Tag: penile implant

Are Men Satisfied with Penile Implants?

  April 19, 2019
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Bill took a deep breath, looked at his wife Judy, and finally told his urologist, “Okay. I’ll get the implant.”
It wasn’t something he necessarily wanted to do. But he had been dealing with erectile dysfunction (ED) for a few years now and no other treatments seemed to be working out. Because he took heart medication, he couldn’t take the pills he saw advertised on TV. And the vacuum device, which was far from romantic, didn’t seem right for him either.
He didn’t like the word “prosthesis” when it referred to his manhood. It made him think of artificial limbs. But he knew that an implant was just that – a device designed to give him an erection when he wanted.
He and Judy were in their fifties - still young - and still had a long sex life in front of them. He wanted to be more spontaneous with their lovemaking. He wanted to feel confident, like he did early in their marriage. And he wanted to keep Judy satisfied. She was patient, but he knew he was disappointing her every time.
Bill had heard that penile implants had a high satisfaction rate. He’d also heard that sex would probably still feel the same as it did before he had ED. But he was nervous. He knew that after getting the implant, there was no turning back. So he wanted to make sure he was doing the right thing.
Many men getting implants share Bill’s concerns. Penile implantation is a big decision. Today, we’ll talk about men’s experiences with implants and some things to keep in mind if you’re considering one.

What kind of implant?

Bill’s urologist recommended a 3-piece inflatable implant, which is currently the most common type. These implants have three components:
  • Cylinders that are surgically implanted into the shaft of the penis. These cylinders replace the corpora cavernosa – the spongy tissue that typically fills with blood and gives an erection its firmness.
  • A reservoir filled with saline fluid. This fluid fills the cylinders on demand, similar to the way blood once filled the corpora cavernosa.
  • A pump placed in the scrotum. When a man wants an erection, he can activate the pump by squeezing it, sending the saline fluid into the cylinders. Similarly, when he no longer desires an erection, he can deactivate the pump, returning the saline fluid to the reservoir until next time.
Another type of implant, but less commonly used, involves malleable rods placed in the shaft. The man can move his penis to an erect position as he chooses.

Why do men like their implants?

In December 2015, The Journal of Sexual Medicine published a study on men’s satisfaction and dissatisfaction with penile implants. The researchers interviewed 47 men with an average age of 61 years and asked them to share their thoughts.
Overall, 79% of the men were “fairly” or “very” satisfied. The main reasons they gave were:
  • Improved sexual performance. Men could get erections, penetrate their partners, and feel sexually satisfied.
  • Improved self-esteem, confidence, and male identity. “It was a giant step I took in my life, and I'm glad I took it,” one man said.
  • Improved relationships. One participant remarked, “My general relationship with my wife is much better now.” Others said they were happy that they could please their partners.
  • Improved urination. Some men said their urinary function was better with the implant.

Why are men dissatisfied?

While the majority of men were satisfied, there were some who were not. Here are some of their reasons
  • Unmet expectations. Some men found that the implant did not “feel” the way they thought it would.
  • Shortening of the penis. In some cases, the penis was shorter than it was before. Two men were not able to have intercourse. [Note: A small 2014 study of penile shortening showed that 70% of men experience some degree of shortening after penile implantation, usually in the range of 0.5 centimeters to 1.5 centimeters. However, over half the men in the study didn’t notice.]
  • Feeling “artificial.” One man said, “It is always artificial. It takes time to inflate, it always disturbs.”
Malfunction. After a while, some men with inflatable implants had trouble activating their devices. It is possible for pumps to malfunction, although this is rare. A urologist should give instructions on how to keep the device in good working order.
Should you get an implant?
That’s a question only you, your partner, and your doctor can answer. As the study suggests, the majority of men are satisfied with their choice. But men should be prepared – and have realistic expectations – before surgery. If you have any questions or concerns, be sure to let your andrologist know.

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What is postcoital dysphoria (“post-sex blues”)?

