Mangaluru: Recently a penile prosthesis surgery was performed for the first time at Manipal Ankur. The procedure was successful with the patient returning to normal sexual activity. The surgical team which performed the surgery consisted of Dr Vasan S S, Dr Laxman Prabhu and Dr Bharath Kumar.

Penile implants, an option patients with erectile dysfunction probably hear little about, might offer a lasting and satisfying cure. Dr Vasan S S, Manipal Ankur andrology and reproductive services explains how.

Thanks to Viagra’s introduction more than a decade ago, erectile dysfunction has become fodder for comedians, talk shows, and mainstream media. And there’s clearly a market for Viagra (sildenafil) and its cousins, tadalafil: the Urological Society of India estimates that ED, as it has become known, affects 25 million Indian men.

Medications have helped a significant number of men achieve an erection firm enough for intercourse. A 2014 study of medication long-term effectiveness reported an overall success rate of 69%. However, the response can depend on what caused the ED in the first place. Men who have vascular problems as a result of diabetes, hypertension or heart disease find that the drugs work only about half of the time or even lesser. Response rates are lower - just 30% - for men who have had a prostate surgery.

Men who cannot take the ED medications due to side effects or find them ineffective do have other options. For these men, a penile implant, also called a penile prosthesis, may be the best option. Men with an implant can have an erection at any time - and maintain it for as long as they want - without the use of medication or other devices, allowing for greater spontaneity. Broadly speaking, there are two types of implants: malleable and inflattable.

What holds men back from undergoing surgery?

Lack of awareness!
Most of the men we talk to say that penile implants were never presented to them as an option. The number of urologists who regularly perform implant surgery is limited. As the surgery though simple can lead to complications in inexperienced hands, they do not suggest it to patients, or they downplay the possibility when asked. Sometimes patients fear having something artificial in their body or worry that the implant will look and feel unnatural.

We feel this option should be provided to patients after appropriate counselling and ensuring they understand the implications of a prosthesis surgery. Though it’s an implant surgery the infection rate is about on par with that of other surgical procedures — about 1% to 3% of patients develop an infection, however it requires strict infection control before surgery.

The procedure itself takes about one to two hours and by a simple incision under the penis surface near the scrotum the penis cylinders called corpora are opened and on either side 2 silicone implants are inserted into the corporal cylinders. 24 hours later the patient can be discharged home.

The important thing to realize is that just about any man with erection problems can be successfully treated and can have satisfying sexual activity again. Penile implants have allowed many men to regain the ability to achieve an erection and have sex — and restore intimacy in their relationships. For single men who have been afraid to date because they are embarrassed by their ED, penile prosthesis surgery may bestow the self-confidence they need to find a wonderful, supportive partner.

Do not let ED stand in the way of enjoying life. If things are not working out the way one would like, consult an expert.