What is erectile dysfunction (ED)?
ED is defined as the persistent inability to achieve or maintain an erection that is firm enough to have sexual intercourse.
How common is ED?
ED is a common problem and it’s important to know you’re not alone:
What causes ED?
There’s no single cause of ED. There are real physical and psychological reasons for ED.
Some common causes are:
- Diabetes
- Cardiovascular disease (high blood pressure, heart disease)
- Prostate cancer treatment
- Surgery (prostate, bladder, colon, rectal)
- Medications (blood pressure, antidepressants)
- Lifestyle choices (smoking, excessive alcohol, obesity, lack of exercise)
- Spinal cord injuries
- Hormone problems
ED is not just a medical issue; it can also deeply affect relationships
"The intimacy that we used to have went away. All of a sudden, it was like we were completely separated. There was no connection."
Erections and how they work
To learn more about ED, it is important to understand how the penis normally works. The erection process includes the following 5 stages:
1. Initial Filling
When you are sexually aroused, nerves signal the penile smooth muscles to relax. This relaxation allows for an increase in blood flow into the two chambers, the corporal bodies, which are located inside the shaft of the penis.
2. Partial Erection
The arteries inside the penis expand to accommodate the increased blood flow. The penis starts to fill with blood,expand and elongate.
3. Full Erection
As blood continues to increase inside the penis,it starts to make the penis stiff and hard, or erect.
4. Rigid Erection
Maximum rigidity is achieved. The glans, or tip of the penis and the penile shaft enlarge or engorge with blood until the penile veins are forcefully compressed. This traps blood inside the penis to maintain maximum penile rigidity.
5. Return To Flaccidity
Once a man climaxes or has an orgasm, the nerves send a signal to allow the blood to leave the erect penis. This is called detumescence. The penis returns to a flaccid, non-erect state.
ED treatment options
Whatever is causing your ED, there is a treatment option that can provide a satisfying solution.If you try one of the treatment options listed and it doesn’t work for you or you aren’t completely satisfied, don’t be discouraged and give up hope.
These treatment options have varying degrees of success for each man depending on the cause of the ED. Irreversible vessel or nerve damage may impact the success of some of these treatments. For example, oral medications don’t work well for some men. In fact, half of men who try oral medications give up on the pills or they stop working.
It’s important to know all of your available options and discuss them with your doctor to determine which will be appropriate for you and your lifestyle. An ED Specialist will help you find a permanent treatment for your ED.
Oral medications
There are a number of prescription medications available tha tmay improve blood flow to the penis. Combined with sexual stimulation, this can produce an erection.
Vacuum erection devices
A hollow plastic tube is placed over the penis and a pump (hand/battery-powered) is used to create a vacuum that pulls blood into the penis. Once an erection is achieved, an elastic tension ring is placed at the base of the penis to help maintain the erection.
Penile implants
A device is implanted into the penis that is intended to allow a man with ED to have an erection. The device is entirely contained in the body so no one is able to see it and is controlled by the user to achieve an erection. This treatment is designed to allow for spontaneity and the erection is maintained for as long as the man desires.
Injections
With injection therapy, a needle is used to inject medication directly into the penis. The medication allows blood to flow into the penis, creating an erection.
Intraurethral suppositories
An applicator containing a small pellet (suppository) is inserted into the urethra and the pellet is released. The pellet dissolves and increases blood flow to the penis,creating an erection.
What is a penile implant?
A penile implant is designed to be a permanent solution for a man suffering from ED and a concealed support for an erection whenever and wherever desired.
The implant procedure is usually done on an outpatient basis. A small incision is made in the scrotum or above the pubic bone and a urologist inserts all components through this small opening. The procedure is performed under anesthesia. It generally takes a few days to return to your regular routine of light activity. Urologists typically instruct men to wait 4 to 6 weeks before using the implant for sexual intercourse.
A penile implant may provide a permanent option for men who have tried other treatments without success or satisfaction.Compared with other treatment options, the implant provides spontaneity — it allows you to have sex when the mood strikes and the erection can last as long as you want it to last.The implant is discreet and entirely contained inside your body — there are no visible components so it would be difficult for someone to know you had this device.
Features of a penile implant:
- Designed to be a permanent solution for ED
- Spontaneous — you can have sex when the mood strikes
- Once activated, the erection can last as long as you desire
- Entirely contained inside the body — no one knows you have one unless you tell them
- Designed to feel natural during intercourse
- High patient and partner satisfaction reported
- Typically does not interfere with ejaculation or orgasm
Risks of a penile implant:
- Will make natural or spontaneous erections as well as other interventional treatment options impossible
- There may be mechanical failure of the implant, which may require revision surgery
- If the implant needs to be removed and replaced, the penis may become shorter, curved or scarred
- Pain (typically associated with the healing process)
- Men with diabetes, spinal cord injuries or open sores may have an increased risk of infection
Penile Implant Surgery
A penile implant is a device that can help a man achieve and sustain an erection. When other treatments have been unsuccessful, you may be a good candidate for this minimally invasive procedure. Penile implants offer many advantages such as:
- Patient Satisfaction: Over 93.8% of patients report satisfaction, far outpacing satisfaction levels for Viagra (51.6%) or injection therapy (40.9%).
