PENILE PROSTHESIS AND DIAGNOSIS
SYMPTOMS AND TREATMENTS [EBOOK]
What is the Penile Prosthesis used for?
Unlike what many men think, the need for a penile implant is not cosmetic. Despite having a positive impact on this aspect, its main function is to solve problems in the functionality of the penis, aiming to provide the necessary rigidity for sexual intercourse.
Before delving into the subject, it is important to make it clear that penile prosthesis is not used to increase the size of the penis, a myth that is very widespread among men.
The device helps in treating erectile dysfunction and provides good penetrative ability.
The lack of firmness in the limb can be related to the difficulty to maintain an erection or, in rarer cases, to the fact that the penis is thin and long. The relationship between the length and caliber of the penis is very important and, therefore, must be studied by the doctor before any decision is made.
Penis reduction and thinning care
As important as the surgery to implant the prosthesis is to assess whether the penis is shrinking, or thinning, to consider the multiple relaxation incisions and to expand the tissues of the penis with the aim of recovering the lost measurements.
This condition is an effect of other problems that can lead to the need for the implant and is usually associated with cases of acquired penile curvature, also known as Peyronie’s disease. This does not happen to all men, but it is important to be aware of this issue to seek an efficient treatment.
Due to the poor quality of the erection, some men do not notice this loss, so it is important to make sure your doctor makes this assessment. Currently, one way to carry out this study is through an exam with artificially induced erection, combined with a high definition ultrasound.
In situations where size loss is identified, in addition to the implant, it is important to consider performing penile reconstruction before implanting the prosthesis. Penile reconstruction aims to expand the tissues of the penis to receive a larger and greater caliber prosthesis.
It is possible to perform penile prosthesis implantation associated with geometrically calculated reconstruction, all in the same surgical procedure. Learn more about the Egydio Technique on page 34 of this guide.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
What are the advantages and disadvantages of placing a prosthesis?
The advantages of penile prosthesis implantation are many and can include both physical and psychological aspects. The procedure can bring numerous benefits to the patient’s quality of life, some of which are listed below:
Recovering stiffness and penetrative ability
The prosthesis is indicated for men who have lost penile rigidity due to erectile dysfunction. When drug treatment does not work or is not recommended, the implant will be responsible for recovering the health of the penis and providing a performance with quality and safety, which satisfies the couple.
Regaining self-confidence
Men with erection problems end up adding other psychological factors that directly interfere with their well-being. The lack of confidence in knowing if the penis will work during sex can even worsen the quality of the erection.
The prosthesis will allow him to be ready and will leave the patient ready to surprise his/her partner with a firm erection, until the end of intercourse.
Preventing Peyronie's Disease
Acquired Penile Curvature, or Peyronie’s Disease, occurs by the formation of scars in the tissue that covers the corpus cavernosum of the penis. Often these scars are formed by trauma or micro-trauma during sexual intercourse, cracks that tend to happen when the penis is not rigid enough to perform penetration safely. This is where the prosthesis comes into action, providing the best possible rigidity to allow a pleasurable act without discomfort for the couple. If, when treating Peyronie’s Disease, the erection problem is not solved, the penis will likely bend again.
Resuming sex life
There is no age to retire sex life. Many men with dysfunctional problems, sometimes at an older age, end up giving up on this important aspect of life because they feel there is no way out. The reality is that there is a solution, and the prosthesis can be a great ally to maintain a healthy and active practice.
Is there a downside to penile prosthesis?
Among so many positive factors in placing a prosthesis, only one issue can be considered a disadvantage: financial planning.
As in Brazil there is still no full coverage of health plans for this type of treatment, the available budget can be an obstacle to overcome. On the bright side, in many cases it is possible to request a partial refund of the investment from your health plan, but this should be analyzed on a case-by-case basis.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
What types of penile prosthesis are available?
There are different types of penile prosthesis on the market. Knowing the different styles and features is essential for those who need this treatment.
The choice of the type of prosthesis to be used, however, will depend on a pre-assessment at the time of the medical appointment. In addition to patient preference, other factors are evaluated for the decision, such as medical condition, lifestyle and costs.
Learn about the different types of penile prosthesis by clicking on the links below:
Know how a malleable or semi-rigid penile prosthesis work
Good rigidity and malleability of the penis. These are the main characteristics of the malleable or semi-rigid prosthesis, which also has the advantage of not having liquid leaks, rarely stopping working and having a low need for replacement, especially when compared to inflatable models.
