The surgical procedure may aim to treat selected functional alterations. The possibility of using a particular size or caliber of a prosthesis depends on the anatomy, the condition of the tissues, the existing deformity and the assessment carried out in the context of each case. Before surgery, the objectives, limits, risks and therapeutic alternatives should be discussed.
The placement of a penile implant is indicated for men who have lost the function of the penis and currently experience difficulties during sex, such as a lack of rigidity for penetration.
The penile prosthesis is indicated when the patient, despite the use of medications, presents with a loss of vertical resistance for penetration, that is, when the penis does not have the firmness necessary to overcome penetrative resistance and, during sexual intercourse, may slip and/or bend.
The penis is a hydraulic column, and the penile prosthesis serves to create the structural rigidity necessary to prevent collapse of the penile column. In many cases, the patient can even penetrate, but during movement the penis bends and slips easily, which makes sexual intercourse a very embarrassing situation.
This is the case for patients affected by Peyronie’s disease, diabetes or who have undergone prostate surgeries, among other health problems. These may be cases in which, in addition to the deforming aspect, there is an impact on the functionality of the penis – and it is the recovery of this function that should be the patients’ concern.
Find out when to consider a penile implant.
The objective is not to achieve a longer or more “attractive” penis, and therefore the traditional before-and-after images common to aesthetic surgeries need not cause patients fear.
Penile Implant for Peyronie’s Disease
Generally, until the patient is indicated for a penile prosthesis implant, the tissues may lose elasticity as a result of fibrosis. This results in a smaller and retracted penis.
A preoperative outpatient assessment is important to determine what has been lost with regard to size. This is the best time to offer the patient the possibility of performing penile reconstruction geometrically defined by the “Egydio TEP Strategy” together with the penile prosthesis implant.
It is worth emphasizing that penile reconstruction is important, because the prosthesis alone cannot increase the dimensions of a diminished penis.
Before knowing the result of the surgical procedure, it is important to clarify that specifically the treatment for severe cases of Peyronie’s disease may combine two strategies in a single operation: penile reconstruction based on the Egydio Technique followed by the implant.
Penile reconstruction aims to correct the organ’s deformities, according to geometric principles systematized by urologist Dr. Paulo Egydio. For this, multiple horizontal and/or vertical incisions are made that will allow tissue expansion so that the penis is straightened and so that the patient obtains an expansion of diameter and/or length relative to the current state of the penis.
In the second part of the surgery, penile prostheses are placed, indicated only for men who have lost rigidity in the organ. They can be malleable, articulating or inflatable, a decision that should be made together with the specialist to choose the one that best suits you, always respecting your anatomy.
If the penile implant is not performed together with the reconstruction, the prosthesis placed may be disappointing, as it may not meet expectations due to the size and caliber that could have been improved.
Attention: after surgery, the penis will not necessarily increase compared to its original size.
It will be corrected up to the limits of the vessels and the urethra, which is the possible limit within penile reconstruction. This limit varies from patient to patient and can only be determined intraoperatively. When this limit is reached, with the penis elongated, the implantation of the prosthesis is performed with the objective of maintaining the penis elongated at that new size and girth.
Penile Implant Before and After Surgery: Expectations, Possible Outcomes and Follow-Up
In Brazil, the dissemination of result images in medical advertising must have an educational purpose and comply with the rules of the Federal Council of Medicine, including preservation of the patient’s anonymity and privacy. When used, images should be accompanied by information about therapeutic indications, factors that may influence results and possible complications, without suggesting a promise of individual outcome.
Surgery can change the appearance of the penis, but the anatomical and functional evolution varies according to the clinical situation, the indicated technique, healing and other individual factors. Potential benefits, limitations and risks should be clarified before the therapeutic decision.
Size
When there is a clinical indication to associate penile reconstruction and prosthesis, the anatomical and functional results may vary. The technique eventually chosen, its limits, risks and alternatives should be discussed on an individualized basis, without predicting a specific result in terms of length or caliber.
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- The penis may become larger than in its original state, that is, before the progression of the disease.
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- The penis may remain the same size or very close to its original state.
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- The penis may be smaller than the original, but larger than it was due to the disease-related reduction.
The sizing of the prosthesis is defined during the procedure according to the anatomy and the clinical limits identified by the surgeon. Healing and the dimensions observed after the operation may vary, so it is not possible to ensure absence of retraction nor exact maintenance of the measurements obtained during surgery.
Function and Appearance
Anatomical and functional results may vary according to diagnosis, erectile function, the extent of the deformity, the indicated technique and healing evolution. The intervention may aim to improve certain aspects of the deformity or function, without ensuring alignment, penetrative capacity, sexual performance or absence of scars and residual deformities.
After the penile prosthesis implant, the appearance of the penis and the position of the foreskin may vary according to anatomy, the type of prosthesis, healing and postoperative evolution. Before surgery, the patient should receive individualized information about the changes that may occur and about their respective limits.
In hydraulic penile prostheses, the appearance and the possibility of penis positioning may vary depending on the type of device, anatomy and each patient’s evolution. These characteristics should be explained during the consultation, according to the model eventually indicated.
In terms of urinary flow, in general there are no changes. The prosthesis is lodged in the corpora cavernosa, a part of the penis separated from the urethra, so that the act of urination tends to be preserved.
But it is when we talk about the sexual function of the organ that we find the main change before and after surgery.
Resumption of sexual activity should be authorized by the care team according to recovery, healing and absence of complications. The timeframe may vary between patients. The prosthesis may contribute to the rigidity necessary for sexual activity in selected cases, but functional results should be evaluated individually.
The penile prosthesis acts mainly on penile rigidity and does not replace the neurological, psychological, relational and clinical factors involved in pleasure and orgasm. Sexual experience and rigidity after orgasm may vary, and these aspects should be clarified individually before the procedure.
Learn what sex is like with a penile prosthesis.
Erectile dysfunction and other penile alterations can have emotional, sexual and relational impact in some patients. The decision about a penile prosthesis should result from individualized clinical assessment and an informed discussion about indications, potential benefits, limitations, risks and alternatives, without using testimonials as a prediction of experience or outcome.
