Loss of erectile function is not always amenable to conservative treatment or is the result of a psychological disorder. Especially for advanced cases, implants in the penis have been developed to help get rid of impotence.

What is penile prosthetics?

Anatoly Krivulin

Surgeon

Endophalloprosthetics is a radical method of restoring rigidity by surgery. Surgical intervention consists of replacing the cavernous (cavernous) bodies inside the penis with a phallic (phallic) implant. The body, the appearance of the penis, ejaculation are not affected. A man is able to lead an absolutely normal sex life.

The indications for prosthetics are:

• Peyronie’s disease, manifested by a violation of blood filling due to the replacement of functional tissue with connective tissue;
• fibrosis of the corpora cavernosa;
• acquired or anatomical (congenital) defects of the genital organ;
• venous or arterial insufficiency that cannot be corrected by microsurgical techniques;
• impotence associated with such endocrine disorders as diabetes mellitus and other hormonal congenital pathologies;
• sexual disorder resulting from a previous surgical intervention – revascularization, an attempt to increase the size of manhood.

Psychogenic impotence can also be a reason for implantation if conservative methods have not helped. The operation is never appointed immediately, since this is a rather serious step. Conservative techniques are always used first.

Phaloprosthesis

Contraindications to the operation are poor blood clotting, exacerbation of prostatitis, uncontrollable painful, prolonged erection (arterial priapism), mental disorders when the patient is inadequate.

It must be understood that such a surgical intervention is irrevocable. Further sexual life is already completely dependent on the functioning of the prosthesis. If it fails, then a replacement will be required. Its removal leads to the fact that the man can no longer have an erection, since the cavernous bodies are destroyed irrevocably.

Types of implants

Phalloendoprosthetics is performed using implants of various designs. They are selected according to physiological indicators (anatomical features), financial capabilities, personal wishes, and are divided into three groups:

• Silicone semi-rigid. Not managed. They are always in an excited state, snuggling against their underwear. The cheapest and most inconvenient. Today, prosthetics using these structures have practically ceased.
• Plastic. They belong to the managed. There is a strong rod inside that allows you to adjust the position of the prosthesis by hand. The “body” is made of silicone.
• Inflatable (hydraulic). The most physiologically suitable, allowing you to almost completely imitate a natural erection.

The main disadvantage of a semi-rigid prosthesis is that implantation with a similar design leads to a decrease in the penis in an erect state by 2-4 centimeters.

Penis prosthetics

Denture design

Endoprostheses differ in structure:

• One-component. Semi-rigid (plastic), consisting of a wire-based silicone cylinder. No additional elements are present.
• Two-component. They consist of cylinders that replace the cavernous bodies, as well as pumps with a reservoir. The latter are installed in the scrotum. The elements are connected to each other by flexible tubes.
• Three-component. They have a design similar to the one described above, but with additional capacity, being the most advanced among the manufactured implants.

The most widespread are the latter. They are as easy to use as possible, repeating the anatomical shape of the phallus.

Penis prosthesis

How much does penile prosthetics cost?

The cost of endophaloprosthetics is due to two factors:

• the type of implant that is being installed;
• qualifications and experience of the surgeon performing the operation.

Another important point is the clinic. The more modern it is, the higher the prices.

The price for a one-component prosthesis varies between 60-140, two-component – 200-300, three-component – from 350 thousand rubles and more. The place of purchase also matters. From official distributors, the price will be lower than in the clinic, but it is difficult to purchase an implant on your own.

Falloprosthetics

The cost of surgery is complex. It all depends on the type of implant. The more complex the design, the more expensive the operation, since the work is more painstaking. Anesthesia is included in the price list.

Implantation progress

Falloprosthetics is prescribed exclusively as a radical measure for treating a patient when medications, physiotherapy and other conservative methods are powerless. It is a complex surgical intervention that requires preliminary preparation:

• Preliminary consultation to confirm the possibility of prosthetics. The structure of the genitourinary system may be such that the installation of an implant is undesirable or impossible.
• Conducting an examination to exclude the presence of tuberculosis, sexually transmitted diseases, cancer, diseases of the cardiovascular system.
• Psychological preparation, which consists in clarifying the fact that further treatment of impotence will become impossible. If, for example, an operation is performed, it will be impossible to remove the implant and undergo therapy even if there are other methods of treating the dysfunction.
• Selection of the correct model according to the length of the phallus and taking into account the design features. Least of all length is lost when choosing a three-piece device.