The two rods – metallic filaments wrapped in silicone – make it easy to disguise the everyday erection by making the penis malleable and allowing it to be gently accommodated down or to the sides. At the time of sex, just place it in the straight position and you are ready to start intercourse.
On the other hand, the degree of malleability of the penis and the sensation of residual erection do not depend only on the type of prosthesis.
A satisfactory result will mainly depend on an adequate surgical procedure that preserves the internal structures of the corpora cavernosa.
The great differential for a better result is the reconstruction of the tissues aiming at the recovery of the size and caliber of the penis, associated with the correct sizing of the implant in the reconstructed organ. When the prosthesis is placed without reconstruction, the chances of patient dissatisfaction are high.
Know how an inflatable penile prosthesis works
The greatest advantage of this type of prosthesis is the possibility of inflating and resuming the flaccidity of the penis when it is most convenient. This makes many men consider it the more discreet option, however, it has a functioning that requires more attention.
In this type of implant, the man produces an erection by manipulating a pump housed in the scrotum with saline solution. The liquid travels through the cylinders implanted in the penis, which activate the hydraulic system and inflate them. Simply press the deflate button on the pump, which is placed in the scrotum for a few seconds so that the liquid returns to the reservoir and resumes its resting position.
The inflatable prosthesis can have two or three volumes and both work in a very similar way. The difference is that the three-volume one allows greater exchange of liquid in the system, allowing greater filling of the cylinders when activated for erection and, consequently, greater sagging when deactivated. This is because this model, in addition to the two cylinders and the pump, also has an extra reservoir of saline solution installed imperceptibly in the patient’s abdomen.
The disadvantage of the inflatable prosthesis, be it two or three volumes, is the possibility of saline solution leakage. Because it is more complex, its system is subject to mechanical failures due to liquid leakage, pump lockup and loss of resistance in the cylinder walls, which may require a new surgery for replacement.
In this case, the surgeon’s experience and skill is even more important, both during implantation and when connecting the entire system, in order to avoid possible problems.
Usually, this prosthesis is indicated for patients who are more concerned with discretion, usually younger men, or for those who have organic problems with blood filling in the penis, in which the malleable prosthesis would not solve satisfactorily. This issue, however, is deeper and should be discussed during a face-to-face medical evaluation.
Know how an articulated penile prosthesis work
The articulating prosthesis can be bent more easily than the malleable one. In addition, it is coated with silicone, which makes it even easier to hide the erection. However, the small articulated sections that make up the prosthesis contribute to a scenario of lower penetration firmness, also known as low vertical or axial rigidity.
It is a less popular penile implant model than the others, but it is important to know the existence of this model to solve all doubts about the types of prosthesis.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
What is the relationship between penile prosthesis and erectile dysfunction?
The penile prosthesis is indicated for patients with problems in the functionality of the penis, that is, when the lack of rigidity makes the relationship less pleasant or impossible.
The most accurate way to diagnose the need for an implant is through a functional examination. It must be done by a specialist doctor, who will artificially induce an erection and perform a detailed ultrasound of the penis.
The difference between erectile dysfunction and sexual impotence
When hearing about impotence and erectile dysfunction, it is important to know that the two terms mean the same medical condition. The choice of the name erectile dysfunction to classify the clinical picture of erection problems in a patient is a recent term, since sexual impotence has been classified as pejorative by most men and health experts.
With this explained, it is important to understand that erectile dysfunction is a disorder characterized by the difficulty in obtaining and/or maintaining an adequate and sufficient penile erection for satisfactory sexual activity, from penetration to ejaculation.
According to research by the Brazilian Society of Urology , this condition affects half of men between 40 and 70 years old, and can also affect younger men, and has different degrees of intensity, ranging from mild to severe.
For reasons of misinformation, fear or shame of looking for a professional for the appropriate treatment, many men end up compromising their relationships, failing to enjoy a healthy and happy sex life, with quality of life. Therefore, knowing the problem, overcoming prejudice and seeking specialized medical help are decisive factors in treating erection problems.
