The penile prosthesis is a subject that creates doubts among men. Many think that its function is to increase the size of the penis, but we have already shown that this is a myth. Curiosities aside, the most accurate way to diagnose the need for an implant is through a functional examination of your penis. It must be done by a medical expert, who will induce the erection artificially and make a detailed ultrasound of the penis.
But if you are just getting started on this, be aware that there are some indications that suggest the need for a prosthesis. This is what you are going to learn how to identify now.
WHAT IS THE PENIAN PROSTHESIS, WHAT IS IT FOR AFTER ALL?
The penile prosthesis is recommended for those patients with some penis disorders. These may be due to the lack of firmness in the limb, which hinders or impedes the sexual act, or a condition that impacts on its anatomy, such as Peyronie’s Disease.
In some cases, clinical treatment based on medications or injections can solve the problem. In others, the implant is the most appropriate solution, especially for older patients suffering from medical conditions that restrain the use of these medicines.
WHEN A PENILE PROSTHESIS IS INDICATED
There is no way to be sure of the need for prosthesis based on theory, each patient has his particularity. In more than 20 years of experience in the field, I have seen many cases in which only the implant solved the problem, but this was only defined after trying some clinical treatment and based on a set of factors. Here follow some examples.
When clinical treatment hasn't worked or the effect has decreased
Many men began to treat erectile dysfunction with medicines and injections, but with no satisfactory results. Others, at first, were successful, but over time the problem continued to worsen, causing an increase in the required dosages and decreasing the effect of clinical treatment. That's why it's important to always keep an eye on your buddy's performance.
When the patient didn't adapt to the use of pills or injections
The use of medications or injections to stimulate the erection may cause some side effects, such as nasal obstruction, headache and facial blushing. Not everyone goes through this, but if you notice some of these symptoms during clinical treatment, talk to your doctor so the situation doesn't get worse.
Another disadvantage of injections that makes many men don't want this form of treatment, is the inconvenience of its application. It should be done right before the moment of having sex, disrupting the climate of the sexual relation. In this kind of situation it's normal for the man to omit this fact from his partner and hide the use of the injection. This is not a behavior that I would suggest because it may lead to assumptions and misinterpretations of the other part, such as the use of illicit drugs, for example.
When there are fibroses associated with erectile dysfunction
Many patients may notice the appearance of fibrosis plaques inside the penis (below the skin) during clinical treatment, due to the continuous use of injections to stimulate the erection, for example. Aside from causing pain, it can provoke deformities in the penis, causing it to bend, reduce size or get thinner.
The lack of firmness in both nocturnal and morning involuntary erections, is also an indication that something is not going well. This situation may be related to conditions such as Diabetes and Prostate Cancer, which in turn can cause fibrosis and even a decrease in penile size.
When the anatomy of the penis favors penile curvature
Very long and thin penises tend to bend over time due to a sustaining problem. If the quality of the erection is good, but you still notice that the penis bends during the sexual act, this is a sign that needs to be discussed with a medical specialist.
A detailed assessment will define the need to place a prosthesis, often preventively, to avoid more serious problems, such as Peyronie's Disease.
When hormone reposition did not succeed
Another possibility is when erectile dysfunction persists even when testosterone is within normal range, including when a hormone reposition therapy has already been done.
In elderly patients, testosterone reposition is not always recommended due to the risk of prostate enlargement.
CARES WITH THE INDICATION OF PENILE PROSTHESIS
You have seen above some indications that the solution of erection problems is penile prosthesis implantation, and that may be a definitive treatment for erectile dysfunction. Let us assume that your urologist has indicated the need for a penile implant. What now?
There's no reason to worry. When it is done with the right care and specialized medical guidance, it is a safe, efficient treatment and with a high satisfaction rate for the couple. But a special care is needed to ensure the best results, such as assessing if there was any loss of size and to do a penile reconstruction to lengthen, in order to recover the largest possible length and diameter.
Dr. Paulo Egydio
MD, PhD, Dedicado no Tratamento da Doença de Peyronie, Pênis Curvo e Implante de Próteses Penianas. Doutor em Urologia pela USP, CRM 67482, RQE 19514. - Vencedor do Debate do Sobrevivente da AUA em 2019.