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Penile Implants

Penile implants are devices put inside the penis that allow men with erectile dysfunction (ED) to get an erection. Penile implants require surgery. There's a risk of infection and a risk that the device won't work. But new materials, designs and surgical procedures have greatly improved results. Most men with penile implants and their partners say they're satisfied with the results.

For most men, erectile dysfunction can be successfully treated with medications or use of a penile pump (vacuum constriction device). Penile implants may be an option to consider if you can't get an erection sufficient for sex with these other methods or if other methods cause undesirable side effects.

Risks of penile implant surgery include:

• Infection. As with any surgery, infection is a possibility. You may be at an increased risk of infection if you have a spinal cord injury or diabetes. Men who need surgery to adjust or replace an implant (revision surgery) are at higher risk of infection than they were with the first surgery.
• Implant problems. New penile implant designs are reliable, but in rare cases the implants may not work correctly. For example, in some semirigid devices, internal parts can break down over time. In inflatable devices, fluid can leak or the pump device can fail. Surgery is necessary to remove, repair or replace a broken implant.
• Internal erosion or adhesion. In some cases, an implant may stick to the skin inside the penis or wear away the skin from inside the penis. Rarely, an implant breaks through the skin.

Types of penile implants:

There are two types of penile implants: inflatable implants and semirigid rods.

Inflatable implants are the most common type of penile implant used in the United States. Inflatable devices are more natural than semirigid types are because they can be inflated to create an erection and deflated at other times. Inflatable implants also reduce the possibility of damage to the inside of the penis due to constant pressure — which can be a problem for some men with semirigid implants. There are two- and three-piece inflatable implants.

• The two-piece model works in a similar way to a three-piece design, but the fluid reservoir is part of the pump implanted in the scrotum.
• Three-piece implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis. Before you have sex, you pump the fluid from the reservoir into the cylinders to cause an erection. After sex, you release the valve inside the scrotum to drain the fluid back into the reservoir.

Semirigid rods are always firm. The penis may be bent away from the body to have sex and toward the body to conceal the device. Although less commonly used than the inflatable type, semirigid implants are less complicated, easier to place and have less risk of failure.

The decision about which type of implant you should have is based on both your preference and your medical situation. Your doctor may suggest one type of design over another based on factors including your age, risk of infection, and health conditions, injuries or medical treatments you have had in the past.

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