Penile Prosthesis Implantation in Turkey

Types of Penis Prosthesis

Semi-hard (malleable) penis prostheses are prostheses that have been used for a very long time, consisting simply of two bendable cylinder rods. Bendable semi-hard prostheses, which are the first type of prosthesis that have been used, have an extremely simple structure unlike inflatable prostheses and are a prosthesis that can be used with almost any ease without the need for dexterity. It is a very ideal type of prosthesis, especially for the elderly, people with limited mental or dexterity. This simplicity also eliminates any malfunction in the prosthesis. In addition, semi-hard prostheses are more economical than inflatable penis prostheses.

However, besides such advantages, there is also a great disadvantage, which is that the penis remains in a constant state of erection. For this reason, patients who have one-piece, semi-hard prosthesis fitted may not feel comfortable enough in daily life and an unnatural appearance occurs. Patients often have difficulty hiding their penises in pants. In addition, this state of constant erection can cause injury by applying constant pressure to the inside of the penis. The penis prosthesis provides a penis that is in constant erection, but always “a little stiff”. In other words, both less and more unnatural hardening can be achieved compared to inflatable prostheses.

Inflatable penis prostheses are a type of prosthesis that the patient can inflate at any time with the help of the mechanism of the prosthesis, which provides hardening by filling the cylinders in the penis with water. These are the most used implants today. There are two different types available.

We can define 2-piece penis prostheses as partially inflatable prostheses. Transverse and longitudinal expansion is not possible in these prostheses, it only provides longitudinal expansion. Two-piece penile implants consist of a pump in the testicles and two cylinders inside the penis. Since it does not contain reservoirs, it is difficult to provide a full natural erection and lowering, and does not provide a very hard erection, as it can only expand as wide as the width of the cylinders. In addition, its mechanism is complex, and therefore the probability of deterioration of the mechanism is also high. Therefore, the least preferred prosthesis by patients is two-piece penis prostheses.

3-piece penis prostheses are the most preferred prostheses. The reason is simple; “the Toughest and the Most Natural!”

Three-piece penis prostheses provide both transverse and longitudinal expansion thanks to the reservoir located in the structure. Erections and downloads closest to natural can be achieved. There are two types of three-piece penis prostheses, both longitudinal and longitudinal and transverse. So much so that a patient who has a three-piece penis prosthesis implanted in an operation performed by an expert and experienced surgeon may not even understand that he has a penis prosthesis if he does not tell them. Because of the appearance of the penis and its stiffness during erection are also very natural. In addition, after a good operation, the surgical wound is not easily noticed.

3-piece penile implants, which are also very practical to use; it consists of two inflatable cylinders and a reservoir and a pump connected to these cylinders. After the pump is tightened several times, it transmits the water in the reservoir to the cylinders and an erection is provided. When the relationship ends, the small button on the pump is pressed and the pump sends the liquid back to the reservoir.

Three-piece inflatable penile implants are the most preferred prostheses for all these prostheses, which patients and their partners say they are most satisfied with.

How is Penis Prosthesis Surgery Operated?

Preoperative

A detailed examination is performed before the surgery, including urological examination. In addition to the physical examination of the patient, the urologist who performs penile prosthesis implantation listens to his detailed history and decides on the operation if he finds that there is no other treatment possibility. In addition, the doctor examines the patient’s dextity and mental competence to determine which prosthesis would be more beneficial to the patient.

Before the operation, the patient is informed in detail about the risks of complications, about the changes he may experience in his sexual life, as well as important issues such as that the procedure is permanent and irreversible, so he should make sure that he chooses the type of prosthesis that best suits him.

How to Insert Penis Prosthesis?

During the operation, a catheter is inserted into the patient’s bladder for the collection of urine. The surgeon who performs the operation then inserts the cylinders of the prosthesis into the penis through the incision he makes in the lower abdomen or under the head of the penis.

If the doctor wears a two-piece prosthesis, he inserts a pump and valve into the testicle bag. If the prosthesis is 3 parts, a reservoir is also placed inside the abdominal wall. After the prosthesis is inserted, the incisions are sewn and the operation ends. This operation takes an average of 45 to 60 minutes.

Postoperative

After penile prosthesis surgery, the patient is likely to feel some pain and painkillers are given to relieve the pain. Mild pain may persist for 1 week in some patients. To prevent infection, your doctor may prescribe you antibiotics.

The hospital stay after surgery is 1 to 2 days. The recovery time is between 2-4 weeks. During this time, a number of ailments such as pain, bruising and swelling may occur. After the operation, you may need to go to the dressing several times. After 4-6 weeks, you can go for a check-up and return to your normal sexual activity if your doctor approves.

How Will My Sexual Life Be Like After Having a Penis Prosthesis Fitted?

Due to many false beliefs, men who have erectile dysfunction problems have undue anxiety or unrealistic expectations about penis prosthesis. Let’s see what awaits you after the operation:

•     Penile prostheses do not prevent having children.
•     Penis prostheses do not affect the pleasure taken from sexual intercourse. So the fear that I will no longer enjoy sexual intercourse and the expectation that I will enjoy it more is unwarranted.
•     Penis prosthesis does not affect orgasm and ejaculation.
•     Penile prostheses do not increase sexual desire. There may be an increase in the patient’s sexual desire due to the psychological relief caused by the elimination of the erectile dysfunction, but this effect has nothing to do with the prosthesis directly.
•     Penile prostheses cannot lengthen or enlarge the penis. Penis prosthesis only increases hardening.

What are the Risks of Penis Prosthesis Surgery?

There are of course general risks arising from anesthesia and complications that may occur during the operation, which also applies to all surgeries in penis prosthesis surgeries.

Although it is rarely seen after the replacement of the prosthesis (between 1.5% and 3%), there is a risk of infection. If the infection develops, depending on the patient’s condition, either the prosthesis is removed and a new prosthesis is expected to be inserted, or salvage therapy is performed. This treatment is the procedure of removing the infected prosthesis, washing the canals inside the penis with antibiotics and replacing it with a new prosthesis at the same time. If it is deemed appropriate for the patient, it is more advantageous for the patient to apply this treatment. Thus, the patient will not have to undergo more than one operation and tissue boiling and shortening of the penis can be prevented after the removal of the prosthesis.

Another risk is that the tissue around the prosthesis, called erosion, is damaged and somehow the prosthesis comes out. Erosion is also usually related to infection and in some cases may require the removal of the prosthesis.

Finally, there is also a risk of mechanical failure in prostheses. One-piece (Semi-hard) prostheses are unlikely to fail. In inflatable prostheses, there is a higher risk of mechanical failure than single-piece prostheses. The most common failure that may occur is the loss of fluid due to leakage in the cylinders. This liquid that seeps into the body is harmless and a liquid that can be absorbed by the body, so there is no need to worry. While the probability of mechanical failure is 15-30%, failures can usually be seen within 10-15 years after the prosthesis is inserted.