Penile Prosthesis Program
If drug treatments, injections, and other non-surgical therapies do not resolve erectile dysfunction (ED), and we do not think psychological causes are involved, you and your physician may consider penile implant surgery. Studies show high satisfaction with this treatment option among patients and their partners.
Penile implants (also called a penile prosthesis) are devices, known as prostheses that can restore erection in many men with erection dysfunction (ED). Penile implants require a surgical procedure and it is the most common surgery performed for treating ED. The implant is concealed entirely within the body, and requires some degree of manipulation before and after intercourse to make the penis erect or flaccid. There are different types of implants. In choosing a penile implant, we consider your medical condition, lifestyle, and personal preferences.
There are three types of penile implants used to treat ED.
- Non-inflatable implants or prostheses consist of a pair of cylinders that we place into your penis. You can position these up for intercourse or down for regular lifestyle activities.
- Two-piece inflatable implants or prostheses are a pair of cylinders implanted into the penis and a single pump bulb that we place into the scrotum. You squeeze the pump to inflate it and bend the penis to deflate it.
- Three-piece inflatable implants or prostheses provide a natural appearing erection and greater flaccidity than the two-piece or malleable (non-inflatable) implants. This prosthesis consists of a reservoir implanted in the abdomen, a pump placed into the scrotum and a pair of cylinders implanted in the penis.
Penile implant surgery is performed under sterile conditions in the operating room where you will be under general or spinal anesthesia. The operation usually takes between 1 and 2 hours and is performed as an outpatient day surgery with no overnight stay required in the hospital.
The surgery involves the following steps:
- An incision is made across the top of the scrotum at the base of the penis
- Special instruments are inserted to stretch the spongy tissues inside the hollow chambers of the penis
- The chambers are then flushed with antibiotic fluid to reduce risk of infection
- Implant rods or cylinders are then inserted into position inside the penis
- If an inflatable prosthesis is used, a pump and valve is inserted into the scrotum and a fluid reservoir is implanted under the abdominal wall through an incision
- When the prosthesis is in place and functioning, incisions are then sutured
Patients are advised to apply an ice pack to the groin area to minimize pain and swelling and also oral antibiotics are given to decrease the risk of post-operative infection. The surgeon will instruct you on how to use your new implant once the pain and swelling has subsided. Most patients can resume sexual activity in 6-8 weeks.
Medicare and most commercial insurance providers cover the diagnosis and treatment of ED.
Risks & Complications
The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. Most patients do not have complications after Penile Implant surgery; however complications can occur and depend on which type of surgery your doctor performs as well as your current health status (i.e. obese, diabetic, smoker, etc.)
Our Contributions to the Field
The Penile Prosthesis Program is led by Robert J. Valenzuela, MD, FACS Director of Penile Prosthesis Surgery, Assistant Professor, Milton and Carroll Petrie Department of Urology Icahn School of Medicine at Mount Sinai. Dr. Valenzuela is one of the most prolific implanters of penile prostheses, artificial urinary sphincters and male slings in the Northeast. As Director of Penile Prosthesis Surgery, he specializes in Prosthetic Urology, Sexual Dysfunction, Peyronie’s Disease, Urinary Incontinence and Benign Prostatic Hypertrophy (BPH). He has developed the Sub-Coronal Inflatable Penile Prosthesis procedure (SC-IPP) and the Modified Sliding Technique (MoST/ MuST). These are unique procedures for penile length and girth restoration at the time of penile prosthesis insertion. Dr. Valenzuela is routinely sought out by his peers for the management of complex prosthetic cases.