Why see a penile prosthesis specialist
Despite being a delicate topic that generates many doubts for men, especially about how the penis will function after the prosthesis, there is no reason to worry if the procedure is done correctly. Receiving care and specialized medical advice are important aspects to make penile implants a safe and efficient treatment, not only for the man but also for his partner.
To aim for a good result, however, it is important to be aware of some special care that will directly influence your pleasure and self-esteem. Patients who place the implant without taking into account the reduction in penis size, for example, are usually dissatisfied with the final result.
When this happens, there is a solution, but it is a little inconvenient. It is necessary to remove the prosthesis and repeat the procedure, this time with penile reconstruction. The new prosthesis will be placed in the same act, this time with a larger caliber and size.
To avoid this type of situation, it is essential to evaluate the doctor’s experience and the techniques that will be used for penile prosthesis surgery. A trained professional will make the best surgical approach for each case and will choose the most appropriate type of implant, together with the patient.
The prosthesis, when implanted correctly, preserves as much as possible the structures, tissues and nerves linked to the pleasure, sensitivity and temperature of the penis.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
What are the causes and consequences of erection problems?
Erection problems can happen to men of any age. They can have psychological causes (such as anxiety, stress and depression) or physical causes, such as hormonal problems, excessive alcohol consumption, diabetes, trauma to the penis, cardiovascular diseases, prostate surgeries, among other factors.
Understanding what causes erectile dysfunction is important both in its prevention and in the search for the most appropriate treatment.
Erectile Dysfunction and Testosterone
The proper functioning of the smooth muscles of the corpora cavernosa depends on good levels of testosterone to maintain the function of relaxation and contraction of the penis, which will directly impact the quality of the erection and its maintenance.
That’s why men, especially over 40, should periodically check the levels of this hormone in the body, either through a blood test or by checking the functioning of the testicles.
In addition to erection difficulties, low testosterone can lead to other problems that affect quality of life, such as increased abdominal fat, tiredness and lack of libido.
Erectile dysfunction in patients with diabetes
Diabetes is one of the main causes of erection problems because the disease causes an increase in the amount of sugars in the blood.
A quality erection is directly related to the flow of blood inside the penis, however, the lack of control of sugar levels causes damage to the functioning of blood vessels and nerves, compromising penile rigidity. In some patients, erectile dysfunction can also be a side effect of medications used to treat diabetes.
Erectile Dysfunction, Penile Fibrosis, and Peyronie's Disease
Peyronie’s Disease does not always cause erectile dysfunction, but the opposite is true. Erection problems are the main cause of the development of Acquired Penile Curvature, since the lack of rigidity in the penis during sexual intercourse predisposes the occurrence of trauma, resulting in the appearance of fibrosis.
These fibrosis, which can be internal and/or superficial, limit the elasticity of penile tissues and make them curve. In other words, Peyronie aggravates erectile dysfunction, but it is not the main cause of this male condition.
Erectile dysfunction and prostate surgery
Prostate cancer is one of the most curable types there is, but it can have some consequences for men that must be treated with caution.
Generally, radical prostatectomy is the most suitable treatment for cancer cases, but this directly interferes with the nerves that pass close to the prostate, leaving patients who have undergone this procedure predisposed to developing partial or total erection problems.
Other treatments for prostate cancer, such as radiation therapy, brachytherapy or hormone therapy can also cause erectile dysfunction, so it is essential to have a urologist follow-up throughout the recovery process.
Erectile dysfunction and priapism
Priapism is a prolonged erection lasting more than 3 hours, persistent, usually painful and without sexual stimulation.
One of the causes of this condition is that blood fills the corpora cavernosa, causing an erection, but it does not circulate and is deprived of oxygen. This leads to cell death, causing fibrosis and scarring inside the penis which, in turn, can cause erectile dysfunction.
Erectile dysfunction, vascular problems and high blood pressure
Vascular problems can harden the arteries and slow the flow of blood within the penis, affecting the ability to have or maintain an erection. When we talk about high blood pressure, the disease prevents the arteries, responsible for transporting blood to the penis, from dilating as they should and this prevents the penis from receiving enough blood to remain erect.
Erectile dysfunction, smoking, alcoholism and other drugs
The use of tobacco, alcohol and other drugs, both legal and illegal, can greatly exacerbate the problem of erectile dysfunction. Smoking can lead to vascular disease or other health problems that inhibit blood flow to the penis. Alcoholism disrupts hormone levels and can lead to permanent nerve damage.
