Penile Implants

Even prior to the appearance of Masters &Johnson's book, those who were searching for a remedy for physical impotence had developed the first penile implant.

These devices, called penile prostheses, are surgically implanted into the penis in order to make it hard enough to permit sexual penetration. In fact, it is known that centuries ago, men sometimes inserted a long thin bone into their penises in an effort to mimic an erection. Experiments with surgical implants took place as far back as 1936, when portions of human ribs were used, but these operations were usually not successful and were quickly abandoned.

In 1952, there were experiments with acrylic implants, but they resulted in medical complications due to rejection by the man's body and eventually had to be taken out. The modern generation of implants, made from polyethylene, silicone rubber and other materials that the body does not reject, were developed in the late 1960s and the early 1970s, and have been refined and improved since that time. The newer models rarely malfunction, as did earlier ones.

Today's implants will often be used as a treatment of last resort and now, with the introduction of Viagra, they may initially be selected by men and their partners even less often. However, they have been effective for many men and will certainly continue to be used in the future. Due to the Viagra phenomenon, in absolute numbers it is expected that many more men will receive implants than had in the past because many more men are going to come into the "treatment pool" and some will fall with Viagra and other non surgical treatments.

The decision to have an implant is a very serious one, because the operation involves the permanent destruction of some erectile tissue to make room for the device, and this surgery is not reversible.

There are two main types of implants: the inflatable and the non inflatable. The non inflatable is simpler to insert, costs less, and has fewer problems. Once implanted, this device keeps the penis in a perpetual semi rigid state, allowing the man to manipulate it when he is ready for intercourse.

Some complain that this non inflatable, malleable device looks artificial because it is always semi rigid, but in past studies, four out of five men who have it say they are satisfied with it.

There are two main types of inflatable implants: (1) a two part prosthesis, which consists of two cylinders that are surgically implanted into the two chambers of the penis and contain fluid and a pump; and (2) a three part prosthesis, which consists of two cylinders that are implanted into the penis, a separate pump that is placed inside the scrotum and a bulb shaped reservoir containing fluid, which is placed behind the abdominal muscles.

There is another similar device where the pump and reservoir are contained in the scrotum, and another where only the pump is in the scrotum. In this latter type, the fluid is contained in chambers in the cylinders, like the two part prosthesis. To make these devices work, a man squeezes the pump, sending fluid into the two chambers and giving himself an erect penis.

The three part model is more complex and, therefore, more expensive and more complicated to implant, but the separate reservoir holds more fluid and gives a better erection. According to surveys, the rate of satisfaction with the non inflatable implant is about 80 percent and with the inflatable it's about 80 to 90 percent.

However, some men complain that their post surgical penis is too short, not firm enough, not as wide as before or has diminished sensation, especially at the glans (the tip of the organ). In addition, when the device is not inflated, some men are uncomfortable because their penis retains some hardness. Some of these problems can be prevented or corrected. The cost of this surgery can be up to $15,000 or more and is almost always covered by insurance. It may be done on an ambulatory basis, but occasionally requires hospitalization and a recovery period of up to six weeks before intercourse can be attempted. Antibiotics are required to prevent postoperative infections and any mechanical failures could necessitate further surgery.

At this point, if you are thinking that all the men who have penile implants should have waited and used Viagra instead, you are not entirely correct.

Even before Viagra penile implants had been used in recent years only for those men with very severe conditions that render other available treatments ineffective or for men who specifically requested an implant due to its attractive features and virtual one time treatment to "fix" the problem. As we will see, Viagra does not work for every man and there will be an increasing number of candidates for penile implants, even with the availability of this amazing pill.