FAQ - PENILE PROSTHESIS
FREQUENTLY ASKED QUESTIONS
Dr. Paulo Egydio CRM 67482 RQE 19514
Does the penis increase in size with the placement of the prosthesis?
First, tests should be carried out to verify if the penis has reduced in size throughout life, that is, to verify if there are tissues with fibrosis in the body of the penis. If a decrease in size is observed, penile reconstruction may be indicated before implanting the prosthesis. The objective of this surgical strategy is to make geometrically calculated incisions to expand the retracted tissue to the limit of the nerves, vessels and urethra, which is the limit possible.
REMEMBER: the implant alone does not restore the size, it will only give more support and firmness to the penis. It is necessary to expand the penile tissues to the limit of the nerves and urethra, before placing the prosthesis.
Click here and see if the penile prosthesis increases the size of the penis.
Does the prosthesis affect ejaculation, sensitivity and orgasm?
Does the prosthesis affect ejaculation, sensitivity and orgasm?
The evaluation of the filling and sensitivity of the glans must also be done by means of erotization. This is because simply touching the penis, as in the case of hygiene, does not result in an erection. Therefore, genital sensitivity must be evaluated with an erotic stimulus.
The tendency is not to affect, because the penile nerves must be protected during the procedure. In this way, the objective is to preserve sensitivity and pleasure in the sexual act.
The article published in the Journal “Translational Andrology and Urology” says the following:
“We observed a significant increase in the length and circumference of the penis after placement of the Penile Prosthesis Implant, with no significant changes in sensory conduction.”
Click here to learn more about penile temperature and sensitivity after prosthesis implantation.
"We observed a significant increase in the length and circumference of the penis after placement of the Penile Prosthesis Implant, with no significant changes in sensory conduction."
What is the recovery time after surgery?
The procedure is in a hospital environment, that is, the patient is usually admitted in the morning, receives sedation and local anesthesia for the procedure. If the surgery is performed in the morning, he may be discharged later in the day and there may be no need to sleep in the hospital.
There are three stages to the patient’s final recovery:
- Return to work (7 – 10 days after surgery);
- The return to physical activities (30 days after surgery);
- Return to sex life (45 – 60 days post surgery).
*Dates may vary according to each patient’s recovery process, subject to medical evaluation.
Learn how the pre and post op of penile prosthesis implant surgery works.
Will I lose Caliber and Size after putting the penile prosthesis?
The surgical strategy that uses geometric principles and adjuvant maneuvers, with multiple incisions to expand the penile tissue and stretch it to the limit of the nerves, vessels and urethra, aims to optimize the dimensions of the penis to the anatomical limit possible, which varies from patient to patient. for patient.
The ideal time to optimize penile dimensions is when there is an indication for penile prosthesis implantation, but before that, tissue expansion surgery is necessary. It is important to emphasize that the size of the penile prosthesis should be chosen only after this expansion so that the ideal size of penile prosthesis for the reconstructed penis is implanted.
Remember: Simple prosthesis implantation, without penile reconstruction, is not associated with improvement in penile dimensions.
Watch Egydio’s Surgical Strategy demonstration video.
How will the penis look after the penile implant?
There is no way to predict an increase in centimeters before an evaluation in consultation, as each organism has its particularity.
Penile prosthesis implant surgery can be performed in two ways, with or without penile reconstruction:
Without reconstruction:
The dimensions of the penis will not be worked out, but only the adjustment of the implant for the diminished, thinned and/or curved penis. In these cases, it is possible to witness the patient’s dissatisfaction after the penile prosthesis implant surgery due to the observed decrease in size.
With reconstruction:
Before penile prosthesis implantation, geometrically calculated relaxation incisions are made in order to expand the penile tissue. Once the penis is expanded to the limit of the nerves, vessels and urethra, the ideal size and caliber of the cylinders of the prosthesis to be implanted is determined.
Click here and watch the demonstration video of Egydio’s Strategy.
Is it possible to identify men with penile prosthesis, is it visible on clothing?
Is it possible to identify men with penile prosthesis, is it visible on clothing?
This is a very common question asked by patients who opt for a malleable implant. With this implant the penis is elongated. Once the penile reconstruction is performed through multiple incisions to expand the penile tissues, the set, penis with the penile prosthesis, tends to have more malleability to accommodate it more discreetly in the clothes.
Patients who opt for the inflatable prosthesis, although they may also have a longer penis, have the possibility of deflating it after the sexual act, facilitating accommodation in the clothes. It is worth mentioning that for the hydraulic model, the penis will not retract as in its natural pre-implantation penile prosthesis form.
The study published in 2018 in the “Journal of Sexual Medicine” says the following:
"We found that Malleable Penile Prosthesis is as effective as the Inflatable Penile Prosthesis in correcting curvature in patients with Peyronie's Disease, with similar patient satisfaction for the 2 groups."
Will my penis be cold after the surgery?
What allows a greater flow of blood inside the penis, is the erotic stimulation, which happens in the brain. This stimulus will allow vasodilation in the penis and consequent increase in blood flow and the heating will depend on the best erotic stimulus and vascular conditions of each patient.
Knowing this, the penile prosthesis is peripherally allocated, aiming to preserve as much of the sponge of the cavernous bodies as possible. It is worth noting that the temperature of the penis must be evaluated under erotic stimulation.