- Natural Appearance: Achieve and maintain a natural looking erection at any time with normal sensation.
- Minimal Recovery Time: Following the minimally invasive outpatient procedure, a short four to six-week recovery period is all that is needed before the implant can be used.
- Insurance Coverage: Most insurance, including Medicare, cover the implant.
What penile implant is utilized by AUC?
Devices by Boston Scientific
Boston Scientific offers three types of three-piece implant:
AMS 700™ LGX Penile Implant
- The only penile implant on the market with cylinders designed to expand in length 10-25% depending on patient anatomy
- Cylinders designed to address the #1 concern men with ED have — loss of penile length
- Controlled expansion is designed to provide maximum rigidity and optimal girth expansion
- Firm, rigid erection that can last as long as desired
- Natural, flaccid appearance when deflated
AMS 700™ CX Penile Implant
- Controlled expansion is designed to provide maximum rigidity and optimal girth expansion
- Firm, rigid erection that can last as long as desired
- Natural, flaccid appearance when deflated
AMS 700™ CXR Penile Implant
- All the benefits of the AMS 700 implant series, including girth expansion for patients who may require narrower cylinders
- Controlled expansion is designed to provide maximum rigidity and optimal girth expansion
- Firm, rigid erection that can last as long as desired
- Natural, flaccid appearance when deflated
Devices by Coloplast
There are two basic types of penile implants that Coloplast offers:
The Titan Touch® inflatable penile implant
The Coloplast Titan Touch inflatable penile implant is a self-contained, fluid-filled system made from Bioflex and silicone. Titan penile implant is designed to mimic the look and performance of a natural erection.
Its unique features include:
- Maximized Girth and Rigidity – Coloplast implants provide greater girth and rigidity compared to other cylinders on the market. Sizes range from 11 cm to 28 cm.
- Natural Appearance – Designed to emulate the look and performance of a natural erection.
- Ease of Use – Titan Touch pump is easy to locate, inflate and deflate.
- One-Touch Pump – Titan Touch is the only penile implant pump with a true one-touch release. It only requires a momentary compression of the deflation button to allow a complete fluid transfer out of the cylinders.
- Innovative Cloverleaf Reservoir Design – Only penile implant featuring a Lock-out™ value on the reservoir to help prevent against the 2% need of surgical revisions due to auto inflation.
- Lifetime Replacement Policy – Coloplast provides a lifetime replacement policy with all of its penile implants. The inflatable implant, or any component, can be replaced due to device malfunction.
The Genesis™ flexible rod penile implant
The Genesis® is a flexible penile implant that consists of two firm but flexible rods that are placed into the shaft of the penis. There are no other parts to this implant. To have an erection, you simply hold the penis and move it into the desired position. When you are finished, you bend it back down to conceal it. The malleable penile implant can be a good option for men with limited dexterity.
Both enable men with erectile dysfunction to have a satisfactory erection for sexual intercourse and to experience the joys of sex again. You should be able to have an orgasm with a penile implant if you were able to have one before your surgery, unless you have another medical problem that affects it. Consult your physician about this. The primary difference between the two implant types is that flexible rod implants (the Genesis) produce a permanently firm penis, while the inflatable implants (the Titan) produce a controlled, more natural erection.
Frequently Asked Questions
Will my penis look different to me or will others notice a penile implant?
Once in place, your implant will be completely undetectable. It’s fully concealed in the body. No one will know unless you tell them—even in the locker room.
Will I lose any length after getting a penile implant?
Each penile implant is custom fitted to your anatomy. Discuss this in greater detail with your physician.
Will I be able to have spontaneous erections with a penile implant?
In order to place the implant in the body, the corpora containing the spongy tissue is removed to make room for the cylinders. If you are still able to have erections on your own, which are satisfactory for intercourse, you should consider very carefully whether or not an implant is the right fix for you. However, if you cannot have erections or if they are not satisfactory for intercourse, then an implant will be able to provide you with a more “instant” erection when compared to pills, or vacuum devices.
What is the recovery time?
Each individual is different and therefore their recovery will be different as well. Typical recovery is between 4-6 weeks. Your physician will determine what you can and cannot do during this time. It is important to follow the recommendations that your physician gives to you to ensure the best outcome.
Is the cost of a penile implant covered by insurance?
A penile implant is prescribed by your physician. Most insurance plans, including Medicare, cover the implant. Check with your physician’s office to determine your actual cost.
Are there risks associated with the penile implant?
As with any surgery, there are some risks associated with the penile implant procedure including pain, anesthesia reactions, repeat surgery due to infections, or mechanical problems with the device. Discuss this in greater detail with your physician.
Will anyone notice that I have an implant?
Since the implant is completely placed inside your body, no one will see the implant. In fact, no one will know unless you tell them.
Can I have an orgasm with a penile implant?
You should be able to have an orgasm with a penile implant if you were able to have one before your procedure. Consult your physician about your expected outcome.
