A penile implant is an implanted device intended for the treatment of erectile dysfunction. But what are the different types of ...

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Watch This Before You Get A Penile Implant! | Penile Dysfunction Treatment

have you ever heard of a penal implant well I'm Dr Reena Malik urologist and pelvic surgeon and today I'm going to talk about the three different types of penile implants that are available for men with erectile dysfunction all right so as I mentioned penile implants are an option for men who have erectile dysfunction and don't respond to other treatments and other treatments include things like medications injections or vacuum erection devices and you can learn all about that on my previous video where I talk about all the options for erectile dysfunction so before we get into the different types of penal implants I want you to realize that this is sort of an endof the line treatment option for erectile dysfunction once you do this you can't go back to having normal erections so it's really for men who've tried other things and are really unsuccessful and unable to get a natural erection on themselves while sometimes it can sound really tempting to get something like this because it will make life a lot easier it is different than having your your own natural erection but there are many benefits and the most obvious benefit is that you can achieve an erection whenever you want and overall this leads to improved sexual satisfaction and these implants last a long time somewhere from 10 to 15 years to Forever and they really require less maintenance than taking a pill every day or injecting your penis every time you need an Direction and people who get them are really satisfied and they tend to recommend this surgery to other people and in fact their partners are also satisfied and while there's not a ton of data on Partner satisfaction we do find that men who get penile implants have partners that are satisfied now how does this work exactly so for a penal implant to be inserted it is a surgical procedure and during the surgical procedure you have an incision that's either created between the penis and the scrotum or above the penis called infr pubic so below that bone the pubic bone and the penis and from there from through that incision you have the implant inserted and as I mentioned there are three different types of implants and soon to be only two but I share this because they're at this moment in time are still three options so the first type of implant is a semi- rigid implant now this is made up of two bendable rods and these are essentially semi- rigid or somewhat firm all the time and when you want to have an erection you essentially bend it up and when you don't want to have it you bend it down now the nice part about these implants are that they're really easy to use it's really good for people who have limited dexterity and it really is almost zero chance of having any malfunctions because it's just two straightforward rods and there's really no moving fluid and there's no device pieces or anything like that and the major downside is it never really gets deflated so you don't get that natural flaccid feel and two it is always sort of semierect which causes increased pressures in the tissues and because it's the cylindrical shape that's sort of always semi- rigid it creates constant pressure on the tissues which can put you at a slightly higher risk of that implant actually eroding out of the tissues now it's rare but it can happen and you can see here that it has these gradations so that it is shaped um so that when we measure the penis intraoperatively we can cut it to the right size based on the length of your penis and then of course you get two and so these two are inserted like this so moving on the two-piece inflatable implant now this implant is only around for a limited time because I'm told that they're going to stop manufacturing new two-piece implants but basically what it is is you have two fluid filled cylinders that go into the erectile tissue and then a pump that goes into the scrotum and when you press that pump in the scrotum you get fluid that transfers from the pump into the cylinders to get a more firm erection however the pump is not very big so you're not going to get a ton of fluid movement and for this reason it doesn't get completely deflated you'll always have a little bit of fluid in the cylinders so it does however get more firm than the semi- rigid and this is a good option for a few patients one is that the pump is pretty easy to use it usually requires like two or three pumps so for someone who has some limited dexterity but doesn't want to have a semi- rigid this is a nice option also if you have had a of abdominal surgery and you don't want the third piece of the pump which is what we're going to talk about next this is a good option because it is a little bit safer so this is sort of wrapped in liquid because that's how they give it to us but you can see here there's two cylinders and a pump and this pump goes into the scrotum and this goes into the rectile tissue and you can make this longer or shorter cuz you could add a extension on the back here and they come in different sizes so you essentially Pump It Up it gets firm and then when you done you deflate it by bending it like this and it deflates a little bit and you can see it got a little deflated now compared to before I'll show you again inflate it like this and you see it's getting a little firmer and deflate it like this and the next is the three-piece pum so the three-piece implant is basically the most popular implant and it's meant to appear the most natural so what that means for VI is that the same sort of fluid filed cylinders go in the erectile tissue but they're attached to two pieces one is the pump in the scrotum and one is the reservoir which is essentially inserted below the abdominal muscles or in the abdomen and that holds fluid so when you want to have an erection you pump up the pump in the scrotum it fills fluid into the cylinders from that Reservoir and when you're done you press another button you deflate the implant and the fluid goes back into the reservoir and I made a video on the differences between the two Brands so between coloplast and Boston Scientific both of which make excellent implants but if you want to learn more about those