Review of Penile Implant (Prosthesis): the pros and cons
Penile Implants: “80-90% satisfaction rates”
Penile Implants. Medical sources make them sound like the Promised Land:
“Over 90%-95% of inflatable prosthesis implants produce erections suitable for intercourse. Satisfaction rates with the prosthesis are very high, and typically 80%-90% of men are satisfied with the results and say they would choose the surgery again”. (WebMD)
However, let’s ask a man who has been there, done that, got the erection.
This blog post is by John, he had his implant surgery January 2019 (11 months ago).
John runs the St. Kilda, PCFA Support Group . He wants to share his story because he wished this information was available to him pre-prosthesis.
These are his words below…
Why I opted for Penile Implant Surgery
Sex has always been extremely important to me in different ways and it is now certainly a vital way that I express and feel love, closeness and connection with my partner.
When I was diagnosed with Prostate Cancer in 2017 I raised my fear of E.D. with my first Prostate Surgeon. His cold response was – “do you want to live or not?”.
I vividly remember saying to my new (somewhat more empathetic surgeon) on the operating table a few seconds before the anaesthesia set in - “please spare those bundle of nerves if you can”.
Unfortunately given the location of the cancer this was not possible and he had to cut through the left side completely.
After the surgery, Viagra and Cialis was ineffective. I found Caverject (penile injections) way too painful. Thankfully a friend put me on to TriMix (penile injections). This injection formula didn’t particularly hurt and worked adequately for about 12 months when taken at full strength.
However, I started to find it increasingly difficult to get the needle in, its effectiveness became intermittent. The whole experience of injecting became anxiety provoking.
I knew something was wrong so I saw a Urologist who diagnosed me as having Peyronie’s Disease. This build up of scar tissue exacerbated by the injections explained why I had trouble inserting the needle.
I realised I only had months left with injections. Soon there would be no more places left to inject, and I would continue to further damage my penis by doing so.
I have a fully supportive, caring and understanding partner. But I found the potential loss of such an important part of our relationship devastating and very hard to deal with emotionally.
After much discussion and research it became clear that if I wanted to continue to have erections I really only had one realistic option - a prosthetic implant.
How my Penile Prosthesis works
There is a little reservoir or tank with saline solution in it which lives in my abdomen. This is joined to two plastic tubes that run either side of my penis. These tubes become inflated with that saline solution when I squeeze (roughly 20 times) on a small pump in my scrotum. It does not hurt. The process takes about 30 seconds to full erection.
To deflate I push on a small button next to the scrotum pump and squeeze my penis for about 10 seconds. Gravity then does its job and it deflates. It will not deflate until I do this process.
Watch this Youtube video for detailed explanation by Dr. Chris Love.
John’s Cons for Penile Implant Surgery.
1. High Upfront costs if done privately (between $5,500 and $7000).
2. Considerable pain for 2 to 3 months.
This was understated and quite difficult. Pain, swelling, bruising and sudden shooting pains. Ice packs helped.
I had initial concerns as to whether or not this pain was normal, if possible I now highly recommend the ‘buddy system’ approach to deal with these first months. My buddy was a bloke who had the operation an hour before me, we met in the ward and later traded texts, emails and calls checking if our experiences were similar. Usually they were, which was quite reassuring for both of us.
3. Constant semi-erection for one month post surgery.
After the surgery to ensure that tissue doesn't adhere or further scar after the operation, the implant needs to be semi-inflated. Therefore you have half an erection, 24 hours a day, for 1 month. Sounds better than the reality. It is certainly a relief once this period ends. In particular this made sleeping awkward and I recommend loose underwear (boxers rather than jocks).
4. Inability to fully deflate the penis.
This was a problem initially but I did get used to it with practice.
5. Having to inflate the penis every day indefinitely.
This is important for device maintenance. Although not a lengthy procedure, it is another task to add to that never ending task list.
6. Risk of infection for the first 3 months.
If infection does occur you potentially have to go through the whole operation again. Make sure your Doctor has good track record and takes many precautions.
7. Needs replacing in 10-15 years time.
Implants need replacing down the line. 5% need replacing within 10 years, 20% by 15 years.
8. Some level of anxiety.
I initially worried about inflating/deflating the prosthesis successfully. Luckily, this was easier than expected after some practice
9. Urination can be messy.
When urinating sometimes it squirts in a different direction or even a double squirt. This is as a result of the tubes either side of my penis. This can be a bit messy and annoying. Need to be vigilant.
John’s Pros for Penile Implant Surgery.
1. Full, firm erections within 25 seconds, at any time I choose.
This will remain the case for the rest of my life, even if I have reduced testosterone as a result of age or Androgen Deprivation Therapy. This facilitates the ability to have spontaneous sex and masturbation sessions.
2. Penis straightening
I finally had relief from the Peyronie’s disease curvature.
3. Penis growth by 1-2 cms
The daily inflation exercise means that your penis may stretch and grow a centimetre or so. For me, this means that my previous retraction issue as a result of the surgery has now been eliminated. I no longer urinate on myself when I sit on the toilet.
4. Saving approximately $120 per month
This is as a result of not needing to use injections or pills anymore. So there is a basic monetary ROI on the surgery in just under 4 years.
5. No more pre-sex anxiety
I no longer worry about whether or not I will be able to have a fully erect penis. Plus, I do not have to go through injecting the penis with a needle.
6. No more anxiety during sex
This and the previous point cannot be underestimated. I am now able to fully focus on the sexual experience in a mindful manner. This enhances the whole experience as I can mindfully focus on my partner and my orgasm experience. This was not a benefit I had anticipated.
7. The ability to maintain a fully erect penis post orgasm.
Therefore if your partner has not yet had an orgasm, you have the choice to gently continue or not.
8. Less pressure on your partner
There is no need for them to have to think about helping to obtain and keep the erection.
9. Maintained size on Androgen Deprivation Therapy (ADT)
I am now on Hormone Therapy, as a result both my penis and testicles have significantly shrunk (I’m told this is a normal side effect). However, because of the tubes in my penis and the pump in my scrotum it still appears physically normal on the outside. This means I do not feel self-conscious in the communal showers of the local leisure centre after a swim.
10. A good talking point if you are up to it (so to speak) over a dinner party or a beer.
Certainly beats talking about the cancer!
BONUS: I also read that if you use a condom there is now a much reduced chance of it coming off after orgasm due to a non-erect penis and hence reducing chances of STD’s etc.
In conclusion, my implant surgery has resulted in considerably enhanced self-esteem and confidence. On top of that, sex has moved from a focus on process/technique based to pleasure, closeness and intimacy.
In fact, recently I feel like I have won the trifecta. I am now on Androgen Deprivation Therapy as well as Chemotherapy, yet I still manage to have sex and orgasms against all evidence that is not likely to occur during these treatments.
At times I have felt quite hopeless about the possibility of things turning to relative normality in terms of my sex life. What I have learnt is to not give up as there maybe other alternatives out there.