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IMAGE When other treatments for impotence are ineffective, unsatisfactory, or cumbersome, men turn to penile implants . Whether impotent because of diabetes , radiation therapy , prostate surgery , or another physical cause, a surgical implant can help men regain erectile function.

What Types of Implants Are Available?

There are different types of implants. The simplest, called a malleable implant, consists of a pair of silicone rods. They are bendable, yet stiff enough to allow penetration.

To initiate sex, the penis is lifted to position with the rods straightening out. Men can conceal this type of implant by bending the malleable rods downward; however, the penis will appear semi-erect.

The second type of implant is an inflatable implant. The device uses fluid to achieve an erection. Fluid is controlled by a pump. It allows men to experience a natural erection. The device is easily concealed when not in use.

No one implant is good for every man. A urologist can provide you with all the various options based on an array of factors, including your specific anatomy and needs.

What Can You Expect After Surgery?

None of the implants affect your ability to ejaculate or have an orgasm. Rarely, some men end up with persistent pain or a loss of sensation in the penis. Many men are surprised to learn that, with an implant, their erection does not appear as it once was. For example, the erection may be shorter. Also, the flaccid penis is not quite as relaxed as it used to be. But, these outcomes generally depend on the type of implant used and how well you heal. Overall, the success rates are high for penile implant surgery.

What Are the Potential Risks?

No surgery is without its risks, and that includes implant procedures. In a very small percentage of cases, the wound can become infected. While implants have gotten more reliable over the years—tubing is kink-resistant and the connectors and reservoir are seamless—a variety of problems may still arise.

In general, the more complex the implant, the greater the likelihood there will be mechanical problems. For example, saline can leak out. While saline presents no medical risk, a second operation would be needed because the implant would not work without this fluid.

Sometimes the reservoir or pump may protrude through the skin. Occasionally, the unit will auto-inflate or deflate without warning. Or, the healthy tissue adjacent to the implants may break down. Men should accept that there is a chance they might need to undergo a second operation either to remove the implant or have another one inserted. It is hard to say how long an implant will last, because, as with any medical device, there is ongoing wear and tear.

Silicone penile implants, though solid and not gel-like, carry the same risks inherent in silicone breast implants. There have been reports that silicone particles, shed from the implant, can migrate to other parts of the body. But, there are little data to confirm silicon-related health problems associated with these devices.

Think carefully about an implant because they are generally irreversible. The penile chambers are permanently altered by the device, making it unlikely that natural erections could ever return. Despite the risks, many patients and their partners are satisfied with the decision to get an implant. For these men, implants mean a renewed confidence in their ability to perform.

  • American Diabetes Association

    http://www.diabetes.org/

  • The Official Foundation of the American Urological Association

    http://www.urologyhealth.org/

  • Canadian Diabetes Association

    http://www.diabetes.ca/

  • Canadian Urological Association

    http://www.cua.org/

  • Penile prosthesis insertion. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 30, 2011. Accessed September 19, 2012.

  • Campbell MF, Wein AJ, Kavoussi LR, et al, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders Elsevier; 2007.

  • Penile prosthesis. University of Washington Urology Department website. Available at: http://depts.washington.edu/uroweb/treatment-22-Penile%5FProsthesis.php. Accessed September 19, 2012.