Erectile Dysfunction - Penile Prosthesis

Penile prosthesis

A penile prosthesis is an artificial support for the penis. Men should only consider this procedure after other treatments have been exhausted. It's also advisable to talk to your GP first to investigate any possible underlying cause of impotence.

How do penile prostheses work?

Patients should understand that these devices are only a mechanical way of providing an erection to allow them to have sexual intercourse and not to enhance libido (sex drive). There are two types of penile prostheses; both involve a small amount of surgery and both are likely to reduce sexual sensation and ejaculation.

- Semi-rigid prosthesis: this consists of two rods of silicone rubber that are fitted into the length of the penis and requires a small operation. This provides some rigidity as well as a certain amount of flexibility so that the penis can either be curved downwards in the normal position or put into an erect position for intercourse.

- Inflatable prosthesis: this consists of two cylinders, a pump and a reservoir. The cylinders, which are placed inside the penis, can be inflated with fluid to produce an erection and deflated after intercourse. All parts of this 'hydraulic' system have to be implanted inside the penis and scrotum. When an erection is required, the pump is activated by squeezing a device placed in the scrotum. In doing so, fluid is drawn from the reservoir to the cylinders, making the penis hard. Following intercourse, a valve is pressed and the fluid runs back into the reservoir. The main advantage of this method is that it looks more natural. There are, however, also a few disadvantages. For instance, the inflatable prosthesis is quite expensive and it is unlikely that the operation will be available on the NHS in your local hospital. Also, this type of surgery is more complex and involves more parts that can go wrong. Lastly, this option requires more manual dexterity, which might not be suitable for everyone.

When is a penile prosthesis suitable?

Usually, patients who have had a physical injury to the erectile tissue within the penis require a penile prosthesis as first-line treatments will not help. Possible causes of such injury may include:

• damage caused by repeated injection treatment, which can cause fibrosis within the erectile tissue
• damage caused by previous surgery
• Peyronie's disease, which causes fibrosis within the erectile tissue
• patients who have unsuccessfully tried all first-line treatments for ED, such as oral drug treatment and injections

What if you do not want an operation?

Assuming that all other available treatments have been exhausted, it is important to remember that there are other ways to enrich your sex life to make it exciting and enjoyable.

Endless sexual intercourse may be the fantasy of someone who cannot get an erection; however, vast numbers of men and women are satisfied by other kinds of lovemaking such as oral sex and touching. Although you will obviously miss being able to have intercourse yourself, it is possible to derive considerable satisfaction from knowing that you can still love and satisfy your partner.

Ask a HealthExpress doctor to recommend a penile prosthesis specialist to talk to about the procedure.

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