Some medications can also affect the blood flow inside the penis, so it's important to see a doctor before opting for a medication and clarify any concerns about its effect on erectile function.
Erectile dysfunction, depression and antidepressants
The use of antidepressants can cause erectile dysfunction due to the interference that these drugs have on the blood flow to the penis. Allied to low sexual appetite, normally observed in patients who suffer from the problem, this contributes to an unfavorable situation for the patient’s well-being.
Attention to psychological erectile dysfunction
The issues caused by erectile dysfunction go far beyond the impossibility of having a full and satisfying sex life. It can cause serious problems to a man’s quality of life. The difficulty of erection can generate low self-esteem and bring several negative feelings to the patient, such as frustration, anxiety and sadness.
When the man is in a relationship, the problem can also bring great upheavals in the intimate relationship, causing fights, arguments and even the breakup.
The fact of not being able to fulfill their sexual desires can also generate psychological problems for men, which will only increase the inability to achieve an erection. Among the causes of psychological origin, sexual dysfunction can generate stress, depression, feelings of guilt and even worsen other problems that are not directly linked to the lack of an erection, such as worries about money, bills to pay, instability at work, among many others.
For these reasons, treatment is of fundamental importance, and often the most appropriate solution is the implantation of a penile prosthesis.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
How to identify erectile dysfunction? Symptoms and signs
Erection is an involuntary reaction in response to sexual stimulation or eroticization. Both make the brain, nerves, heart, blood vessels and hormones work together to quickly increase the amount of blood flowing into the penis.
The organic erection process includes five stages. It starts with psychological stimulation, where neurotransmitters cause the smooth muscles of the penis to relax and increase blood flow to the corpora cavernosa. The increased flow lengthens and expands the penis, which leads to the second phase, when the penile arteries expand to accommodate the increased blood flow needed to lengthen and expand the penis.
Phase three is complete erection, when the volume of blood inside the penis is prevented from draining and promotes its expansion until full erection. The moment when maximum rigidity is reached is when the process reaches the fourth stage. The glans and corpus spongiosum enlarge until the penile veins are forcefully compressed, maintaining maximum penile rigidity.
The last stage of erection is the return to flaccidity. Muscle contractions result in blood flowing out of the penis, thus decreasing its length and thickness.
Difficulty getting and maintaining an erection
During erection, blood remains within the two spongy chambers (corpus cavernosa) located in the shaft of the penis. As they fill with blood, they make the penis become rigid, increase in size and diameter.
If the difficulty in getting or maintaining an erection happens constantly, it is a sign that some of the blood flow processes are not working properly. In these cases, consulting a doctor is essential to find the cause of the problem and seek appropriate treatment.
Lack of firmness for penetration
Many times the penis is erect, however, without the necessary firmness for a safe penetration. This happens when the man is unable to achieve maximum rigidity in the erection process due to the low blood flow going through the penis.
Attention to firmness must be redoubled at the time of sex because, without the necessary rigidity, there is a great chance that the penis will escape, causing trauma and other diseases, such as Peyronie’s Disease.
Associated penile curvature
Many people ask why many cases of Acquired Penile Curvature, also known as Peyronie’s Disease, are linked to erectile dysfunction. The connection between one problem and another causes questions that make men imagine that they were powerless because of the disease. Usually what happens is the opposite.
Erection problems are the main cause of Peyronie’s Disease development, as the lack of rigidity in the penis during sexual intercourse predisposes to trauma and microtraumas. This causes the formation of internal and/or superficial fibrosis that limit the elasticity of penile tissues and cause the limb to bend sideways, up or down.
That is why, in cases of Peyronie’s Disease, it is important to assess the need for penile prosthesis implantation, as this condition also aggravates erectile dysfunction.
Responsible for bringing back the quality of the erection when clinical treatments are not effective, the prosthesis will improve the rigidity of the penis and provide a quality sex life, minimizing the risks of curvature returning.
Decreased involuntary erections
Nocturnal or involuntary erections, those that happen during sleep or without sexual stimulation, are an indication that everything is going well with the flow of blood running inside the penis. They are necessary to oxygenate the penile tissues while it is not in use and thus prevent the appearance of fibrosis in the corpora cavernosa, caused by low blood circulation. The more blood circulates in your penis, the more oxygenated it is and the greater the guarantee of good erections in the future.
