The penile prosthesis aims to restore erectile function, which can contribute to improving sexual quality of life.
For many men, when conservative treatments do not provide a satisfactory response, the penile prosthesis can be considered an alternative for erectile dysfunction. This recommendation often comes after a journey marked by frustration, insecurity, and impact on intimacy, but with positive expectations for sexual life.
Next, learn about the main aspects of before and after penile prosthesis to better understand the procedure and make a more informed and confident decision about this treatment.
What changes after penile prosthesis implant?
In addition to restoring erectile function, implanting a penile prosthesis can help the patient resume sexual activity with greater predictability and peace of mind. The treatment can have a positive impact on self-esteem, confidence, and quality of life.
Pleasure with penile prosthesis
Penile prosthesis implant surgery aims to recover erectile function without interfering with the nerves responsible for arousal. Therefore, pleasure tends to be preserved.
However, it is important to remember that sexual desire begins in the brain and that erotization continues to be an essential component. Therefore, it is important to have sexual stimuli, which can be visual, auditory, tactile, or olfactory, for an even more pleasurable sexual relationship.
Communication with your partner can play a relevant role in adaptation and sexual satisfaction, helping the couple find new possibilities in intimacy.
Orgasm and ejaculation after implant
Orgasm and ejaculation do not undergo changes in most cases after penile prosthesis implant.
In the case of orgasm, since the nerves linked to pleasure are preserved, sensitivity and the ability to feel sexual pleasure tend to be maintained, especially if there is erotization.
In some cases, patients report improvement in sexual experience, especially due to the possibility of recovering the rigidity necessary for sexual intercourse.
There are also no changes in the quality or volume of ejaculation, since the surgery does not interfere with the structures that produce or transport semen, so the patient does not tend to ejaculate more or less after the procedure.
Erection and penetration after implant
The quality of erection and penetration are the main changes between before and after penile prosthesis, as the device is designed to create and maintain erection with sufficient rigidity to allow penetration during sexual intercourse.
However, it is important to understand that erection with penile prosthesis does not happen spontaneously: it is necessary to position or activate the prosthesis, according to the type of device used.
The semi-rigid prosthesis maintains permanent rigidity. When the patient wants to have sexual intercourse, it is simply a matter of positioning the penis appropriately to allow penetration.
In the case of the inflatable prosthesis, the patient activates a mechanism located in the scrotum. This mechanism transfers the saline solution contained in the reservoir to the cylinders implanted in the penis, promoting a more controlled erection with a more natural appearance.
Regardless of the type of prosthesis, the patient can maintain penetration even after ejaculation, since the implant allows maintaining rigidity for as long as desired, according to the partners’ preference.
Urine after prosthesis placement
Urinary flow is not usually affected by penile prosthesis implantation. The urethra, the channel through which urine passes, is not altered during the prosthesis placement surgery.
However, as with any surgical procedure, there is a recovery period during which small temporary changes in urinary flow may occur. In general, urinary function tends to normalize after penile prosthesis recovery.
Appearance of penis after implant
The isolated placement of penile prosthesis does not affect the appearance of the penis. It is important to note that the goal of the prosthesis is to restore rigidity for adequate erectile function, not to alter anatomy.
However, when erectile dysfunction is associated with Peyronie’s Disease, which can cause curvature, loss of length, and penile thinning, the implant can be placed during penile reconstruction surgery. In this specific situation, there may be changes in anatomy due to penile reconstruction and rigidity due to the penile prosthesis.
Does the penile implant come out of place?
It is possible for the penile implant to come out of place. This phenomenon is known as prosthesis extrusion and is one of the possible complications of the procedure.
However, extrusion can be prevented with adequate surgical planning, correct choice of device, and positioning compatible with penis anatomy.
In some cases, the sensation of displacement may be related not to the change in prosthesis position, but to a sizing error during surgery.
Does sexual satisfaction change?
Sexual satisfaction can improve after prosthesis implantation, especially in patients who have lived with erectile dysfunction for a long time.
