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Penile Implants as Treatment for ED



Penile Implants as Treatment for ED
Penile implants or prostheses are another alternative for men who choose not to use injections and in whom oral medications fail. In the right patient a penile implant is a blessing; in a poorly selected patient it can be a nightmare. Prosthetic penile implants have been available since the 1970s.
Unfortunately, the early devices were plagued with malfunctions, infections and erosions resulting in a bad reputation. Deciding to have a penile implant is a very important decision for a man and there are many factors that need to be considered by both the patient and the implanting surgeon. Our personal feeling is that penile implants are the last resort. Men with erectile dysfunction who are unable to achieve a satisfactory erection or maintain an erection and rigidity required for penetration are candidates but the man should also have tried all other therapeutic options. When these options have failed or the man doesn't feel they are applicable to his lifestyle, a penile implant is indicated.

The candidate for penile implant will have the full diagnostic work, including a color flow Doppler examination. Although many urologists have some working knowledge of penile implants, only a surgeon who regularly performs this procedure has the experience necessary, especially when confronting the difficult situations or complications that may arise during the implantation process. It's also important to ask about the number of devices the surgeon has implanted. At least 25 procedures per year are necessary to maintain clinical competence in this arena. If the surgeon does this procedure only infrequently, the patient should ask for names of other surgeons at a referral center. Many of these names are well-known to the urologic community; some information can be even obtained on the internet.

The next step is deciding what type of device to choose. A wide variety of these devices exists, so a good initial question is whether you want a semi-rigid implant or an inflatable implant. Using a car analogy, we generally look at the 3-piece inflatable device as the gold standard or Cadillac. Nothing else is quite as effective. Again, these are important questions to ask your surgeon before considering these devices.