implantation.
• Pain therapy, as well as antibiotics, have been prescribed.
• The first sexual intercourse can start four weeks after the implantation.

What does the penis look like after implantation of a semi-rigid prosthesis and how are they used?

• Thanks to modern operating techniques, after implantation, the penis has a completely normal appearance and it is not possible to see visually that there is an implant implant.
• These implants are used by modeling the rods as needed. When a patient wants to have sexual intercourse, he corrects the rods with one movement and the penis gets the appearance and function of the penis in an erection. At the end of the intercourse, the movement in the opposite direction returns the penis to "relaxed" state.

Inflatable penile prosthesis

Inflatable penile prosthesis represents the most up-to-date model of penile implants. The prosthesis model AMS LGX® (manufacturer: Boston Scientific) and Titan® (Coloplast) have shown extremely good results. 

What do these implants look like?

Inflatable penile prostheses consist of 2 cylinders (can be of different lengths and diameters) that are inserted into the body of the penis, a pump housed in the scrotum, and a small reservoir of fluid housed in the pelvis, next to the bladder. 

What does surgery look like?

• The surgery is performed under general or spinal anesthesia.
The surgery takes about 1.5 to 2 hours.
• Dentures are implanted through the infrapubic (through the root of the penis on the upper side) or through the penoscrotal approach (on the lower side of the penis).
• After surgery, the patient stays in the hospital for 1-2 days with antibiotics and analgetics.

Postoperative recovery:

• The first two days after surgery require rest.
• The patient receives antibiotics and pain therapy, if necessary.
• For wounds on the skin, resorptive stitches are generally used, which break down on their own, so they do not need to be removed.
• The pump is activated after 2 weeks, and the patient is then trained to use it.
• Sexual intercourse is allowed for six weeks from the implantation of the penile prosthesis.

How do you use the implants?

Activating the prosthesis is very simple. When a patient wants to have sexual intercourse, using a few simple presses on the pump causes the fluid to be pumped out of the reservoir into the cylinders, thus bringing the penis to an erectile state. It is practically imitating the physiological process of erection in which the blood fills the penile body.

At the same time, there is an increase in both the length and the circumference of the penis. After sexual intercourse, deactivation is done by simply pressing a button on the pump, after which the penis loses its firmness and goes into a "relaxed" state.

What does the penis look like after implantation and what is the sexual relationship?

Thanks to the operating technique used, after insertion, the penis has a completely normal appearance and it is not possible to visually detect that a person has a penile prosthesis.

Sexual intercourse with this type of prosthesis is the closest to the natural relationship and the partner cannot sense the presence of penile prostheses during the relationship.

The goal of implantation of penile prosthesis is to achieve maximum functional and aesthetic result, which enables sexual relations and thus significantly contributes to the quality of life.