Penis Prosthesis
What is a Penis Prosthesis?
Penile prosthesis placement surgeries are performed when patients with penile erectile dysfunction (erectile dysfunction) do not benefit from drug treatment. Erectile dysfunction in the penis is defined as the inability of the male sexual organ to penetrate the vagina, or the inability to maintain the erection when it occurs. This problem is encountered in 52% of men between the ages of 40-70, with varying degrees of severity.
Who Is suitable to be fitted with a Penile Prosthesis?
The incidence of mild, moderate and complete erectile dysfunction in our country was found to be approximately 70% in total. When evaluated according to age, the frequency of erectile dysfunction, which was observed as 50% between the ages of 40-49, was recorded as 95% at the age of 70 and over.
Erectile dysfunction can develop due to diseases such as arteriosclerosis, diabetes, high blood pressure, coronary artery disease, kidney and liver failure, nervous system, hormonal system and vascular system diseases. Erectile dysfunction can also develop due to some ailments of the penis and psychological reasons. Some injuries, surgeries, and the use of various drugs and substances can also cause erectile dysfunction. Aging, chronic diseases and smoking are the main known risk factors for erectile dysfunction.
The problem with men who complain about incomplete erection is that the erection they have is not sufficient to enter the vagina, or even if it is sufficient, the erection cannot be maintained long enough. This problem can also be a symptom of another underlying disease and the problem might increase depending on the course of this underlying disease. Furthermore, the ageing does not help the problem. Factors such as smoking, systemic diseases (vascular diseases, diabetes, etc.), high cholesterol, high blood pressure are also risk factors for erectile dysfunction and accelerate the course of the problem.
It is possible to continue your sexual life in a robust and uninterrupted way with a penile prosthesis.
Penile prosthesis placement surgeries can be performed in cases where erectile dysfunction cannot be resolved with drug treatments or some vascular surgeries, or in cases where these drugs or surgeries are found to be inadequate or unhelpful. Penile Color Doppler ultrasonography is performed to determine penile blood flow together with blood tests before such an operation. In the disease known as Peyronie’s disease, which is manifested by palpable penile stiffness and penile pain symptoms, and curvature of the penis at the time of erection, a special test can be performed with a drug injected into the penis if erectile dysfunction has started. The result of this test can also be used diagnostically for prosthesis placement.
Penile prostheses are materials produced to be surgically placed into the penis as the last treatment option for men with erectile dysfunction.
What kind of Penis Prostheses are available?
There are basically two groups of penile prostheses.
Malleable (Foldable) penile prosthesis: These are prostheses that remain rigid but have the ability to bend and buckle.
Inflatable (Inflatable / Pumped) penile prosthesis: They are two or three-piece devices with an inflatable and deflatable mechanism.
The constant erection of the prostheses in the first group may be far from natural. The prostheses in the second group can be inflated and deflated, giving them a more natural function.
This surgery can be performed with general or local (numbing from the waist down) anesthesia. Before the operation, the area should be cleaned very well with various special substances. One of the broad-spectrum antibiotics should be administered by injection. These antibiotics should be continued for at least 2 days after surgery. The penis and surrounding hair should be trimmed before surgery. If sensation, orgasm ability and ejaculation function of the penis are normal before the surgery, these functions continue after the prosthesis is placed. The prosthesis only enables the penis to become erect regardless of sexual stimulation. The purpose of prosthetic surgery is to provide erection and upward angulation of the penis. Penile prosthesis placement does not increase the length or diameter of the penis or directly affect the sexual desire of the person.
How long does Penile Prosthesis Surgery take?
This surgery can vary between 45 minutes and 1.5 hours depending on the type of prosthesis to be placed. The postoperative hospitalization can vary between 2-5 days, depending on the patient’s discomfort and healing. The fact that antibiotics are given by injection as a safeguard can also prolong this period.
What are the Points to be Considered after the Surgery?
1 – No contact with water is allowed for one week after being discharged from the hospital and the wound must be kept very clean.
2- No sexual intercourse is allowed for at least 4 weeks. At the end of this period, the necessary controls are made by the doctor who performed the surgery and sexual intercourse is allowed.
3 – It is absolutely necessary to consult the doctor who performed the surgery without delay if symptoms such as high fever, prolonged pain, discharge at the wound site, swelling and redness of the penis, inability to urinate or difficulty urinating manifest themselves.
The most important complication of prosthetic surgery is infection. Maintaining cleanliness of the surgical area and administering broad-spectrum antibiotics are implemented to avoid infection. Antibiotics shall be continued for at least 2 more days after surgery. However, despite all precautions, prosthesis infection can be encountered in 1-10% of cases. Diabetics and patients with spinal cord injury are at higher risk of infection. When infection occurs, antibiotics are started again and the prosthesis is removed. Permanently erect prostheses make future urinary tract interventions difficult, especially in men who have urinary tract disorders such as prostate ailments. Inflatable prostheses that allow diagnostic or therapeutic access to the urinary tract when deflated should be preferred for these individuals.
Advantages of the Penis Prosthesis
When this treatment is applied, patients will have advantages such as being able to have sexual intercourse whenever they want and maintain the erection sufficiently. This treatment option ranks first among other treatments in terms of the satisfaction of spouses.