Penile Implant Specialist in Houston, TX
What is a Penile Implant? Implante de Pene En Español
The Penile Implant or penile prosthesis is a medical device designed to help gain and maintain an erection. It is placed into a man’s body and is designed to help him get an erection. This is a saline (liquid with water and salt) fluid-filled device that is placed inside the penis and help expand the penis to gain an erection. The penile implant consists of three components: Two cylinders or tubes that are placed inside the penis, a pump placed inside the scrotum, and a reservoir (or bag) that contains the fluid, which is transferred by the pump into the cylinders, causing the penis to expand and become rigid.
Many men have a penile implant. Once inserted, the penile implant is invisible and the penis looks normal both in the flaccid and erect positions.
What are the benefits of a Penile Implant?
- Reliable: For men who have erectile dysfunction, the penile implant provides a reliable option to gain an erection. Sometimes oral medications or penile injections cause undesirable side effects, are inconvenient, or simply do not work. The penile implant has no side effects when used and gives you a reliable erection that will assure you to have sexual intercourse.
- Durable: Studies show that most penile implants last more than 10-15 years.1,2
- Natural: The penile implant feels natural for both the patient and his partner.
- Prevents Penile Shrinkage: The penile implant occupies the entire space within the penis, therefore preventing shrinkage. Erectile dysfunction causes penile atrophy or shrinkage. The penile implant will occupy the space within the penis, and will give the resting penis a fuller, ‘longer’ looking shaft.
- Convenient: There is nothing to carry with you, nothing to take by mouth or by needle, nothing to forget at home, and most importantly, it is ready when you are.
- Corrects Curvature: Patients who have Peyronie’s Disease or penile curvature, are likely to have less curvature with the presence of a penile implant. The penile implant is strong enough to overcome many curvatures. If you have severe curvature, Dr. Clavell will discuss with you if you need any additional procedure to make your penis look normal again.
- Maintains Erection After Orgasm: With the penile implant, once you reach orgasm, the penis remains erect until it is no longer desired. The penis will remain erect as long as you want it erect. Premature ejaculation is no longer an issue. You may even have a second orgasm during the same sexual encounter.
- High Satisfaction Rate: When compared to other treatment options, the penile implant provides the highest satisfaction rate, approximating 94-97%, and far outpacing satisfaction levels for oral medications (51.6%) and injection therapy (41%).
Why Choose Dr. Clavell?
The most common complication after penile implant surgery is infection. In the hands of an experienced surgeon, that complication rate is less than 2-3%. The most common source of infection is bacteria in the skin. For this reason, Dr. Clavell prevents contact with the skin by using the “No-touch Technique (NIT)”. By avoiding contact between the penile prosthesis and the skin, we reduce the incidence of contamination of the penile implant with the bacteria in the skin.
In order to prevent complications, Dr. Clavell believes the management before the surgery is just as important as the care after the surgery. Dr. Clavell will provide you with specific instructions of what to do and what to expect before and after the surgery to prevent infection and other complications such as reservoir herniation and hematoma (postoperative bleeding) formation.
With more than 125 implants per year, our office is the highest volume practice in prosthetic urology in the state of Texas and one of the highest volume practices in the United States and the world!
How is the penile implant placed?
There are different approaches to placing the penile implant, all of which have their advantages and disadvantages.
- Provides better exposure of the corporal bodies in case there is fibrosis (scar tissue).
- Low risk of dorsal nerve injury.
- Incision is not visible.
- Allows fixation of the prosthetic pump inside the scrotum.
- Gives the surgeon the ability to perform adjunct procedures (ventral phalloplasty, vasectomy, etc) if needed .
- Allows for the “No-Touch Technique”
- Possible complications associated with pump and tubing since the wound can be over these parts.
- Possible difficulty to placing the reservoir or might require a counter incision.
- Larger incision than infrapubic.
Infrapubic (small incision above the pubic bone)
- Reservoir is placed under direct vision.
- Shorter surgical time
- Possible quicker recovery and shorter delay for patients to start cycling the implant.
- Higher risk of injury to dorsal nerve bundle.
- Possible suboptimal pump placement.
- Limited Exposure for complex revisions.
- May be technically challenging for obese patients.
