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WHAT IS PENILE PROSTHESIS?

Penile prosthesis is a material that is surgically inserted into the penile corpus cavernosum. It helps the patient to get an erection when they want to have intercourse.

When should a man consider a penile prosthesis? Nowadays, phosphodiesterase inhibitors (PDE5 inh.) are used as first-line therapy in the treatment of erectile dysfunction. However, this treatment results in failure in 35% of erectile dysfunction patients.

Treatment options other than penile prosthesis may not be effective or suitable for every patient. Penile prosthesis implantation (PPI) is one of the most important treatment options in erectile dysfunction.

A penis/penile prosthesis (happiness stick) is a material that is surgically placed inside the penile spongy tissue (corpus cavernosum). It helps the patient have an erection when he wants to have sexual intercourse.

There are 2 types of penile prostheses as semirigid, noninflatable and inflatable (2 and 3-piece inflatable).

Radical prostatectomy (a surgery in which the entire prostate and surrounding tissues are removed) is an effective treatment option for prostate cancer.

Despite the advances in the diagnosis, early treatment, and surgical techniques in these patients, erectile dysfunction still remains as an important problem.

Penile rehabilitation treatments including drugs, intracavernosal injections or penile prosthesis implantations are applied to improve erectile functions after a surgery.

One study showed that the majority of patients who underwent penile prosthesis surgery were those who had undergone radical prostatectomy.

Penile prosthesis is a suitable option in patients who have undergone radical prostatectomy, when other treatments are not successful or for those who want an exact solution. Satisfaction rate is over 86%.

Ischemic priapism is a completely hard and painful erection lasting more than four hours without sexual stimulation and requires immediate treatment. If priapism is not treated in the acute period (before 36-48 hours), the patient will develop erectile dysfunction as it will result in tissue death (necrosis) in the spongy tissue (corpus cavernosum). In those patients, penile prosthesis is usually required for the treatment.

Penile prosthesis is applied in the early and late period in this group of patients. Early implantations (within the first 3 weeks following the disease onset) are advantageous as the surgery will be relatively easier and they prevent the shortening of the penis size. Moreover, patient satisfaction rates are at about 96%.

In the natural history of Peyronie's disease, estimated ED rates range from 22% to 54%.

Although the etiology of ED associated with Peyronie's disease is not known exactly, increasing age, psychological factors caused by the disease, comorbidities, and pain contribute to the development of ED.

Penile prosthesis surgery is performed in patients who have poor erection quality in the stable period of the disease and who do not respond to pharmacological treatments.

While more semi-rigid devices were preferred in the past, with the development of inflatable devices, it is currently seen that they are preferred more.

Frequently Asked Questions

Penis / penile prostheses are applied to patients under general or local anesthesia by making an incision in the lower abdomen or in the site where the scrotum is located. Two prosthetic cylinders of appropriate size are placed on spongy tissue by measuring during the operation.

There are 2 types of penile prostheses as semirigid, noninflatable and inflatable (2 and 3-piece inflatable).

Semirigid penile prostheses consist of a pair of parts which are permanently hard. The penis is never in the flaccid state in patients using this prosthesis. The penis is always in the erect state, the prosthesis does not imitate natural hardening and softening of the penis.
Inflatable penile prostheses are fluid-filled devices.
- Three-piece inflatable penile prostheses are devices that provide the best erection and flaccid state, that is, the closest result to the natural function. Today, it is the most commonly used type of the prosthesis. It consists of a pair of penile body cylinders, a scrotal pump, and an abdominal fluid reservoir. The device is inflated by squeezing the pump several times, transferring the liquid from the reservoir to the cylinders. The pump is then used to transfer the liquid back to the reservoir.

Prosthesis infection, which is one of the most important complications, has been reduced to 1-2% with the appearance of new techniques and antibiotic-covered prostheses.

There is a risk of mechanical failure, yet at a low rate. The device is lifetime guaranteed and can be replaced if it fails.

Today, phosphodiesterase inhibitors (PDE5 inh.) are used as first-line therapy in the treatment of erectile dysfunction. However, this treatment fails in 35% of erectile dysfunction patients. Other treatment options for these patients are

intracavernosal injections,
vacuum devices, and
penile prostheses.

Treatment options other than penile prosthesis may not be effective or suitable for all patients. Penile prosthesis implantation (PPI) is one of the most important treatment options for erectile dysfunction.

52% of the patients with erectile dysfunction are between the ages of 40 to 70. Although penile prosthesis surgery is most frequently performed in this age range, it can be performed in any age groups of adults.

You will stay in the hospital for 2 nights following the surgery.

You can go back to work after 7-10 days.

You can start physical activities after 30 days.

You can be sexually active again after 45-60 days.

The prosthesis is completely placed inside your body.

The inflatable penile prosthesis is not noticeable to the eye. When the penis is in the flaccid state, it looks normal.

As the semi-rigid prosthesis is permanently rigid, it can be "visible" through clothes.

The device lasts an average of 15 years. However, it can be used for a lifetime without failing. It has a lifetime guarantee.

Radical prostatectomy (a surgery in which the entire prostate and surrounding tissues are removed) is an effective treatment option for prostate cancer.

Despite the advances in the diagnosis, early treatment, and surgical techniques in these patients, erectile dysfunction still remains as an important problem.

Penile prosthesis (happiness stick) placement is preferred in adult patients who has penile curvature (Peyronie's disease) with erectile dysfunction, and with a surgery performed by an experienced surgeon, the success rate is at around 90-95%.

Penile prosthesis is one of the most important treatment options in erectile dysfunction, which is recommended for patients who do not benefit from other treatment options or for whom other treatment options are not suitable.

Before penile prosthesis surgery, patients with benign prostatic hyperplasia undergo prostate examination, blood (Total PSA) analysis, urinalysis, urination test (uroflowmetry) and amount of urine remaining in the bladder is analyzed. Penile prosthesis surgery can be performed in patients who have normal test results.