Erectile Dysfunction

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What are penile prostheses?

A penile prosthesis is a synthetic device, which is inserted under general or regional anaesthetic into the corpora cavernosa of the penis to provide the rigidity necessary to engage in penetrative sexual intercourse. Penile prosthesis allows reproducing a normal erection preserving all the normal feeling and sensation associated with intercourse and climax. The rigidity of the erections obtained with a penile prosthesis is excellent and this procedure is associated with very high levels of satisfaction of both patients and partners.

Penile prosthesis implantation usually lasts less than one hour and the patients are usually discharged within 24 hours. The prosthesis is usually inserted through a 3 cm long incision on the anterior aspect of the scrotum, at the level of the penoscrotal junction.

Patients are discharged home on oral antibiotics for one week and instructed to avoid physical activity for 4 to 6 weeks. Sexual activity is usually recommenced after 6 weeks. 

Penile implants are available in a semirigid (malleable) and an inflatable (hydraulic) version. Semirigid or malleable penile implants are made of two rods, which are fitted into the corpora of the penis. As they are semirigid, they produce a constant erection. The penis is usually concealed in the underwear by bending the shaft laterally.

Inflatable penile prosthesis is instead made of two cylinders that can be inflated with sterile water by pressing a pump located in the scrotum. Inflatable penile prostheses are available in a 2 piece and 3 pieces varieties. In the 2 pieces implant, the fluid is stored in the rear aspect of the implant, while in the 3 pieces device the fluid is located in an intra-abdominal reservoir.

When the patient wants to achieve an erection, he has to squeeze the pump to transfer the fluid to the cylinders; he will have to squeeze the pump until he has achieved the desired level of rigidity. Cycling the device produces a very satisfactory level of rigidity and the erection looks extremely natural and realistic. 

The patient can then deflate the device by pressing the deactivation button located on the top aspect of the pump to transfer the fluid back into the reservoir and to render the penis flaccid. 

Inflatable penile prosthesis by far produces the better results in terms of rigidity, girth and concealability of the penis in flaccidity when compared with their semirigid counterparts. As a consequence, semirigid devices should be offered only in very selected groups of patients, such as those with poor compliance or poor hand dexterity.

Why Choose Giulio

Giulio is a veteran surgeon with 15 years of experience in the field of Andrology and Reconstruction. He is also one of the largest penile prosthesis implanters in Europe, as well as the surgeon who performs the largest number of procedures for the correction of complex cases of Peyronie's disease. He has been invited to lecture and perform surgery in 21 different countries, in 6 different continents.

130

Penile prosthesis implants last year

300

Complex Andrological procedures every year

700

Phalloplasties over his career