Dr. Clavell has experience in performing the procedure in both approaches. However, he prefers the peno-scrotal (midline on the junction between the penis and the scrotum) approach because he believes it offers several advantages over the infrapubic approach for the patient and provides for a much better cosmetic outcome (refer to Ventral Phalloplasty). It allows for the No-Touch Technique and thus reduces the risk of infection. It also makes it easier to accurately size the penis and provide the longest possible implant. Depending on your medical and surgical history, anatomy, and risk factors, Dr. Clavell will discuss with you what will be the best approach for you.
Coloplast® Titan® Touch
The Cololoplast Titan is a 3-piece (has 3 components) inflatable penile prosthesis made from Bioflex and silicone. Bioflex is a durable, biopolymer material which makes the implant emulate the look and performance of a natural erection. This implant is surrounded by a hydrophilic coating which aids in surgical plcaement and absorbs antibiotic solution.
The Titan Touch Offers the Following Unique Features
- Mechanical Reliability Rates: Recent studies show the Coloplast Alpha 1 and Titan to have mechanical reliability rates of 97.5% after five years on first time implants.2
- Concealable: When implanted, the Coloplast Titan penile implant is not visibly noticeable. The penis appears relaxed and normal in the flaccid state, and it is not obvious by looking at a man that he has an implant.
- Lifetime Replacement Policy: Coloplast provides a lifetime replacement policy with all of its penile implants. Coloplast will replace the inflatable implant, or any component, for any reason during the lifetime of the patient
Genesis™ Flexible Rod Penile Implant
The Genesis is a malleable penile implant. The primary difference between the two implant types is that the Genesis produce a permanently firm penis, while the inflatable implants (the Titan) produce a controlled, more natural erection.
AMS 700™ Penile Implant
The AMS 700 Penile Implant is the most popular Boston Scientific inflatable penile prosthesis line. It most closely mimics a natural erection, provides rigidity when inflated and a natural, flaccid appearance when deflated.
It is the only penile implant pre-treated with antibiotics (Inhibizone™) proven to reduce infection. Inhibizone™ is an antibiotic surface found only on the AMS 700 that has been shown to reduce infection rates to 1.1%.
AMS 700 LGX
- Currently the ONLY penile implant on the market with cylinders that expand in girth and length.
- Firm, rigid erection that lasts as long as desired.
- Natural flaccid appearance when deflated.
AMS 700 CX
- Controlled expansion which provides maximum rigidity and optimizes girth expansion.
- Firm, rigid erection that lasts as long as desired.
- Natural flaccid appearance when deflated.
AMS Ambicor™ (2-piece)
This implant is also contained entirely in the body and was designed for ease of use. This implant consists of a pair of fluid-filled cylinders (tubes) that are implanted inside the penis and a pump implanted in the scrotum. Unlike the AMS 700, this device comes without a reservoir and is mostly used for patients with extensive abdominal scarring.
Squeezing and releasing the pump moves the fluid to the cylinders, creating a rigid erection. The device is deflated by bending the cylinders at the base of the penis.
What can I expect after my procedure?
After the procedure, you will wake up with the device partially inflated to both tamponade (stop) bleeding inside the penis and prevent penile shrinkage. You will also notice a special dressing that will keep the scrotum under compression and will prevent swelling or a hematoma (accumulation of blood). When possible, we prefer to keep patients admitted for observation to administer an additional dose of IV antibiotics to prevent infection. All patients are discharged the day after the surgery. Nobody stays in the hospital.
You will be discharged with the compression dressings. You will remove these dressings 48 hours after your surgery. At this time, you may start showering but should avoid bathing (submerging in water) or swimming. Pain in your penis and scrotum lasts for at least 1 to 2 weeks after surgery. You may return to work approximately 1 week after surgery, as long as it does not involve heavy lifting.
You will follow up with Dr. Clavell 4 to 6 weeks after surgery, when he will teach you how to cycle the device. You may start having sexual intercourse after your first follow-up appointment.
This article has been authored by Dr. Jonathan Clavell.
Dr. Clavell is a surgeon urologist with fellowship training in sexual dysfunctions, penile implants, reconstructive surgery for Peyronie’s disease, and BPH management.