If they do not happen or are less frequent, the first step is to see a urologist to check if the cause is a slight hormonal imbalance or if this is linked to the onset of erectile dysfunction.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
Healing of Erectile Dysfunction: Medicines, Injections or Penile Prosthesis?
Many men begin to treat erectile dysfunction with drugs and injections. However, this is a palliative treatment, which may resolve the situation for some time, but does not bring a definitive cure. Even with increasing drug dosages, erectile dysfunction can continue to cause problems, as its effects tend to diminish with continued use.
In these cases, the most likely treatment will be the implantation of a penile prosthesis, which treats erectile dysfunction, with a good improvement in penetration rigidity and, according to the São Paulo State Health Department, with a high level of satisfaction with the result in general, both of the man and the partner.
The most accurate way to diagnose the need for an implant is through a functional examination of the penis. It must be done by a specialist doctor, who will artificially induce an erection and perform a detailed ultrasound of the limb to assess its internal structure and its blood flow.
Advantages and disadvantages of drug treatment
Medications or injections to stimulate an erection can work, but it is important to note that their use is subject to some side effects, such as nasal obstruction, headache and facial flushing. Not all men experience this, but it is a common effect. In older patients, drugs or testosterone replacement to try to improve an erection can also increase the risk of prostate cancer.
Another disadvantage in this type of treatment is the inconvenience of the injections. It should be done moments before penetration, and it can ruin the mood of the moment. In these situations it is normal for the man to omit this from the partner and use the injection hidden. This is not an indicated situation as it can open assumptions for misinterpretations by the other party, such as the use of illicit drugs, for example.
Why is a penile prosthesis indicated? (Surgical treatment)
There are some degrees of erectile dysfunction, which can be divided into acute, moderate and severe. Generally, treatment for acute and/or moderate erectile dysfunction consists of oral or injected medications to seek penile rigidity and good penetrative ability.
According to a multicenter study, published in the journal Nature Reviews Disease Primers, penile prosthesis implantation is the most indicated treatment to resolve cases of severe erectile dysfunction.
While drug treatment can bring side effects and not fix the problem permanently, the prosthesis is a good option, adaptable to man’s needs, whose objective is not to fail when you need it.
The implant not only restores the rigidity and health of the penis, but also prevents the aggravation of other diseases resulting from the poor quality of the erection, such as Peyronie’s. In addition, its use contributes to the maintenance of self-confidence, health and well-being of many couples.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
How is penile prosthesis surgery made with the Egydio Technique?
The Egydio Technique was published by Dr. Paulo Egydio in 2002 in Urology magazine, and according to experts in a multicenter study published in the Arabic Journal of Urology, it is a “safe, reproducible, easy and effective method” for the correction of penile curvature.
The method uses geometric principles to lengthen and recover the largest possible size and diameter of the penis, up to the maximum limit of the nerves, vessels and urethra. This brings greater satisfaction to patients after implantation of the prosthesis, which is performed in the same surgical procedure, since it is rare for men to deal well with the decrease in the penis. If size loss is not identified and treated properly, this can happen.
Application of this technique by an experienced physician is safe and reliable. Thousands of surgeries based on these principles have been performed by Dr. Paulo over the past few years. This surgical method won, with 75% of the votes, the award of the American Society of Urology (AUA19) as the most indicated procedure for the treatment of Severe Peyronie’s Disease associated with erectile dysfunction.
Main cases of penile prosthesis
The need to place a prosthesis comes from the problem of erectile dysfunction, which can be related to Peyronie’s Disease, with advancing age, or with other diseases that affect the proper functioning of the penis.
Conditions such as prostate cancer, diabetes and cardiovascular disease can affect not only the ability to have an erection, but also reduce the length and girth of the penis.
The application of the geometric concepts, known as the Egydio Technique, will allow, in the placement of the prosthesis, that all the necessary procedures for the treatment of the penis are performed in the same surgery.
Treatment is indicated when the patient has already used drugs to solve the erectile dysfunction problem, and even increased the doses, but did not show a satisfactory response or brought uncomfortable side effects.
Among the most common cases where penile prosthesis and the Egydio Technique are necessary, we can mention the patient who notices the decrease or thinning of the penis, together with the erection problem, patients who have not had an erection for years and have abandoned their sex life, as well as men who manage to get an erection but have difficulty maintaining it until the end of intercourse, making it less pleasurable.
