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Implanting a penile prosthesis is one of the newest methods to aid in restoring erections without needing to take medications that might cause negative long-term bodily effects. But how is the procedure performed? And what is the reality of implanting a prosthesis outside the corpus cavernosum? This is what our following article addresses.
Anatomical Structure of the Penis
Discussing the penis from an anatomical perspective is useful for understanding how prostheses function and the possibility of implanting a prosthesis outside the penile corpus cavernosum.
The penis is an external organ of the male reproductive system, responsible for urination and conjugal relations. It consists of several components, which are:
The glans penis.
The urethra, which is a tube extending from the bladder to the glans penis through which urine and semen pass.
The corpus cavernosum, which is composed of two cylinders of spongy tissue surrounded by an outer membrane, extending internally along the penis. It is responsible for sexual pleasure and the erection process; when it fills with blood, an erection occurs.
The corpus spongiosum, which is a cylinder of spongy tissue surrounding the urethra, and it is one of the parts that assists in the penile erection process.
Read also: Flexible Prosthesis
How Penile Prostheses Are Fitted
The procedure for implanting penile prostheses involves several steps, which we outline below:
Surgical Incision: In this step, the surgeon makes an incision in the penile skin, around its head, or at the junction of the penis and the testes. Upon reaching the membrane surrounding the corpus cavernosum, a surgical cut is also made there.
Enlarging the Implant Area: This stage involves expanding the corpus cavernosum using specialized instruments called dilators, which come in various sizes. The surgeon inserts them between the corpus cavernosum and its surrounding membrane, starting from the smallest diameter to the largest, with the aim of creating space for the prosthesis insertion.
Prosthesis Implantation: After reaching the maximum space inside the corpus cavernosum, the surgeon determines the prosthesis size and then fits it. There are two types of penile prostheses available for implantation: rigid and hydraulic prostheses.
What is the Reality of Implanting a Prosthesis Outside the Corpus Cavernosum?
We previously mentioned that prosthesis implantation occurs inside the corpus cavernosum, but where did the question about implanting a prosthesis outside the penile corpus cavernosum originate?
Many years ago, at the beginning of penile prosthesis implantation for treating erectile dysfunction, doctors relied on compressing the corpus cavernosum to the maximum extent to fit the largest possible prosthesis size. Due to this, men frequently complained about the absence of sexual pleasure for themselves and their spouses, and that conjugal relations had become purely mechanical.
Because of this, some suggested the possibility of implanting the prosthesis outside the corpus cavernosum, but this endeavor was unsuccessful. Therefore, physicians became more cautious about fitting a smaller-sized prosthesis to preserve the largest part of the corpus cavernosum and maintain sexual climax at its best levels during conjugal relations.
What is the Effect of Prosthesis Implantation on Penile Size and the Quality of Conjugal Relations?
Implanting penile prostheses does not affect the size and shape of the penis, as the surgeon measures the internal part of the penis during surgery and places the appropriate prostheses.
As for its effect on conjugal relations, the prostheses make the penis rigid and thicker, just as happens in a natural erection. They do not alter the sensation of pleasure during conjugal relations nor affect the ability to ejaculate. It only takes a few weeks or months for the husband to adjust to the presence of the prostheses.
Similarly, the wife is not affected by the presence of the prosthesis and will not be able to notice any difference between a natural erection and an erection with a prosthesis.
What are the Advantages of Fitting Penile Prostheses?
The primary benefit of implanting a prosthesis inside the penis is achieving and maintaining an erection sufficient for engaging in conjugal relations. Other advantages of the penile prosthesis procedure include:
Safety, as the probability of having risks afterward is low.
The procedure is successful and yields satisfactory results in over 90% of cases.
Durability, as penile prostheses last for nearly 20 years.
The ability for patients to return to their homes on the same day as the procedure.
What are the Risks of Penile Prosthesis Implantation?
The procedure for implanting penile prostheses is considered a successful surgery, but like any surgery, it may involve very few complications. These complications include:
Bleeding.
Damage to the urethra.
Infection.
Scar formation.
Displacement of the pump—or reservoir—one of the hydraulic prosthesis components.
Prosthesis malfunction.
Shortening of the penile length.
Reduced blood flow to the glans penis, consequently decreasing the sensation of climax and sexual enjoyment.
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