When It's Time for a Penile Implant

Approximately 20 million men (and 40 million people, if you include their partners) suffer from erection problems. Most can be helped back to a full sex life with simple, noninvasive approaches such as medications and external vacuum devices. But a few percent of those men have severe enough penile tissue damage—typically smokers, people with heart disease, and diabetics—that no form of mild coaxing will do the job. When the other methods have failed, a penile implant is the last resort.

Penile prostheses have been around for more than 20 years. Dr. Brantley Scott from Houston pioneered the bionics for the first implant—a device that goes inside the penis to make it stiff enough for intercourse—but those early devices bear little resemblance to the ones we use today. Modern implants are both easier to install and more effective.

My first implant surgery took 2 1/2 hours; today it takes me only 50 minutes, and it's an outpatient procedure. Early implants were semi-rigid—they could be bent up for erection and more or less down for a semi-flaccid condition. Today's three-piece implants are hydraulic, with a reservoir for inflation, and achieve much more natural erect and flaccid states.

The early days of implants weren't without their problems. Complications and reoperation occurred in 20 to 40 percent of all cases, and infection wasn't uncommon. Device failures, too, were more frequent than we liked. Today, the complication and infection rates are very low, and the few problems that do occur are almost always a result of surgical errors or poor patient selection.

If you're considering an implant, be careful who you see. Before even considering an implant, you should be fully evaluated and the cause of your impotence determined. Then you should try all the other options. If they fail, consider having an experienced surgeon who has satisfied patients (ask to talk to some) do the job.

 

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