Another important fact to note is that, in sexual intercourse that involves erotic stimulation associated with good penetrative capacity, the penile prosthesis will hardly be noticed.
Click and learn more about temperature and penile sensitivity after prosthesis implantation.
What is the most suitable prosthesis for my penis?
This will be defined after face-to-face evaluation and specific exams that are carried out in consultation, each penis has a type of anatomical structure and its particularities.
The patient’s preference for a model and their lifestyle should also be considered. All aspects must be evaluated to provide tissue expansion and allow for a larger implant size and caliber, which, according to studies, is a very important factor in increasing patient satisfaction.
With the malleable penile implant, will I have a permanent erection?
According to the Portal of Urology of the Brazilian Society of Urology (SBU), malleable prostheses are manufactured with moldable solid silicone that involves a metallic alloy that gives a “memory” to the piece, allowing the prosthesis to be positioned depending on the moment: folded down, or to the sides, according to the patient’s preference, when in the “rest” state. This care aims to facilitate the social life of the patient. When in sexual activity, the prosthesis can be positioned forward, in order to allow a perfect sexual relationship.
The SBU portal adds that, contrary to what many people think, satisfaction with the result does not depend on the type of prosthesis used, whether inflatable or malleable.
Click here and learn about the types of penile prostheses available.
What is the lifespan of the prosthesis? Can the prosthesis break during sex?
As long as the implanted penile prosthesis is offering good penetrative rigidity, there is no need for changes.
The study published in the Archivio Italiano di Urologia e Andrologia says the following:
We determined in this study that malleable or semi-rigid penile prostheses were associated with lower complication rates compared to the inflatable group, particularly with regard to mechanical failure.
Is it possible to replace the prosthesis for some reason?
Generally, it is indicated only if the functionality of the prosthesis is compromised, that is, it does not offer good rigidity for penetration. Also, if the patient does not adapt to the chosen model, whether it is malleable or inflatable, it can be replaced.
Remember: If you do not adapt to the implanted model, penile prosthesis replacement surgery may be indicated between 6 to 12 months after the first surgery.
*This will depend on the evolution of each case.
May there be infection or rejection of the prosthesis?
The prostheses I use are bathed in antibiotics to minimize the risk of infection, in addition to performing the surgery with the rigor of international protocols to minimize this risk.
Click here to learn more about the precautions taken when implanting a prosthesis.
With the surgery the penis will start to fill both sides of the penis?
Before answering this question, it is important to emphasize that the penile prosthesis was developed to offer the patient the vertical resistance necessary for the sexual act.
To preserve as much of the corpora cavernosa as possible, it is important to minimize the use or not use of dilators during the penile prosthesis implantation process. The use of dilators to perform prosthesis implants harms the corpora cavernosa, which can result in loss of residual penile filling quality.
The conservation of the cavernous bodies as possible is essential so that the patient can enjoy the residual penile filling that he had before the implantation of the prosthesis. For this preservation, instead of inserting the penile prosthesis in the middle of the penis, it is necessary to make a separation between the cavernous bodies and the tunica albuginea where the prosthesis is implanted.
Thus, when the patient has a cerebral erotization and penile vasodilation, he will be able to enjoy the filling and heating of the penis closer than he was able to before undergoing an implantation process.
After creating the space between the tunica albuginea and the corpora cavernosa, a malleable or inflatable penile prosthesis is inserted, which aims to provide the vertical rigidity necessary for the sexual act.
After placement of the prosthesis, will it require any medication for continuous use?
The patient is indicated for penile prosthesis when oral or injectable drugs do not provide the necessary rigidity for good penetration. The purpose of the prosthesis is to give this rigidity, independent of the filling of blood inside the penis and oral stimulants.
Patients who opt for the use of oral and/or intra-urethral medications after penile prosthesis implantation, aim to obtain, accompanied by good erotization, better blood filling and penile heating.
The choice of taking or not taking medication after penile prosthesis implantation will depend on each patient.
*It is important to talk to your urologist to define the best treatment options for your case.
During surgery, may it be necessary to remove the corpora cavernosa?
Before answering this question, it is important to emphasize that the penile prosthesis is intended to provide the necessary rigidity for penetration.
The use of dilators can directly affect the preservation of the corpora cavernosa, as a result, and to preserve the erection as much as possible, it is important to minimize or even not use dilators to preserve the integrity of the cavernous bodies after penile prosthesis implantation.
Once the patient has a good pre-surgical filling and as much of the cavernous bodies as possible are preserved, it is possible that through brain erotization and penile vasodilation, the patient will enjoy filling and warming close to what he had before surgery.
After penile implant, can there be pain during sex?
The adaptation of the penile prosthesis usually takes place over time, so it is common to occasionally experience small twinges or some pain after surgery. This is normal.
Your body may need time to fully recover from the surgery and adjust to the implant. Small moments of discomfort are a normal part of this process.
After the implant, how should the sexual act be like?
There’s a video on YouTube, recorded by Dr. Paulo Egydio where he answers the main questions related to “How is life after the Penile Prosthesis Implant”. Click here to watch.
The penile prosthesis has the main function of providing vertical rigidity for penetration, without the need for the use of oral or injectable stimulants. This minimizes the chances of the penis bending or escaping during intercourse.
For the patient to be satisfied after the implantation of the penile prosthesis, it is important to choose the type of penile prosthesis that best fits each profile. To know the types of penile prosthesis available, click here.
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