  December 24, 2017
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What is postcoital dysphoria (“post-sex blues”)?

Sometimes, people feel deep sadness or agitation after consensual sex. The medical term for these feelings is postcoital dysphoria (PCD), but some call it the “post-sex blues.”

In some cases, people become tearful or depressed after orgasm. In others, they become argumentative with their partner. These feelings occur even if the sexual encounter has been satisfying and enjoyable.

Not much is known about PCD, but research published in the journal Sexual Medicine in 2015 has revealed how common it is among women.

Researchers from the Queensland University of Technology (QUT) in Australia asked 230 female university students to participate in a survey about their experiences with PCD. The women ranged in age from 18 to 55 with an average age of 26 years.

Forty-six percent of the women said they’d experienced PCD in the past. About 5% said they’d had symptoms over the past month. And about 2% reported having PCD “always” or “most of the time.”

However, PCD was not linked to intimacy in close relationships, the researchers reported.

Experts aren’t sure why PCD happens. It may be that the bonding with a partner during sex is so intense that breaking the bond triggers sadness. Childhood sexual abuse may play a role as well.

The QUT researchers noted that their findings may not apply to other groups, as their participants were heterosexual, mostly Caucasian, and university students.

Additional studies with larger, more diverse groups may provide more clues. It is also uncertain to what extent postcoital dysphoria affects men.

People who are concerned about the post-sex blues are encouraged to talk to their doctor or a sex therapist.

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Penile Prosthesis

  November 27, 2017
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Penile Prosthesis

When should a man consider a prosthesis?

Usually, a prosthesis is considered a last resort. Men with erectile dysfunction (ED) are encouraged to try all other possible treatments (such as pills, injections, and vacuum devices) before getting an implant. However, some treatments are not suitable for all men. For example, men who take nitrates cannot take certain ED medications.

What types of prostheses are available?

Generally, there are two different types:

Semi-rigid positionable rods have an inner core made of stainless steel or interlocking plastic joints. A man can bend the penis up when he wants an erection and bend it back down when he’s finished with sexual activity.

Inflatable implants use a pump system. When a man wants an erection, he activates a pump placed in the scrotum. This action sends fluid (usually a saline solution) into inflatable cylinders placed in the penis.

Inflatable implants can have 2 or 3 parts. With 2-part implants, the fluid is held in the back part of the inflatable cylinders. With 3-part versions, the fluid is contained in a separate reservoir.

Nowadays, 3-part inflatable implants are the most common.

Both semi-rigid rods and inflatable implants are completely concealed within the body. Nobody can see them.

What are some of the drawbacks of a penile prosthesis? Can the device malfunction?

Infection is one risk. If the implant becomes infected, it will need to be replaced. Sometimes the implant damages surrounding tissue.

It’s possible for an implant to malfunction. This is more common with inflatable devices, which can leak saline fluid into the body. The fluid itself shouldn’t cause problems, but the device should be replaced or repaired.

What is the implant procedure like?

For some men, an implant procedure is same-day surgery. Others need to spend one night in the hospital. Men receive general anesthesia and incisions are made in the penis, lower abdomen, or scrotum. Afterward, many men need to take oral medications for pain. Sexual activity should be avoided for about a month after surgery.

Can the prosthesis wear out?

Yes. Normally, the device will function for about 12 to 15 years. After that, it will probably need replacement, if the patient wishes.

What is the satisfaction rate for penile prostheses?

The satisfaction rate is very high. For men with implants, the rate can reach 85%.  For their partners, it can be as high as 90%.

Will sex still feel the same with a prosthesis?

Most men feel sensation, reach orgasm, and ejaculate just as they did before getting an implant.

What if I don’t like the implant? Can the operation be reversed?

No. The implant replaces the corpora cavernosum, the spongy tissue that typically fills with blood during an erection. So, it’s important that men discuss the pros and cons with their physician before getting an implant. Usually, other treatments for erectile dysfunction (such as oral medications or vacuum devices) are tried before an implant is considered.

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