Ms. Maria Satchi
Consultant Urologist and Andrologist, Kings College Hospital NHS Foundation Trust
Penile prosthetics offer a transformative solution for erectile dysfunction. These devices can restore confidence and intimacy, marking a significant advancement in medical technology and patient care.
Erectile dysfunction (ED), the persistent inability to achieve or maintain an erection for sexual performance, is self-reported in 50% of men aged 40–70.1 It can have a profound impact on men’s health and wellbeing, causing strain on relationships. It is associated with cardiovascular disease, diabetes, obesity and smoking in addition to other psychological disorders such as depression and anxiety.2
Multifaceted approach to ED treatment
ED management requires a holistic approach tailored to the underlying cause. Lifestyle modifications include a healthy diet, regular exercise, improved sleep, stopping smoking and reducing alcohol intake. Various medical options are available, including tablets, topical creams, intraurethral pellets and penile injections, as well as vacuum erection devices. Psychosexual counselling is pivotal when potential psychological factors such as performance anxiety and relationship issues are present.
Two types of devices can be
inserted inside the penis: malleable
(semi-rigid) or inflatable implants.
Impact of prosthetics on erectile dysfunction
Penile prosthetics are a surgical option, typically considered when other treatment options are unsuitable or have failed. Two types of devices can be inserted inside the penis: malleable (semi-rigid) or inflatable implants. A malleable implant is bent upwards to facilitate sexual intercourse and bent down when not required.
The inflatable prosthesis offers a more natural option dependent on a hydraulic mechanism. It is activated when a pump, located in the scrotum, is engaged. This pump moves fluid from a reservoir in the abdomen to the penile prosthesis, which inflates to provide a rigid penis.
The procedure has potentially serious risks and complications. However, in a suitable, well-counselled patient, studies have demonstrated one of the highest satisfaction rates of 80–90%.3 It offers men with ED restored erectile function, eliminates dependence on variable effectiveness of medical therapy and offers a degree of spontaneity.
Accessing ED medical interventions
Men should seek medical attention and treatment information, as it may also be the first presentation of underlying disease. As research and technology advance, the future holds promise for even more effective and accessible solutions for ED.
[1] Henry, A. et al. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54-61. https://doi.org/10.1016/S0022-5347(17)34871-1.
[2] Yafi, F. A. et al. (2016). Erectile dysfunction. Nature Reviews Disease Primers, 2, 16003. https://doi.org/10.1038/nrdp.2016.3
[3] Hellstrom, W. J. G. et al. (2010). Implants, mechanical devices, and vascular surgery for erectile dysfunction. Journal of Sexual Medicine, 7(1 Pt 2), 501-523. https://doi.org/10.1111/j.1743-6109.2009.01626.x
