Penile Implant Candidate

A penile implant is a surgical solution for patients who experience erectile dysfunction (ED) and have not found success with other treatment options, such as medications, therapy, or vacuum devices. The implant works by manually or mechanically creating an erection, depending on the type of implant used. During the consultation period, patients undergo a thorough assessment of their overall health, goals, and expectations to determine their suitability for the procedure. Below is an overview of who qualifies as a penile implant candidate.

Failure of Non-Surgical Treatments

Oral medications known as phosphodiesterase type 5 (PDE5) inhibitors are often the first-line treatment for erectile dysfunction. They work by increasing blood flow to the penis by relaxing the blood vessels and causing them to remain open, resulting in an erection. In addition to medications, lifestyle changes such as avoiding stress, smoking, alcohol, and unhealthy foods are recommended. In some cases, these non-surgical treatment options may be ineffective. As a last resort, surgeons might suggest the possibility of surgery, such as the insertion of penile implants. These implants, which can be inflatable or bendable rods, are placed within the penis, giving the patient the ability to manage how long the erection lasts.

It is important to keep in mind that suitable candidates for penile implants are patients who do not respond to non-surgical treatment options. These methods must be explored first because surgery is an invasive procedure and comes with inherent risks.

Presence of Physical Causes of ED

ED can result from various physical causes. Suitable candidates for the procedure are those with medical conditions that affect the blood supply or nerve signals going to the penis, which in turn affects erectile function. These are the most common physical causes:

• Peyronie’s Disease: This condition involves the formation of scar tissue inside the penis, leading to curvature and erectile issues.
• Diabetes: Elevations in blood sugar levels for longer periods can damage the blood vessels and nerves in the penis, thus affecting erectile function.
• Prostate Surgery: This surgical procedure can damage the nerves in the penis and impair the process of erection.
• Spinal Cord Injury: This type of injury can affect the transmission of signals between the brain and the nerves within the penis, leading to erection problems.

Having Realistic Expectations

Suitable candidates are those who have realistic expectations about the outcomes of the procedure. It is important to remember that penile implants involve permanent alteration of the body. While they can provide the physical ability to have an erection, these medical devices do not increase sexual desire or sensation.

In addition, penile implants have associated risks and complications, such as:

• Anaesthesia risks
• Auto-inflation (for inflatable implants)
• Chronic pain
• Device breakage or malfunction
• Erosion or migration
• Implant malposition
• Infection
• Mechanical failure
• Reduced sensitivity
• Scar tissue formation
• Shortened penis length

Good Overall Health

Before the procedure, the surgeon will conduct a detailed patient health assessment to determine factors that can affect the outcomes of the surgery. This also helps determine if the patient is a suitable penile implant candidate. Based on these assessments, the surgeon will customise the treatment plan or suggest alternative treatment options.

In general, penile implants are not suitable for patients with the following:

• Significant heart or vascular disease
• Poorly controlled diabetes
• Immune system disorders
• Active infections
• Blood clotting or bleeding disorders
• Previous pelvic surgeries, particularly related to the prostate or bladder (can increase the risk of scar tissue formation or difficulty placing the implant)