What Are the Different Types of Penile Implants?

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Penile implants, or penile prostheses, can help men who experience erectile dysfunction. These implants have the potential allow men with severe erectile dysfunction to once again experience penetrative sex, orgasm, and ejaculation. (Men who have a difficulty with orgasm and ejaculation unrelated to erectile dysfunction will not be helped by penile implants.

Penile implants can also be used in men who experience other types of erectile problems, such as those caused by Peyronie's disease.

As more effective medical treatments have become available, fewer men have received penile implants for erectile dysfunction. However, for some men, they are the only effective option for treatment. This is particularly true for men who have had total phallic construction and do not have other options for achieving an erection.

Types of Penile Implants

There are several different types of penile implants. Broadly speaking they can be broken down into two types. There are inflatable implants, which tend to be used most commonly in the United States. There are also non-inflatable implants.

Infla​table Implants

In general, inflatable implants are used most commonly in the United States, although this varies depending on where people seek care. There are two types of inflatable implant—two piece implants and three piece implants. Neither type of implant inflates with air. Instead, they are filled with fluid from a fluid reservoir that is implanted in the body.

The pump is usually implanted in the scrotum.

Two piece implants are simpler and easier to use. However, there is usually a trade-off between the firmness of the erection and how flaccid the penis can become. Men tend to be more satisfied with one than the other. This is because the small size of the one piece fluid pump and reservoir doesn't allow for large adjustments.

Three piece implants, in contrast, are slightly more complex. In addition to the prosthesis and pump, they also contain a separate reservoir. The added parts allow for several benefits. The flaccid penis is fully flaccid, and there is a valve to release pressure in the penis. The additional reservoir space also allows erections with this device tend to be firmer than with the two piece implant.

Non-Inflatable Implants

Non-inflatable implants are exactly what they sound like. They are semi-rigid tubes that can be bent to shape. The penis can be pointed down for everyday use. It can be pointed up for sexual intercourse. There are several different types of non-inflatable implants with varying trade-offs. Some offer greater stiffness for sex, but that comes alongside the potential for more discomfort at other times.

The biggest advantages of non-inflatable implants are cost and ease of insertion. The surgery to implant these devices is much simpler than for inflatables. They are also less expensive. In addition, some men find them easier to use, as there are no mechanical parts. However, men do have to become used to having a firm, rather than flaccid, penis at all times.

Alternatives to Penile Implants

There are several options that doctors may recommend before recommending a penile implant.

The surgery to place an implant is non-trivial. It can also lead to a number of side effects. Some potential side-effects of penile implants include:

  • Problems with the implant
  • Infection
  • Shortening of the penis
  • Changes in sensation of the penis

Therefore, implant alternatives are always a good starting place for erectile dysfunction treatment. The most well known treatment for erectile dysfunction is probably PDE5 inhibitors. These are oral medications, such as Viagra, Cialis, and Levitra, that can help with erectile function in some men. Vacuum pumps, which use suction to pull blood into the penis, are also effective for some men.

(Vacuum pumps are NOT household vacuums. It is not safe to use a household vacuum to try and get an erection.) Finally there are drugs that can be injected directly into the erectile tissue of the penis to increase blood flow and produce an erection.

Are People Satisfied With Penile Implants?

Research suggests that most of the men who choose to get penile implants are happy with their choice. So are their partners. This is good news for men for whom penile implants are a reasonable option. These implants can make a big difference to sexual function and satisfaction within a relationship. However, that doesn't mean that penile implants are the best choice for all men with erectile dysfunction. It is a very invasive procedure. Furthermore, a significant percentage of men who get an implant will need a replacement or revision at some point after implantation.

If you're considering a penile prosthesis, talk to a doctor who is well informed about the risks and benefits. It is important to discuss potential side effects, and less invasive alternatives before choosing this surgery. It is also a good idea to investigate your options for getting an implant placed, if you decide to do so. As has been seen with a number of types of surgeries, the likelihood of successful implantation of a prosthesis is higher at hospitals that do larger numbers of the procedures.

Sources:

Alwaal A, Harris CR, Hussein AA, Sanford TH, McCulloch CE, Shindel AW, Breyer BN. The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000-2010. Sex Med. 2015 Sep 17;3(4):280-6. doi: 10.1002/sm2.82. 

Levine LA, Becher E, Bella A, Brant W, Kohler T, Martinez-Salamanca JI, Trost L, Morey A. Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine. J Sex Med. 2016 Apr;13(4):489-518. doi: 10.1016/j.jsxm.2016.01.017.

Lledó-García E, Jara-Rascón J, Moncada Iribarren I, Piñero-Sánchez J, Aragón-Chamizo J, Hernández-Fernández C. Penile Prosthesis First and Replacement  Surgeries: Analysis of Patient and Partner Satisfaction. J Sex Med. 2015 Jul;12(7):1646-53. doi: 10.1111/jsm.12932.

Mulcahy JJ. The Development of Modern Penile Implants. Sex Med Rev. 2016 Apr;4(2):177-89. doi: 10.1016/j.sxmr.2015.11.003. 

Zuckerman JM, Smentkowski K, Gilbert D, Storme O, Jordan G, Virasoro R, Tonkin J, McCammon K. Penile Prosthesis Implantation in Patients with a History of Total Phallic Construction. J Sex Med. 2015 Dec;12(12):2485-91. doi: 10.1111/jsm.13067.

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