Many men face erection problems at certain periods of their lives. Today, the majority of erection problems can be corrected with modern treatment methods without the need for surgery. If non-surgical treatments fail to correct erection problem, then the only option is Penile Prosthesis (Penile Implant) surgery. Installing a 1-piece or 3-piece artificial tool, which we call penile prosthesis, inside the penis is the conclusive solution for erection problem. The surgery for penile prosthesis requires experience and strict precision.
What is Penile Prosthesis (Penile Implant)?
Penile prosthesis is the conclusive solution to erection problems. During penile prosthesis surgery, 2 inflatable and deflatable bars, which replace 2 pcs spongy bar objects that provide erection, are placed inside the penis. These artificial bars provide the erection and softening of the penis. 1-piece prostheses are not much preferred, as they don’t imitate the normal erection and softening of the penis. On the other hand, the 3-piece penile prosthesis fully imitates the erection and softening of the penis. The penile prosthesis consists of 3 parts: the section consisting of 2 pcs cylindrical bars that erect the penis, a pump and a reservoir (storage). The liquid from the 50-60 cm reservoir, which is placed inside the abdomen, is pumped into two pcs bars that are placed within the penis and penile erection is therefore obtained. With the pump placed in the scrotum, the patient controls the erection and softening of penis.
In Which Cases is Penile Prosthesis Surgery Performed?
- Penis erection may fall insufficient due to diabetes, long-term hypertension, smoking and neurologic diseases. Penile prosthesis surgery represents the conclusive solution in cases where drug treatments fail.
- The interiors of two pcs corpus cavernosum, which erect the penis, become calcareous in Peyronie’s Disease leading to erection problems. Penile prosthesis surgery is performed in this case. However, penile prosthesis surgery that is performed in advanced degrees of Peyronie’s Diseases requires more skill and experience.
- The nerves and blood vessels that erect the penis may become damaged after prostate cancer surgery. After they recover from cancer, patients may need penile prosthesis in the face of erection problems.
- In urinary channel ruptures that result from pelvic bone fractures during traffic accidents, the nerves and blood vessels that provide penile erection are damaged and ruptured. Patients may not achieve sufficient erection even if the urinary channel is repaired and they need penile prosthesis surgery.
Prior to Penile Prosthesis Surgery
Pre-operative preparation is quite vital for the success of penile prosthesis surgeries. The mechanics of the penile prosthesis is a technological masterpiece. But as it is a synthetic material, it is prone to inflammation. The genital region hosts various microbes. A triple antibiotic combination is prescribed to the patient prior to surgery. Studies have shown that a prior cleaning of the whiskers in the genital region introduces more microbes and therefore increase the probability of infection. For this reason, the whiskers in the genital region are always cleaned by the doctor during surgery. Before commencing the surgery, the genital region is washed and cleaned by a special antiseptic solution for 15-20 minutes. More attention should be paid for diabetes and obese patients as their bodily endurances are low. The skill and skill of the physician as well as his knowledge on the tissue represent importance factors for the success of surgery.
Penile Prosthesis Surgery
Penile prosthesis surgery can be performed from different incision regions. The most commonly used incisions are the perineal (perineum) and penoscrotal (place where the penis and the scrotum coalesce) ones. Penoscrotal incision is more esthetic as incision scars are almost invisible. Penoscrotal incision, which we also prefer, is ideal for placing all 3 pieces. 3 pieces of the penile prosthesis are placed from the same incision. But in perineal (perineum) incision, a second incision is made for placing the reservoir.
In our surgical technique, we place a catheter into the bladder from the urinary channel. A horizontal incision of 3-4 cm is made on the penoscrotal region (place where the penis and the scrotum coalesce). We reach the bars called corpus cavernosum on both sides of the urinary channel, which provide erection. A 1-2 cm vertical incision is made on the Corpus Cavernosum (bars that provide erection). Nests are made within the Corpus Cavernosum by special metal plugs. This allows the obtainment of a tube with an empty interior space, with a firm outer shell and with two edges closed. The surgical area is cleaned frequently during surgery by antibiotic solutions. The precise length of Corpus Cavernosum is measured by a special measurement apparatus. A 3-piece penile prosthesis with an appropriate length is chosen. During surgery, the officer assigned by the company for technical procedures opens the appropriate penile prosthesis package. These two bars, which are both inflatable, are placed separately inside two pcs Corpus Cavernosum in the penis in a deflated format. During second phase, we reach the cavity in the lower abdomen proximate to the bladder by the index finger inserted from the point of incision. The reservoir (water storage) is placed in this cavity in an empty format. The reservoir’s capacity is 60-100 cc depending on the type of penile prosthesis. Connection is made between the reservoir and two bars that will provide erection. The Penile Prosthesis is tested by inflating and deflating several times in order to identify any possible liquid leakage. The miniature button is placed inside the scrotum during the third phase. The pump and the button are connected to the system. This allows the patient to erect and soften the penis by pressing the button in the scrotum.