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#GatekeepersofMen Series

Episode 19

Penile Implant: The Solution for ED?

Is the Penile Implant the “last resort” or “best option” for ED?

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Every day in clinic I meet men who complain that their erection is weaker. I repeat: every single day.  Erectile dysfunction is very common and occurs to approximately 40% of guys above 40 years old.  These men often come in to see me after they‘ve done their research online to know what their options are.  They find many alternatives which include oral medications, injections, urethral gels, vacuum therapy, shockwaves, PRP, stem cells and the penile implant. Unfortunately, some of these are experimental and have not been proven to work. Without knowing the pros and cons of each treatment option, it is hard to know what is the best option for each individual.

“My erection is getting weaker, what can I do?”

I first wish to clarify that ED is NOT an “on and off switch”.  What I mean by this is that many people think that men either have a VERY STRONG ERECTION or NO ERECTION at all.  However, those who suffer from it know that it is a spectrum. Think of it as a scale or grading system.  The erection can be anywhere between 0% (completely flaccid) and 100% (hard as a rock).

Happy couple in nature

That said, every man who notices that he is having problems with either gaining or maintaining an erection should consider going to see his primary care doctor.  They should first make sure that there is no medical condition that could be contributing to his sexual impotence.  If you are diagnosed with Diabetes, heart disease, high blood pressure, thyroid problems, low testosterone, etc : these medical conditions could be the cause of your weak erections.  The second thing they should do is:  visit a specialist!  Visit someone who knows all the treatment options and can help guide you to what is best for you.


What is the best treatment for ED?

This is a difficult question to answer because there are different causes of erectile dysfunction.  For example, men with “hormonal ED” will benefit from Testosterone Replacement Therapy. Men with psychogenic ED benefit from behavioral sexual therapy. However, men with vascular erectile dysfunction, that is problems with blood flow in the penis will not necessarily respond to Testosterone or behavioral therapy.  This is why it is important you go visit a SPECIALIST who can help guide you towards the best treatment specifically for you.

“My doctor told me the penile implant is the last resort”

Another thing we need to clarify is that the penile implant is probably the MOST EFFECTIVE therapy for ED, no matter the degree or severity of erectile dysfunction.   Multiple research studies have shown that men with penile implants are more satisfied with their sexual function than those taking pills, injections or vacuum therapy.  If you wonder, treatment satisfaction rate after the implant is more than 95% for BOTH patients AND partners.  That is more than 30% more than pills, injections and vacuum therapy!

So… why do some consider it the “last resort”?

Most of the time we offer the penile prosthesis for men with severe ED that do not respond to medications or other therapies. The inflatable penile implant is a device that is placed inside the penis. It will occupy the space and disrupt that space within the erectile tissue.  If the implant needs to get removed; then, other therapies (like Sildenafil, Tadalafil or injections) will not work. This is the reason some doctors consider it as the last resort. “….because once you have the implant there is no going back”.  However, I do not think this way and I will explain why…

Does the Penile Implant need to be replaced regularly?

There is a big misconception regarding penile implants.  Many men think that it needs to be replaced regularly, but the fact is that it does not.  In 5 years, 95% of implants still work.  Research studies have gone up to 15 years, and 70% of penile prostheses were still working!  I have seen men 18 to 20 years after their original surgery who still have a functional implant that helps them gain and maintain the erection they want.

Happy couple outside camper van

Is the penile implant the best option for me?

As previously mentioned, the inflatable penile prosthesis has been scientifically proven to be the BEST treatment option for ED and the therapy with the highest satisfaction rate. Even though it is mostly reserved for men who do not respond to medications or other therapies, there are men that get the procedure done for other reasons.  Here are some examples:

  1. Some men do not want to go through EVERY… SINGLE.. THERAPY before they find a solution.
  2. Some men do not want to take medications even though they work.  Oral medications like Sildenafil or Tadalafil are known to have side effects like headaches, back pain, flushing of the face, etc.  To be honest…. Men don’t have to “settle” for a treatment that is causing them side effects.
  3. Other men find injections and vacuum therapies are not good for their lifestyle.  Injections require timing and preparation.   Most of these injectable medications, like Trimix, need to be refrigerated and can cause long-lasting painful erections, scar tissue, among other side effects.  Vacuum therapies need lubrication and a rubber band to “keep the blood trapped” inside the penis which can cause pain and discomfort.  These inconveniences can decrease the spontaneity of the sexual encounter and be a “turn-off” for most couples.
  4. Some men have already failed everything. They still fear the penile implant because someone told them “there is no going back”.  I usually answer them with..   “you’ve already failed everything. What is it you ‘would be going back to, injections or pills that you already know don’t work?’.  Immediately, they understand that it is time to take the next step if they wish to recover their sexual life back.
So… is the penile implant the best option for guys with ED? In most cases, it actually is! Think about it.  The inflatable penile implant is inside your body, completely concealed. It will be there on demand, every.. single.. time you need it.  After you recover from the surgery, it is unlikely you will have pain or discomfort.   It will take you 30 seconds to achieve an erection and it will remain erect until YOU make it go down.

Happy couple on boat

The sexual encounter lasts exactly the amount of time you (and your partner) want it to last. 

In Summary…

Although erectile dysfunction is very common, there are many causes and severities that make treatments to be different for each individual.  Goals are very different for every man and every couple.  My goal as a specialist in Urological Sexual Medicine is to help you reach your goals.  If you think a penile implant is an option for you, come visit us.  You do not have to FAIL everything and all other treatment options to be a “candidate”.   If you have erectile dysfunction, I have great news for you:  You ARE A CANDIDATE for the penile implant. It is not the last resort. In most cases, it is the best resort and solution for ED.   We can help you reach your goals!   Call us!  I would be honored to help you.   Remember we are….  GatekeepersofMen!

This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a board-certified urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH. 

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