check out that video so here's the coloplast here is the same cylinders it's attached to a reservoir which goes into the lower part of the abdomen and then a pump is you pump it up in the scrotum so what you do then is you pump it up in the scrotum takes a few more pumps than that um two piece usually 10 to 15 pumps and here is the fully inflated cylinders okay and this is empty ER and then you press the top button here and you can squeeze the fluid here and the fluid goes back see I'm squeezing and the fluid goes back into the reservoir and here is cylinders okay so this is the Boston Scientific version I some for some reason have lost the reservoir but the reservoir is pretty similar again two cylinders attached to a pump there so bottom line is any of these implants can give you a firm erection that is sufficient for penetrator intercourse the remainder of the things to think about are if you have the dexterity to handle a pump and which pump you like the best so they are a little bit different in terms of handling so when you see a urologist make sure you get to see this is the Boston Scientific pump and this is the coloplast pump and also the two-piece pump is a little bit different as well and you can see that here in terms of what you need to know before deciding to have surgery the first thing you need to know is what to expect about your penal length so you are not going to get longer with an implant what you need to do is stretch your penis and see what the length of it is when it's fully stretched that is how long it's going to be when it's erect it's not going to be longer so I tell people that often times it may even appear a little shorter because the glands doesn't inflate the same way as it did before it doesn't get hard the whole way around because that's not possible with the implant and so as long as you are okay with that and you're happy with that and understand that you can go ahead and as I mentioned before this is a last line therapy once you get the surgery you can't go back to taking medications or using other treatments for erectile dysfunction because they're not going to help when we place this we place it in the erectile tissue however again as I mentioned before this is a reliable and consistent way to get an erection each and every time and you will still have normal orgasms ejaculation and sensation the same way you had it as you did before surgery now what are the risks the biggest risk here is infection now infection rates are extremely low in fact people say somewhere between 1% to 10% depending on if it's a new surgery or you're getting a revision so if you are diabetic if you're smoking if you're taking medications that compromise your immune system you're going to be at higher risk so it's important to realize that and understand that you want to do everything we can to reduce that risk of infection and this is because if you get an infection with this surgery God forbid you're in that 1% or you're in that 5% whatever it is it doesn't matter what percent it is it is your issue right and if that happens that implant has to be removed sometimes it can be replaced but sometimes it has to be completely removed and again I leave that to the discretion of your surgeon depending on what things look like at that time so ultimately if it gets removed there is no going back you will then have tissue that will potentially become more scarred because you had surgery in that area and then you may also notice shortening so it is a real issue and preventing infection is a real serious part of this surgery and we've done lots of research in this area looking at ways to prevent surgery so all of us surgeons who do penal implants we spend a lot of time making sure that our or are set up correctly that we're using the right antibiotic solution all sorts of things to help prevent vent you from getting infections also if you are taking medications that may cause anti-coagulation or thin your blood you may need to stop those medications prior to surgery up to a week before so make sure you talk to your surgeon always tell them everything you're taking including supplements other risks are injury to surrounding structures like the urethra or P tube infection as I mentioned and then malfunction or erosion of the implant so because it is just an implant there can have issues with the implant itself and it can stop working also erosion can occur meaning it comes out of the skin although that's very rare again happens less than 3% of the time it is an issue that requires immediate surgery so the semi- rigid implant has very little malfunction and that can stay in as long as possible but the other implants usually last 10 to 15 years and when you look at the data about 85% of people still have a good functioning implant at 10 years and 75% still have a good implant at 15 years now what should you know after surgery so after surgery is super important to avoid sexual activity you want to avoid for at least 4 to 6 weeks again discuss with your surgeon and you want to avoid heavy lifting or strenuous activity in my practice I see all my patients at 3 weeks after surgery to make sure that things are healing well and the incision looks good and there's no signs of infection you can also start cycling the implant meaning start inflating and deflating it usually around 3 to 4 weeks just so that it can start sort of really sitting well in the tissues so bottom line penal implant surgery is a wonderful surgical option for men with erectile dysfunction particularly those who don't respond to other treatments there's three major types of implants a semi- rigid a two-piece and a three-piece implant all of which are great options and can be individualized depending on your needs now every surgery including implant surgery has risks so it's important to know all these risks and always discuss the issues and concerns that you might have with your doctor now if you want to see me for erectile dysfunction or any Urologic issue you can make an appointment at ramik md.com back/ appointments I would love to see you and if you enjoyed this video please do check out my video on Boston Scientific versus coloplast that I mentioned earlier in the video because I think you'll find a lot of information there and as always I'm going to take care of yourself because you're worth it

Dr.

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