Cases of unsuccessful surgeries without penile reconstruction
There are situations in which the patient has already placed the prosthesis to treat erectile dysfunction, but the result was not satisfactory. Usually this happens due to the lack of a detailed evaluation of the penis to identify other issues linked to the erection problem.
Most of the time, patients complain that the penis has become smaller or too thin; that the prosthesis was placed in an incorrect size and ruptured the glans or left it drooping; that it was necessary to change the prosthesis due to lack of adaptation or, even, that the implant did not solve the lack of rigidity.
In other cases, on the verge of meeting the patient’s expectations, the urologist places a penile prosthesis that is larger than the body of the penis can accommodate. This maximizes the risk of Penile Prosthesis Extrusion.
The first step, in these cases, is to perform a functional reassessment of the penis through an ultrasound of the corpora cavernosa. This is because it is essential to assess whether there was a loss of size or thinning of the penis to correct the problem in the same surgery, or if there are fibrosis that, when removed, improve the final result of the implant.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
Penile prosthesis implantation: how does the pre and post op work?
The secret to the success of any surgery is planning. And to implant a penile prosthesis, it is no different.
The first step towards the preparation of the surgery is to check how the blood circulation is going inside the penis and the existence of fibrosis that may be hindering the erection. For this, an exam with induced erection and color ultrasound is performed, which will evaluate penile functionality and help the doctor understand the procedure that must be done.
If erectile dysfunction is associated with Peyronie's disease and/or penile deformity, it is possible to treat them in the same surgical procedure, applying the geometric principles known as the Egydio Technique.
With all the exams carried out, it’s time to choose the prosthesis model to be implanted. The decision is made from a conversation with the doctor, added to the results of the exams mentioned above. Factors evaluated for choice are patient preference, lifestyle, existing medical condition and costs. In addition to personal preference, the indication of the type of prosthesis also depends on a precise study of the penile anatomy, in order to aim for good vertical rigidity after implantation.
After identifying the situation in which the penis is and choosing the model of prosthesis to be implanted, it is time to set a date. The surgery lasts on average, between 2 and 3 hours and generally, there is no need for an overnight stay.
Patients residing outside São Paulo should reserve 5 to 7 days to stay in the city: one day for consultation and exams, another for surgery and 3 to 5 days for medical follow-up at the beginning of recovery. Those who opt for the inflatable prosthesis should take into account the possibility of another face-to-face return after the surgery, to receive guidance on how to handle the implant. If there is no doubt, this can be reassessed together with the patient.
Before the surgery
When the surgery for the penile implant finally has a date and time, just wait for the day and think about the confidence it will bring you.
If the exams have indicated the existence of fibrosis, they will be treated before placing the prosthesis, but in the same surgical procedure. This is extremely important to preserve as much of the corpora cavernosa as possible, blood circulation and penile temperature after placement of the prosthesis, in addition to having the objective of its proper functioning, helping in the malleability of the semi-rigid model and allowing the full filling of the inflatable prosthesis.
The procedure does not require large preparations. As with all surgery, blood tests, urine tests and cardio evaluation will be necessary to avoid any mishap. It is important that glucose levels are controlled to ensure good healing and avoid the risk of infection. In addition, an eight-hour fast from both solid and liquid foods is required before the start of the surgery.
You will also be instructed on how to clean the pubic area with antibacterial soap, which must be done for two days before surgery. After that, just get a good night’s sleep and get ready for the day to treat erectile dysfunction once and for all.
The day of the surgery
With the planning done and the previous care taken, it’s time for the doctor to put all his knowledge and experience into practice, taking care to obtain an optimal functional and aesthetic appearance. In addition to regaining the firmness of the penis, it is possible to recover its caliber and size to the maximum limit of the nerves and urethra.
The entire procedure is usually not very long. The patient is admitted to the hospital in the morning and, at the latest, in the early afternoon, he will probably be ready to go home. The surgery lasts between 2 and 3 hours and is performed under local anesthesia.
The shaving of pubic hair is done in the operating room itself, by the doctor and his team. So, you don’t have to worry about that, as they will take great care that there is no risk of infection.
After the surgery
As with the entire procedure, the post-surgical implantation of a penile prosthesis requires care but is not complicated.
