The ins and outs of penile prosthesis

Dear Dr. G,

I am a 54 year-old man who has type I diabetes since my adolescence.

Despite sticking to a stringent diet and careful monitoring of my glucose, I continue to have problems with diabetic complications.

My kidney function is slowly deteriorating and my eyesight is also failing.

My specialist told me this was due to nerve and blood vessels damage caused by diabetes, and it is also likely to affect other organs.

Sadly, this is now causing worsening of my sexual function.

I first experienced erectile dysfunction in my forties, and I was so pleased the problem was solved with the magical blue pills.

I began to notice the medicine losing its functions after several years and the increase in dosage and change to other medications also had no effect.

My doctor asked me to use injections into the penis, truthfully, I simply find this impossible! Don’t get me wrong.

I am not scared of needles. I have been injecting myself with insulin since I was seventeen.

But Injection to the penis myself? Seriously?

I have heard about penile prosthesis, but always assume this is an urban myth.

I simply cannot imagine how the implants work and would like to put Dr. G on the spot for some clarifications.

What exactly is penile prosthesis?

How does an artificial penis work? What are the complications of penile prosthesis?

Prosthetic Pete

Aimee Mullins, a 38-year-old American athlete, actress and fashion model born with missing fibula bones which resulted in the amputation of both her lower limbs at the age of one.

Despite her shortcomings, she started her career in modelling for Alexander McQueen by opening his London show on a pair of wooden lower limb prosthesis.

She became global L’Oréal Ambassador in 2011 and was named one of the fifty most beautiful people in the world by People magazine.

Mullins was the first person in the world on the iconic carbon-fibre cheetah and regarded around the world as a sports pioneer.

Mullins once said: “At some point in every person’s life, you will need an assisted medical device.

“Whether it is your glasses, your contacts. Or as you age, and you have a hip replacement or a pacemaker.

“The prosthetic generation is all around us.””

How accepting are we when the prosthesis is not for a deformed limbs, but a wilting penis?

Mullins is correct as the world is a very much heading to a vision of Lee Major’s “Six-Million-Dollar Man” in the Seventies.

We are accepting synthetic replacement to enhance our ability or to rectify our incapacity.

In fact, penile prosthesis is one of the oldest and most effective treatments for erectile dysfunction and it was introduced in the 70s.

The implant is incorporated into the body of the penis (corpora cavernosa) and still commonly performed for men suffering from pelvic trauma, diabetes and prostate cancer.

There are essentially two types of implants, namely inflatable and non-inflatable implants.

This hydraulic expandable device was invented in 1973, by Brantley Scott, which is filled with saline.

It consists of inflatable double cylinders filling up both chambers of erectile tissues of the penis.

The other components of the device are the reservoir filled with saline and a pump to activate the fluid delivery.

Prosthesis activation started with squeezing the pump to transfer fluid from the reservoir into the erectile chambers.

The pump is usually concealed in the man’s scrotum and the reservoir in the pelvis.

Naturally, after intercourse, the device is deactivated and the deflated chambers will ensure a flaccid penis.

Scott was truly ahead of his time as inflatable penile prosthesis is still widely used forty years after his invention.

The non-inflatable implants are fundamentally two malleable metallic rods, surgically inserted into both chambers of erectile tissues.

This device can be bent into the required position as needed for penetrative intercourse.

Such simple prosthesis may not feel natural as the penis is constantly erected; however, this avoids the potential mechanical failures of inflatable devices.

Although penile prosthesis has provided many men with happy sexual relationships, the devices may not be the answers for all patients suffering from erectile dysfunction.

The devices are not off the shelf purchases. Some men complain of altered sensation and displeasure of permanently semi rigid penis.

Others find the activation and deactivation cumbersome.

Like any other devices, Inflatable penis prosthesis may also have device malfunctions at some point.

Sigmund Freud once said: “Man has, as it were, become a kind of prosthetic God. When he puts on all his auxiliary organs, he is truly magnificent; but those organs have not grown on him, they still give him much trouble at times.”

that note, wishing all the readers and viewers a Godly and Magnificent Christmas Day!!