Penile Implant FAQs
Who is a good candidate for penile prosthesis?
Generally, patients who have failed oral medication, vacuum devices and injection therapy may be good candidates for a penile prosthesis. But many patients cannot tolerate the medication or have fear of penile injections and are also good candidates for this procedure.
How much does a penile implant cost?
Many insurances cover this procedure including Medicare. Our team is very knowledgeable with the process and will work hard to get your implant covered. If the procedure is not covered our team can provide a cash pay alternative which is competitive nation-wide at ~$17,500.
What are my cash pay options?
Cash pay has become a very popular option for patients recently as many insurers have elected against covering this procedure. Payment plans with the facility may be available for most patients.
How is a penile implant procedure performed?
The procedure performed by Dr. Wierschem is the “minimally invasive infrapubic” approach. It is done through a small incision in the lower abdominal area just above the penis. This provides for safer placement of the reservoir and decreased risk of infection. The penile corpora are then measured with a special device and the appropriate size device is chosen and placed. Placing a device too large for the corpora can result in chronic pain or erosion of the device outside the penis. The pump is then gently placed into the scrotum and the device is inflated to ensure a perfect outcome. After a drain is placed and the wound is closed, the genitalia are carefully wrapped to minimize swelling. The procedure takes approximately 20-30 minutes and is performed as an outpatient with no need for a catheter.
Why is the Infrapubic approach better?
There are many reasons why the infrapubic approach should be the preferred approach for penile implant. First, it utilizes the “no-touch” technique so the scrotum is not handled during the procedure which decreases the risk of infection. Secondly, it allows for a much safer and precise placement of the resevoir with less risk of bladder or bowel injury. Third, if a patient should need the device removed or replaced, access to all the components is much easier through one small incision instead of 2 or 3 that are needed with peno-scrotal approach. Lastly, there is much less pain and scrotal swelling using this approach.
What is the aftercare for a penile implant?
You will be given antibiotics to take for 2 weeks after the procedure. There will be a follow visit on day 2 and day 10 to inspect the wound and remove drains and staples. Pain medication will also be utilized in the post-operative period although most patients do not require it for more than a few days. Typically the patient will be taught how to use the implant in 3-4 weeks from the surgery.
Why do I need a drain?
The drain is left in place through the operative site to help drain the post-operative bleeding and decrease the risk of swelling and infection. These patients have virtually no swelling or bruising after the procedure and minimal scrotal discomfort.
How long after a penile implant until I can have sexual relations?
This varies among patients but most patients are able to resume intercourse within 3-4 weeks.
Will I lose length? Sensation? Ability to ejaculate?
While there can be a perception that there is loss of penile length after a penile prosthesis placement, several studies have proved that this is not true. There is essentially no difference in penile length when measured prior to and then after the implant is placed. The reduction of penile length has typically already occurred prior to penile prosthesis placement which occurs due to reduced elasticity and atrophy of penile tissues over time, scar tissue and prior weight gain. It is recommended to use a vacuum device or traction device for several weeks prior to penile prosthesis placement as this is the only known way to increase penile length.
The nerves for sensation and ejaculation are spared during prosthesis placement so there is no change in sensation or ejaculatory function. Oral medications can be used to enhance sensation and fullness of the penile head or glans.
What are the potential side effects of a penile implant?
Device infection, malfunction or erosion can occur which can result in the need for prosthesis removal and/or replacement. Infection rates with our patients are less than 1% and malfunction and erosion rates are even more rare.
How long will a penile implant last?
80% of these devices are still functioning at 10 years and 70% at 15 years. If the device fails, it can easily be replaced and many times a larger device can be implanted safely.