Choosing which penile implant is best for you
Achieving optimum results depends upon selection of a penile device/manufacturer best suited for each patient. Our objective is to find the best combination of variables that will result in complete patient satisfaction. This decision is based on thorough knowledge of those variables, the patients unique history, attributes and available devices. Here are some important considerations:
Factors that Dr. Eid considers when choosing which penile implant is the best for a particular individual:
- Age of the patient and partner
- Overall penile size
- Ratio between crus (buried) and pendulous penis
- Ratio between penile length and size of scrotum
- Overall size of scrotum
- Size of glans penis
- History of previous penile implant
- Presence of penile shaft or glans penis atrophy or deformity (Peyronie’s disease)
- Previous abdominal surgery (bladder, prostate and colon)
- Type of previous abdominal surgery (open vs. laparoscopy or robot)
- Presence of a colostomy, ileal conduit or neo-bladder
- Previous peripheral vascular surgery (femoral to femoral artery bypass)
- History of kidney transplant or other major pelvic surgery
- Presence or absence of penile curvature or fibrosis
- Patient’s body type
- Presence of a very prominent supra-pubic fat pad
- Whether or not the penis is circumcised
- Overall health of patient
- Life expectancy
Often this cannot be decided until internal measurements of the penis are performed intra-operatively.
For this reason, a huge inventory of every brand of prosthesis, including the custom Coloplast XL cylinders, is always available for every case and therefore we do not compromise on the size or types of penile device based on availability, or rely on the delivery of a specific brand of penile implant by a company representative at the time of the procedure. We pick the penile prosthesis that will serve the patient the best and are not obligated to use the brand that was delivered by the representative on the day of the procedure. Our goal is not only to maximize the length and girth of the shaft of the penis but also to optimize rigidity by selecting cylinders with the longest inflatable portion and avoiding rear tip extenders.
Dr. J. Francois Eid discusses the many different types of penile implants available today.
Non-Inflatable Penile Implant
Advantages & Disadvantages:
- Easy for you and your partner to use – You simply bend it up for an erection. Down when not in use.
- Good option for men with limited dexterity – Something to consider if you have arthritis or difficulty using your hands.
- Totally concealed in the body – All parts of the device are implanted inside the body but having a permanent erection is very bothersome for most men.
- The simplest surgical procedure – Good option for penile surgeons with limited surgical experience. Of the three types of penile implants, the non-inflatable device involves the simplest surgical procedure.
- Least expensive – Non-inflatable implants are the least expensive type of penile implant. This may be a consideration for men not covered by insurance.
- Abnormal feel and appearance.
- Causes deterioration and thinning of penile flesh over the long-term.
- Only 20% of implants performed in the USA.
- Most amount of pain and discomfort post-operatively because the penis needs to adjust to a constant erection.
Two-piece Inflatable Penile Implant
Advantages & Disadvantages:
- Easy for you and your partner to use – You simply pump it up for an erection. Down when not in use.
- Thought to be a good option for men with limited dexterity – Something to consider if you have arthritis or difficulty using your hands. However, this penile pump is small and difficult to inflate.
- Because only a small amount of fluid is transferred into the cylinders to obtain an erection, the penis is not as rigid as with a multi-component inflatable penile device.
- Totally concealed in the body – All parts of the device are implanted inside the body but having a partial erection is very bothersome for most men.
- The simplest inflatable implant surgical procedure – Good option for penile surgeons with limited surgical experience.
- Abnormal feel and appearance. The cylinders have an unnatural shape and make the penis look like a broom with a square head.
- Causes deterioration and thinning of penile flesh over the long-term.
Three-Piece (Multi-Component) Inflatable Penile Implant
Advantages & Disadvantages:
- Easy for you and your partner to use – You simply pump it up for an erection. Press the release valve above the pump to deflate.
- A Larger softer pump makes it easier to inflate than a two-piece device.
- Because a larger amount of fluid is transferred into the cylinders to obtain an erection, the penis is most rigid of all the penile implants with a multi-component inflatable device.
- Offers the best flaccidity (softness) of the penile shaft when not in use which is the most comfortable for the patient.
- The only prosthesis that gives the penis a normal look and feel when erect and when flaccid. Many single patients report that the partner does not realize that the penis has an implant in it.
- Because it has the least amount of pressure on penile flesh when not in use, pressure atrophy of remaining erectile penile muscle and of the flesh of the glans penis is less likely to occur.
- Totally concealed in the body – All parts of the device are implanted inside the body.
- The most involved inflatable implant surgical procedure – Good option for penile surgeons with large surgical experience.Because the penis is flaccid after the surgery patient has the least amount of pain post-operatively.