A penile implant is a device that is placed inside the penis of the man to allow him to restore his erectile function. These devices have been available since 1973 when they were first invented. Over time there have been numerous iterations of the device and improvements to the devices that we have today. These are called the inflatable penile prosthesis, which is a hydraulic device that is placed in the penis. By squeezing a pump, it allows water to engorge the penis and develop an erection that is satisfactory for intercourse.
The penile implant is a great option for men with erectile dysfunction and has been shown to be safe and achieve very high satisfaction rates in both patients and partners by over 90%. As with any other surgical intervention, they may be associated with certain complications or side effects. These include the risk of pain and discomfort after surgery in 1-2%, which is mitigated with some pain strategies in which most patients don't require any pain medications postoperatively. There's also the risk of bleeding or swelling in the scrotum, which is also not common and occurs in less than 5% of patients.
The most dreaded complication of a penile implant is an infection of the device. This occurs in 1% of patients getting their first implant and in about 3% of diabetic patients getting an implant. If an infection does occur, the device requires removal. The internal parts of the penis are cleaned in what is called a washout, and another implant is replaced. This strategy is successful in over 87%.
Another complication is length of the penis, which is often a concern for patients. Patients have often lost a lot of length of their penis before surgery and come in expecting that the implant is going to increase their penis size by inches and inches. That is not the reality. On average, the length of the penis is either the same or sometimes mildly increased, but not significantly increased.
And finally, like any other device, there are some mechanical issues that may occur related to the pump, the cylinders, or the reservoir. These occur in about 3-5% of people at an average of 15 years, who then need a device revision.
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