Prosthetics are performed under spinal or general anesthesia. The total duration of the operation is 40-90 minutes or 8-12 hours for complex implants. 

The course of surgical intervention may include the following stages:

• Removal of carious bodies by bougienage. Cylinders or rigidity chambers are implanted into the “released” cavity.
• An incision is made on the scrotum and a pump is implanted if it is a two- or three-piece prosthesis.
• If an inflatable implant is inserted, an incision is made at the bottom of the peritoneum and a reservoir is placed behind the frontal bone. This protects the “container” from damage.

Visual aesthetics are of great importance. To make the seam invisible, use various techniques and threads. This makes it possible to almost completely “mask” the traces of interference. Detailed information can be found in the video, which allows you to better understand the features of the procedure.

In order for the prosthetics to be successful, you must follow the doctor’s instructions exactly:

• For the first two days, strict bed rest is observed. Sometimes the time increases to 3-4 days. It all depends on the degree of complexity of the surgical intervention.
• Often, the patient is given antibiotics prescribed in the presence of any concomitant diseases. In the first 48 hours, they are administered intravenously, and in the next 5 days orally.
• For the first four days, a man must be hospitalized. When everything is successful, the doctor may allow you to go home earlier.
• The stitches take two to three weeks to heal. You should not worry about painful sensations and swelling. They pass in a month.

Correct recovery means abstaining from intercourse for 1.5 to 2 months. You can not start a sex life without first consulting a specialist.

Falloprosthetics operation

How to use a halyard prosthesis for men?

The skill of “managing” the implant is mastered rather quickly. In hydraulic models, you need to learn how to handle the pump before direct sexual contact and after to pump out the solution. Prosthetics have no effect on the ejaculation process (semen secretion) or sensitivity. Almost 97% of men who have undergone the procedure receive complete satisfaction when they reach orgasm.

On a note! Many men are interested in the question of whether others will be able to find out about his “secret”. Visually, a small scar may not be visible at all. No discomfort in the locker room, sauna, shared shower in the gym.

An artificial erection, according to some men, lasts less than their natural one before. The new models are practically devoid of this drawback, but they have a corresponding high price. It is also necessary to take into account the fact that the operation is carried out due to complete sexual dysfunction, which negatively affects its own excitability.

The best prostheses for the penis

To choose the right implant, several factors must be considered:

• quality, which is guaranteed by the manufacturer and the corresponding certificates;
• performance material that meets safety standards, minimizes the risk of rejection, compatible with human tissues;
• the size that is selected according to the anatomy of the penis and allows you to lead a full sex life.

The products of two American companies “Coloplast” and “AMS” have proven themselves to be excellent. They are presented in a size grid from 14 to 20 cm.

Differences between two-piece and three-piece phalloprosthesis

Endoprosthetics can be performed with two different types of inflatable implants – two- and three-component. The first ones consist of cylinders and a silicone pump, and the second ones are additionally equipped with a 100 milliliter reservoir, which is sewn into the area near the bladder under the abdominal muscles. The latter is much easier to use. 

The filling of the two-component phalloprosthesis is carried out by pressing the pump sewn into the scrotum three times. Its deactivation is carried out by bending the phallus down. This action leads to the fact that the liquid will flow into the reservoir after 6-12 seconds. The disadvantage is an insignificant thickening during erection and incomplete relaxation in an unexcited state.

The three-piece implant features an improved design. The sterile solution fills the balloons after pressing the valve in the scrotum. The saline solution is pumped out by pressing on another place. Its use allows you to get a full imitation of a real erection. The phallus thickens noticeably when excited and relaxes. The downside is the high price and the complicated structure, which increases the risks of being broken, and the complex installation.