The ability to achieve and maintain a firm erection can help restore sexual confidence and promote improvement in sexual life after penile implant.
However, it is important to consider that the initial period of adaptation to the implant may take some time. After this phase, many patients report high levels of satisfaction, as well as improvement in sexual quality of life.
Temperature
In any man, the temperature of the penis depends mainly on the state it is in: flaccid or erect.
When the penis is flaccid, its temperature tends to be similar to the rest of the body. During sexual arousal, the increase in blood flow and retention in the cavernous bodies can cause slight warming, as happens in a natural erection.
In men with penile prosthesis who still had some residual erection before surgery, this temperature variation can continue to occur, according to the degree of preserved vascular response.
The exception can occur in cases where the patient had complete erectile dysfunction, without any residual erection before the implant. In these situations, the penis tends to maintain normal body temperature, since there is no increase in blood flow to the area.
Sports and physical activities
In most cases, there are no permanent limitations for physical exercise, as long as the surgery is performed properly and the patient follows the post-operative guidelines for penile prosthesis correctly.
Return to physical activities is generally authorized within up to 60 days after the procedure.
Some specific recommendations should be followed for certain sports, such as:
- Men with semi-rigid prosthesis who play football should position the penis close to the body and wear tighter underwear that provides support.
- Men with inflatable prosthesis and large scrotum who ride bikes should wear underwear with reinforcement in the scrotal area. If this is not possible, it may be necessary to lift the scrotum to avoid direct pressure against the saddle.
Will your partner like it?
In general, the penile prosthesis can contribute to couple satisfaction, especially when there is good adaptation, communication, and alignment of expectations. Some studies suggest relevant levels of satisfaction with penile prosthesis.
One of these studies, conducted with 190 patients, evaluated satisfaction in primary surgeries and penile prosthesis replacement, indicating favorable results regarding the ability to maintain satisfying sexual relationships.
Another study evaluated clinical outcomes, quality of life, and patient and partner satisfaction after three-component inflatable penile prosthesis implantation. The publication indicates high satisfaction rates among patients and partners, although it also describes possible complaints and complications, such as post-operative pain, sensitivity changes, and loss of penile length in some cases.
Finally, a systematic review on partner satisfaction after penile implant, including data related to LGBTQ+ populations, indicated satisfaction rates between 50% and 90%, with improvement in satisfaction metrics and sexual quality of life compared to the period before surgery.
What is it like to have a penile prosthesis?
After the recovery and adaptation period, most patients can resume a normal routine with the penile prosthesis.
When comparing before and after penile prosthesis, it is possible to observe, in many cases, the resumption of a more satisfying sexual life. For many men, the recovery of erectile function can also have a positive impact on self-confidence, self-esteem, and the relationship with their partner.
With adequate follow-up and medical guidance, the prosthesis tends to integrate progressively into the patient’s routine naturally.
Routine care for better adaptation and healing after surgery
Respecting the recovery period after surgery is essential to promote adaptation and healing. Consult the recommended schedule:
- First 5 days: rest and surgical dressing on the penis;
- Days 6 to 10: partial rest and dressing should be changed daily;
- Between 7 and 10 days: possibility of returning to work, as long as without physical effort;
- After 30 days: gradual resumption of low-impact physical activities;
- Between 45 and 60 days: medical authorization to resume sexual life and vigorous physical activities.
During this period, the urologist will follow up to assess recovery and guide the patient on how to handle the device so that the patient can have confidence for sexual intercourse.
Talk to Dr. Paulo Egydio and learn everything about penile prosthesis implant
Erectile dysfunction can affect a man’s sexual life, self-esteem, and mental health. Nevertheless, it is important to remember that these impacts can be treated and, in many cases, improved with the appropriate approach.
Talking about sexual health can be difficult for many men, but this is an important step to seek medical help, especially when conservative treatments do not provide a satisfactory response or when there is associated penile curvature.
The evaluation should be performed by a urologist with experience in penile implant and reconstructive surgery. For evaluation of your clinical case, contact the clinic to schedule a specialized consultation.
