The surgical procedure aims to restore the functionality of the penis. With the geometrically calculated expansion, it is possible to implant a larger and wider prosthesis. Know what to expect.
Although it is not an aesthetic procedure, the before and after penile implant is a very common question for men who are going to undergo the operation. In search of a “perfect penis”, the concern is valid, but it should not be the main one.
Penile implant placement is indicated for men who have lost limb functionality and currently experience difficulties during sex, such as lack of rigidity in penetration.
The penile prosthesis is indicated when the patient, despite the use of medication, presents loss of vertical resistance for penetration, that is, when the penis does not have the necessary firmness to overcome the penetrative resistance and, during the sexual act, it may escape and/or bend.
The penis is a hydraulic column, and the penile prosthesis serves to create the structural rigidity necessary to prevent the penile column from collapsing. In many cases, the patient even manages to penetrate, but in the movement the penis bends and escapes easily, which makes the sexual act a very embarrassing situation.
This is the case of patients affected by Peyronie's Disease, diabetes or who have undergone prostate surgery, among other health problems. There may be cases in which, in addition to the deformed appearance, there is an impact on the functionality of the penis - and it is the recovery of this function that should be the patients' concern.
The objective is not to attain a longer or more “beautiful” penis, and therefore, the traditional before and after common to cosmetic surgeries does not need to generate fears in patients.
Generally, until the patient has an indication for a penile prosthesis implant, the tissues may lose elasticity due to fibrosis. This results in a smaller, retracted penis.
A preoperative evaluation in the office is important to determine what has been lost in terms of size. This is the best time to offer the patient the possibility of having the penile reconstruction geometrically defined by the “Egydio TEP Strategy” together with the penile prosthesis implant.
It is worth mentioning that penile reconstruction is important, as the prosthesis alone cannot increase the dimensions of a diminished penis.
Before knowing the result of the surgical procedure, it is important to clarify that specifically the treatment for severe cases of Peyronie's can combine two strategies in a single operation: penile reconstruction using the Egydio's Technique followed by implantation.
Penile reconstruction aims to correct organ deformities, according to geometric principles systematized by urologist Dr. Paulo Egydio. For this, multiple horizontal and/or vertical incisions are made that will allow the expansion of the tissue so that the penis is straightened and for the patient to obtain an expansion of the diameter and/or length in relation to the current status of the penis.
In the second part of the surgery, penile prostheses are placed, indicated only for men who have lost rigidity in the organ. They can be malleable, articulable or inflatable, a decision that must be taken together with the specialist to choose the one that suits you best, always respecting your anatomy.
If the penile implant is not performed in conjunction with the reconstruction, the prosthesis placed may be lacking, as it may not meet expectations due to the size and caliber that could have been improved.
Attention: after surgery, the penis will not necessarily increase compared to its original size.
It will be corrected to the limits of the vessels and the urethra, which is the limit possible within penile reconstruction. This limit varies from patient to patient and can only be determined during the intraoperative period. When this limit is reached, with the elongated penis, the prosthesis is implanted in order to keep the elongated penis with this new size and thickness.
In Brazil, the Code of Medical Ethics does not allow the exposure of images with before and after the penile implant and any other procedure. Each organization has its particularities and the results may vary from individual to individual, and professionals are not responsible for the promise of a certain result.
However, it is possible to clarify that, if properly performed, the surgery tends to have a positive impact on the appearance of the organ.
Generally, when the patient has an indication for penile prosthesis associated with reconstruction according to the geometric principles of the Egydio Technique, 3 different results can be expected:
* It is worth remembering that the prosthesis is sized for the expanded penis to the limit of the nerve bundle, vessels and urethra, and as a result, the implant is responsible for guiding healing so that there is no retraction. In addition, it aims to maintain the dimensions obtained intraoperatively.
Overall, the result is an aligned penis, with good penetrative functionality and sexual performance. In addition, one can expect a penis without gross scars or deformities that compromise its function.
As previously stated, after the implantation of the penile prosthesis, the penis will have an elongated aspect, whether it is malleable or inflatable. Consequently, it is to be expected that the foreskin no longer covers the glans and the “penis head” is exposed.
It is worth mentioning that even when the hydraulic penile prosthesis is deflated, the penis will maintain its elongated appearance, but it is easier to position it.
In terms of urinary flow, overall there is no change. The prosthesis is lodged in the corpora cavernosa, a part of the penis separated from the urethra, so that the act of urinating tends to be maintained.
But it is when we talk about the sexual function of the organ that we find the main change before and after the surgery.
Between 45 and 60 days after the operation, the patient is usually discharged to resume sexual intercourse. That's when he can see the benefit of the operation, with the return of penile rigidity essential to penetrative ability.
It is worth remembering that the penile prosthesis implant does not prevent a man from feeling pleasure or having an orgasm, as long as he has a brain activity for the erotic. Taking this into account, the prosthesis also aims to maintain rigidity even after orgasm.
The testimonies of those who have penile prosthesis are mostly favorable. There are reports of patients who have resumed not only their sex life, but mental health and social relationships, since the non-functional penis can psychologically impact men.
The entire procedure, as well as the before and after penile implant treatment for whatever ailment, should be discussed with the doctor. Only in this way will it be possible to align patient expectations with the best results provided by medicine today.
Sharing your questions about sexual impotence or erectile dysfunction with the urologist is essential to receive proper treatment and also regain sexual health.
The surgical strategy published by Dr. Paulo Egydio, known as Egydio’s Technique, is part of the guidelines of the American Urological Association (AUA), Canadian Urological Association (CUA) and European Association of Urology (EAU).
To learn more about the work developed at the clinic by Dr. Paulo, check out:
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.