December 6, 2023

Sexual Activity with Penile Prostheses

Written by
Edward Calleja
Impotence (Erectile Issues)
Wave Blue

Erectile dysfunction affects many men, particularly as they age. While several treatment options are available, a penile prosthesis can provide a long-term solution when other methods have proven ineffective.

Are there different penile prosthesis?

Inflatable Prostheses

These are the most commonly implanted devices, especially in the United Kingdom, where their usage accounts for most procedures. A three-piece inflatable prosthesis comprises a cylinder inserted into the penis, a pump in the scrotum, and a fluid reservoir in the abdomen.

Malleable Prostheses

Also known as semi-rigid prostheses, these can be manually bent up or down as required. They offer the benefit of simplicity but are generally less natural-looking than inflatable options.

Who are the market leaders of penile prosthesis?

Two companies dominate this sector: Boston Scientific and Coloplast. They offer a range of products designed to cater to individual needs and preferences.

How is the sexual experience with a penile implant?

Perceptibility of the Implant

While fully implanted under the skin, the device is usually imperceptible to the individual and their partner during sexual activities.

Physiological Processes

Despite using a prosthesis, sensations, orgasm, and ejaculation generally remain unaffected. According to surveys, over 90% of men and their partners were happy with the sexual experience that an inflatable prosthesis provided (Montorsi, F., et al., Journal of Sexual Medicine, 2016).

How long does the erection last with a penile prosthesis?

The inflatable prostheses allow the user to control the duration of the erection manually, providing flexibility and adaptability during intercourse.

A quick overview of the surgical procedure done?

Duration and Anesthesia

The operation typically lasts about an hour and requires general anaesthesia. Adherence to fasting guidelines is critical and usually involves abstaining from food for up to six hours prior.

Postoperative Care

Patients are usually required to stay overnight in the hospital, though some might be eligible for outpatient treatment. A sedentary lifestyle is recommended for 12-24 hours post-surgery, and antibiotics are generally prescribed to prevent infection.

What are the common complications and side effects?

Revision Rate

The need for device replacement or modification is around 30% over ten years (Wilson, S. K., et al., Journal of Urology, 2011).

Infection Risk

Infection is a severe but relatively rare complication, with rates around 2% in recent studies (Culha, M. G., et al., Turkish Journal of Urology, 2018).

Other Concerns

Less severe side effects might include erectile instability and flaccid glans. Serious complications necessitate immediate medical intervention and may have symptoms like profuse haemorrhaging, urinary retention, and fever.

Reflection on penile prostheses to address impotence

Penile prostheses offer a viable solution for men who suffer from erectile dysfunction and have found no relief from other treatments. While the experience of sexual activity may differ slightly, the overarching goal of enhancing quality of life is generally met with high levels of satisfaction.


References

- Montorsi, F., et al. "Inflatable Penile Prosthesis: How Do Patients and Partners Feel?" Journal of Sexual Medicine, 2016.

- Wilson, S. K., et al. "Long-Term Revision Rates for Penile Prosthetic Surgery." Journal of Urology, 2011.

- Culha, M. G., et al. "Penile Prosthesis Implants: An Update." Turkish Journal of Urology, 2018.