I can’t tell you the number of times a patient said to me, after recuperating from hysterectomy for severe menstrual cramps or severe pain with intercourse, once again feeling good and able to be pleasurably sexually active, that “she wished she had done this years ago.” Well, I said the same thing to myself after recuperating from penile implant surgery for erectile dysfunction, in my case secondary to radical prostatectomy for prostatic cancer. The spontaneity to lovemaking was back!
30% of men over 50 and 44% of men over 65 suffer from erectile dysfunction (ED). Why talk about a penile implant, surgery, when there exists a pill for that problem? Well, the overall success of Viagra-like medications enabling men to achieve an erection firm enough for intercourse is 69%. So it doesn’t work for everybody.
There are also men with specific health problems that are a contraindication to the use of Viagra-like drugs:
- Angina, chest pain secondary to cardiovascular heart disease.
- Conditions requiring blood-thinning medication.
- High blood pressure treated with alpha-blockers.
- Enlarged prostate treated with Flomax.
Some causes of ED may make Viagra-like drugs less effective
- Diabetes, only a 50% success rate.
- Excessive alcohol intake.
- Trauma from prolonged bicycling (nerve compression and impaired blood flow from pressure of the seat).
- Radical prostatectomy, only a 30% success rate.
Viagra-like drugs have side effects that may be irritating enough or serious enough for some men to stop using the drug.
- Headache
- Nausea
- Diarrhea
- Dizziness
- Facial redness
- Stuffy nose
- Hearing loss
Men who cannot take Viagra-like medications or find them ineffective or have significant side effects do have other options. Injections, urethral insertions, penile bands, and vacuum erection devices can help achieve and sustain an erection. However, many men and their partners find that these aids eliminate spontaneity and may produce less than satisfactory results. For these men, a penile implant or prostheses may be the best option. Men with an implant can have an erection any time they want and maintain it for as long as they want, allowing for greater spontaneity.
Now, we are talking surgery, with all of the usual risks, mainly anesthetic complications and infection. Some time off work, usually a week, is necessary. Intercourse can be resumed in 4-6 weeks.
Considering all of that, penile prosthesis implantation still has the highest satisfaction of all treatment options for men who cannot take Viagra-like medication or for whom the drug is not effective. Studies consistently show that between 80 and 90% of men who have had the procedure would recommend it to a friend or undergo the procedure again.
The take-home message? There is another option for impotence that does not respond to Viagra-like drugs, or for those with conditions that contraindicate Viagra-like drugs, or for those who stop such drugs because of troubling side effects. Talk to your doctor about an implant. Ask for a referral to a urologist who specializes in the surgery and who does at least 20 procedures a year.
References
Bernal, Raymond M. and Henry, Gerard D, Advances in Urology, Volume 2012, Contemporary Patient Satisfaction Rates for Three-Piece Inflatabel Penile Prostheses.
Morgentaler, Abraham, M.D., www.harvardprostateknowledge.org, Treating erectile dysfunction with penile implants.
Wedro, Benjamin C., M.D., www.medinicenet.com, Erectile dysfunction drug interactions.
Te, Alexis E., M.D., Paduch, Darius A., M.D., Ph. D, Kashanian, James A., M.D., Chugtai, Bilal, M.D., Lee, Richard, M.D., M.B.A., www.cornellurology.com, Penile Implant (Prosthesis) Surgery.
