Patients often question me, “Why should I undergo surgery to remain sexually active?” Patients who undergo this surgery commonly are those who do not respond to oral agents, or have a contraindication to utilizing oral agents. Many patients who opt for this form of therapy do so as it may suit their lifestyle or they desire to not use medical therapy long term.
Prosthetic surgery does offer an excellent permanent long-term solution to erectile dysfunction without the need to rely on oral drugs. Patients who undergo implantation are able to resume a healthy, spontaneous sex life. When the prosthesis is flexed into position, or inflated, sexual activity may last for as long as you wish. Normal ejaculation and orgasm do occur in patients who have been implanted. Reliance upon costly drugs with potential side effects is also eliminated.
As appealing as a prosthetic device may be to some, certain drawbacks do exist. As with all surgical procedures, a period of healing and inactivity must occur. Because the inflatable or malleable erectile bodies are inserted into the corpora cavernosum, the patient loses all possibility of obtaining a natural erection in the future and must rely on the device.
As with any foreign body that is implanted, the concern about infection remains etched in the surgeon's mind. Implants are frequently placed in patients who are diabetics; patients who are notoriously prone to infections elsewhere in the body. Other patients may have had some form of radiation therapy which may also predispose the patient to infection. As a result, surgeons take great care in preparing the patient preoperatively, administering intravenous antibiotics during the course of the procedure and by giving antibiotics post-operatively. Meticulous surgical technique and sterility also helps to decrease the rate of infection in this group of patients.
Some of the newer prosthetic devices have a specialized surface treatment (InhibiZone) which is a proprietary combination of the antibiotics rifampin and minocycline. This coating on the prosthesis has been shown to decrease the rate of infection. Another innovative approach that has made prosthetic surgery safer has been the introduction of Parylene which is a wear-reducing micro coating that the prostheses are made of. This coating has resulted in lower rates of mechanical failure of the inflatable devices.
In the properly selected, motivated patient, the insertion of an inflatable prosthesis is an excellent alternative that is easy to use, and results in both patient and partner satisfaction.
Published On: March 14, 2007