Penile prosthesis, a malleable or inflatable device is a treatment option for men with erectile dysfunction. A simple prosthesis contains a pair of expansive and malleable rods that are implanted surgically within the erection chambers of the penis that makes the penis semi-rigid so that it merely requires lift or adjustment to attain erection to initiate sex. Nowadays, many men choose an inflatable, hydraulic prosthesis, that allows to achieve erection whenever it is chosen and is quite natural easier to conceal. A penile implant is usually applied when during a clear medical need for ED and when the problem cannot be resolved naturally or with any other medical therapy. Sometimes penile prosthesis implanted at the time of surgery for reconstruction of the penis in patient's with Peyronie's disease.
The expansive penile prosthesis consists of two cylinders attached -- a pump and a reservoir -- which are surgically placed in the body. The two cylinders are implanted connected inside the penis by tubing to a separate reservoir of fluid. The reservoir is inserted under the groin muscles. A pump connected to the system placed between the testicles, under the loose skin of the scrotal sac.
Due to the 3 different components, this penile prosthesis is also called a 3-piece expansive penile prosthesis. In 2-piece inflatable penile prosthesis system only two components are present: the attached cylinders and combined pump and reservoir unit. Here the reservoir is not placed behind the groin instead combined with the pump that fits easily within the scrotum. The main advantage of a 2-piece prosthesis is that a shorter and less complicated surgery is possible and the abdomen is completely free of any device parts. On the other hand the disadvantage of a 2-piece prosthesis is that the smaller reservoir may not possess adequate erections in some men.
For inflation of the prosthesis, the user must press on the pump that transfers the fluid from the reservoir to the cylinders in the penis thereby inflating them causing an erection. Deflation of the penis can be achieved by pressing the deflation valve at the base of the pump that returns the fluid to the reservoir, thereby deflating the penis to return to the normal flaccid state.
While a small surgical scar at the bottom where the penis meets the scrotal sac can be visible to the patient who have undergone prosthesis surgery, other people probably will be unable to tell whether the man has an inflatable penile prosthesis.
With prosthesis the inflated penis becomes stiff and thick, which is quite similar to a natural erection. Although most men rate the erection to be shorter than their normal one; however, new models comprise of cylinders that may increase the thickness, length and stiffness of the penis.
Penile prosthesis does not change skin sensation of the penis thereby not affecting a man's ability to reach orgasm and erectile. But once a prosthesis of the penis is done, it may however, destroy the natural reflex of erection. It was found that men usually cannot attain an erection without implant inflation. On removing the implant the person may fail to have natural erections.
It was reported that about 90%-95% of prosthesis implants help achieve erections quite suitable for intercourse. Rates of satisfaction in patients with inflatable prosthesis are very high, and 80%-90% of men are very much satisfied with the outcome and prefers to choose the surgery again. Penile modelling over an inflatable prosthesis of the penis is an emerging technique for patients with severe Peyronie's disease. Reliability of implant reliability is excellent with low postoperative morbidity.
An infection, which is a serious complication has been found to occur in 1 to 3 percent of cases. This is a major cause of concern as elimination of the infection requires no removal of the prosthesis. Also erosion occurs in few people on the protrusion of some part of the prosthes outside the body. Erosion often causes infection that needs frequent removal of the device.
Sometimes mechanical failure is associated with inflatable prosthesis which is less common with a malleable or semi-rigid prostheses. Often leakage of fluid present inside the inflatable prosthesis the body may occur; however, it is not of major concern as these prostheses consists of normal saline that is safely absorbed. Prosthesis replacement surgery is necessary after mechanical failure if a man urges to remain sexually active. Nowadays following implantation 3-component inflatable penile prostheses have about a 10 to 15 % possibility of failure in the first 5 years.
Depending on your geographical region, your choice of surgeon, implant type and placement, in USA the average cost of penile implant surgery is between $16,000 and $20,000 is too Costly; this procedure may be covered by insurance. but in India all procedure done around at $8,000 to $12,000 with all accommodation.
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