Return to the doctor takes place on the same day as the surgery, in the afternoon. In this consultation, the success of the surgery will be evaluated and the latest guidelines will be given so that healing and adaptation takes place in the best possible way.
The penis will be covered with a bandage that will not need to be removed for the first five days. After this period, the bandage must be changed daily for another five days. Due to the simplicity of the replacement, it is not necessary for the patient to return to the doctor for it. The patient can do it himself in just a few minutes.
Patients who opt for the inflatable prosthesis model are requested to have one or more face-to-face return(s) after 28 days. As it requires greater knowledge for its manipulation, the physician needs to follow the evolution of the surgery and instruct the patient on the correct way to use it. So you will have no doubts and will aim for a better performance at the time.
There are three stages for the patient to return to his normal life: between 7 and 10 days it is possible to return to work, if it does not require physical effort; from 30 days onwards he can resume physical activities and from 45 to 60 days he will have resumed sexual activities.
* This estimate may vary from case to case, according to the recovery of each patient’s body.
The recovery process is even more simplified as the surgical stitches are absorbable, minimizing possible post-surgical discomfort. Usually, about two months after the procedure, they will have fallen naturally.
Doubts? Submit your question to Dr. Paulo and receive specific guidance about your condition, in a simple and discreet way.
What changes for men after a penile implant?
The penile prosthesis implant is indicated for men who suffer from erectile dysfunction. Many feel uncomfortable not only because we are talking about an organ that is directly linked to pleasure, but also because they are afraid of facing a surgical process. If this is what prevents you from seeking treatment, it’s time to change your mind. Prosthetic surgery is a quick and easy procedure. For this, it is important to have planning and good medical guidance.
Of course, when leaving the hospital, the patient goes through a period of adaptation in the use of the prosthesis. This time may vary for each person and also depends on the type of prosthesis chosen, as discussed in the third topic of this guide. But this is not a lengthy or painful process, much less something that prevents you from improving your quality of life. After this initial moment, your life will go on normally and, probably, happier, as you will have a healthy sexual routine again, you will avoid future problems due to poor quality of erection and consequently, concerns about the health of your penis will decrease.
It is important to point out that the implantation of the prosthesis will not interfere in a negative way with the natural functions and sensations of the penis, the patient only has to gain if the device is properly placed.
Regardless of the type chosen, the physician must ensure that the implant does not rupture any nerve in the limb and, consequently, does not interfere with the patient’s patterns of pleasure, orgasm and ejaculation.
Prosthesis implant and penis size
The penile prosthesis does not increase the size of the penis, it aims to restore penile rigidity that was lost due to erectile dysfunction. However, other conditions that are associated with an erection problem can cause the penis to become smaller, thin, or bent. The surgical process with the Egydio Technique for implant placement aims to make geometrically calculated incisions to expand the tissues of the penis that have lost elasticity.
Temperature and sensitivity of the penis after implant
A constant concern of patients who need the prosthesis is whether the penis will become cold, as if it were an artificial limb, or if it will lose sensation in the limb. Most likely this will not happen.
What gives the penile temperature is the amount of blood that circulates inside the penis during erection. To keep the blood circulating after the prosthesis, however, it is necessary to preserve the internal structures of the limb, also known as sponge or spongy body.
A procedure done with the necessary care will probably not affect this part and the implant cylinders should be placed with the aim of not harming the passage of blood.
The glans, the most sensitive part of the male sex organ and popularly known as the head of the penis, generally does not lose its sensitivity, as the numerous nerve endings that bring pleasure to men, known as the nerve bundle or neurovascular bundle, are to be preserved.
Orgasm and ejaculation after prosthesis
It is important to emphasize that eroticization in sexual activity is fundamental to assess sensitivity, pleasure and orgasm. Under erotization, there is no significant difference in the man’s orgasm before and after putting on the prosthesis. Considering that the patient comes from an erection problem, the expectation is, in fact, for improvement.
With the penis more rigid and suitable for use, the patient will have more confidence that everything is going well with penile functioning, and this will naturally reflect on performance during sex. The prosthesis, implanted correctly, preserves as much as possible of the structures, tissues and nerves linked to pleasure, sensitivity and penile temperature. In addition, it does not interfere with the volume and quality of your ejaculation, as it does not affect the structure that transports the semen.