A penile implant is a medical device that is implanted in the cavernous bodies (erectile bodies of the penis). It is therefore not visible on the outside, but it is integrated into the male genitalia. The components of the implant are inert biomaterials, known to be generally well accepted by the human body, such as pacemakers, breast prostheses and testicular prostheses.
A penile implant is an effective treatment option for men with symptoms of severe and irreversible erectile dysfunction. The penile implant can help men who have difficulty getting or maintaining an erection, as well as those who cannot achieve an erection at all. It can also help men whose erections are not firm enough for sexual activity.
There are 3 types of implants possible:
Pour ces hommes bien choisis, sans limite d’âge et avec des attentes réalistes, un implant pénien peut être la meilleure option. Les hommes avec un implant peuvent avoir une érection à tout moment et la maintenir le temps qu’ils veulent sans l’utilisation de médicaments ou d’un appareil externe, ce qui permet une plus grande spontanéité. Il y a cependant une absence d’érection du gland.
Any man with erectile dysfunction who does not respond to medical treatment (drugs such as Viagra, Cialis, Levitra and intracavernous injection) is a candidate for the insertion of a penile implant.
The most common indications for penile implant placement are cardiovascular problems and diabetes. Men with erectile dysfunction after radical prostatectomy are also candidates for a penile implant.
Less than 10% of urologists routinely perform penile implant surgery. Dr Hellel Majed is a trained urologist in this surgery. These patients are operated on in the best private clinics in Bizerte and Tunis.
In Tunisia, there are two penile prosthesis firms: AMS from Boston scentific (American brand) and Zephyr (Swiss brand).
The price of the semi-rigid penile prosthesis in Tunisia of the Zephyr and the AMS type is 4000 dt. The price of AMS two-compartment inflatable penile prosthesis in Tunisia is 10 000 dt. The price of Zephyr three-compartment inflatable penile prosthesis in Tunisia is 16 000 dt. The price of AMS three-compartment inflatable penile prosthesis in Tunisia is 25 000 dt.The penile implant only corrects the erection problem. It allows a man to get a hard erection which is sufficient for intercourse. Insertion of a penile implant does not affect sensation or orgasm. If a man has normal sensations in the penis before penile implant surgery, he will usually have the same sensation after a penile implant. This one won't give you a feeling if you don't normally have one.
Additionally, it does not increase or decrease a man's ability to have an orgasm. The penile implant is an effective treatment option for men with erectile dysfunction. The cost of penile implant surgery is usually covered by medical insurance.
Usually the penile pump refers to a vacuum erection device (VED) which is different from the penile implant. Some patients refer to the penile implant as a penile pump. It is important to understand that there are two types of treatment for erectile dysfunction that are very different: the external vacuum pump device and the inflatable penile implant.
It consists of penile implants, a pump and a reservoir. This is considered to be the best type of penile implant available for most men. We use the AMS 700 ™ 3-piece inflatable implant. It has two inflatable cylinders. They are located inside the shaft of your penis. The pump is located in the scrotum. The water reservoir is located in the inguinal region.
You or your partner gently squeeze the pump into the scrotum several times. When this happens, the inflatable element inside the body of the penis inflates, creating a real erection anytime you desire. To deflate, you simply need to put constant pressure on the pump.
We use the AMS 700 ™ 3-piece inflatable implant. It gives the most rigid erections. It also provides a softer penis when not in use. This is the implant that is closest to a natural feeling, whether at rest or when erect. The pump is smaller, so less noticeable in the scrotum. It requires learning and some skill.
All inflatable implants have the possibility of leakage or pump malfunction requiring reoperation (overhaul). However, there is a risk of deformation of the cylinders which may require remodeling.
This implant is composed of a penile implant and a pump. Unlike the 3-piece implant, it does not have a reservoir. Only a small amount of liquid is actually transferred to the cylinders during pump pressure. Erection is easier to achieve. To deflate, you simply have to bend the penis downwards.
This implant is sometimes offered when it might be difficult to place a reservoir after surgery. The two-piece inflatable penis implant is ideal for men who don't have a lot of dexterity in their hands. In the flaccid state (at rest), the penis is less natural. The AMS Ambicor Inflatable Implant is a 2 piece inflatable penile implant without a reservoir. The erection is less rigid than the 3-piece implant. The pump-reservoir is larger. It is sometimes palpable and visible in the scrotum.
All inflatable implants have the possibility of leakage or pump malfunction requiring reoperation (overhaul).
It is a non-inflatable prosthesis which is very easy to use. This type of implant is rigid. It does not inflate and does not deflate. You or your partner simply needs to bend the penis upward from the implant to create an erection. When not in use, just fold it down.
While there are advantages to this implant including its ease of use, there may be disadvantages. Its comfort is rather limited. Since the penile implant is still present, this can be embarrassing for many men. It corresponds to a permanent erection.
However, it is the easiest to install and the most affordable. This is a good option for men who want simplicity and ease of use. In particular, the semi-rigid penis implant is the preferred option for men with reduced dexterity.
What should you consider when choosing penile implants?
Your doctor can help you choose the best penile implants based on the results you hope to achieve. Your satisfaction is important. However, there are limitations and various factors to consider. In choosing an implant, you and your doctor should discuss a number of topics, including:
The penile implant is placed under the skin of the penis. It is located inside the shaft of your penis. When the implant is not in use and it is not inflated, no one will know you have it. It does not protrude from the pants when deflated. When the penile implant is inflated before sexual activity, the penis appears to erect like a normal erection. Looking at the penis, one cannot tell if it is a natural erection or if the erection was achieved with a penile implant.
In the majority of cases, the procedure that takes place without complications. However, any surgery involves a number of risks and complications. Some complications are related to your general condition and to the anesthesia. Complications directly related to the procedure are rare, but possible.
The major risk is infection. It can be early (in the days following the operation) or late, sometimes several months or years later. Certain medical conditions favor infection, such as diabetes, a history of radiation therapy pelvic or pelvic trauma with urethral injury, acute or chronic infections (urinary, sinus, dental, etc.), and certain neurological conditions.
In this case, the simple administration of antibiotics is often not sufficient. The penile implant often needs to be removed with new anesthesia. Usually, several weeks or months after removing an implant after an infection, he it is possible to attempt a new implant. A second implantation is more difficult and the risk of a new infection is not negligible.
A hematoma can also occur. It can be removed surgically or resolve on its own if it is small.
Mechanical implant failure can occur in the medium or long term and may require total or partial surgical change. After 15 years, 60% of implants required a new intervention. The lack of sexual satisfaction despite a Proper functioning of the implant may be related to a decrease in the length of the penis with the implant inflated, or to a soft or sensitive glans. Any surgery carries a number of risks due to individual variations which are not always predictable.
The level of satisfaction with a penile implant settles on average after the first year after the operation. Patients and their partners are generally more often satisfied with the results if they have been well informed, with realistic expectations of the penile implant. The complicity of the partner is important.
Regardless of the model chosen, the couple report a high degree of lasting satisfaction with penile implants. Some patients who have received an implant after Peyronie's disease, radical prostatectomy, or who are obese have some degree of dissatisfaction. More than 90% of patients treated for erectile dysfunction are satisfied with an implant, while 51% are with iPDE5 and 40% with intracavernous injections. The patient should expect a decrease in the size of the penis following the placement of the cylinders in the intracavernous tissue.