Penile Prosthesis

Mr Rees implants all types of Boston / AMS and Coloplast prostheses, with the choice of prosthesis tailored to the individual

Penile prostheses or implants are an excellent option when non-surgical therapies for erectile dysfunction (such as tablets or injection treatment) have failed. Overall they have high satisfaction rates, very low infection rates, and long durability as compared to other medical implants. However the best results are only seen by trained and experienced surgeons in this area. 

Penile prostheses can be considered by anyone who no longer responds to second line ED treatments, and is fit enough to undergo surgery and sexual activity subsequently. They are particularly useful where there has been nerve injury (eg after prostatectomy) or penile scarring (eg Peyronie's disease), or where there has been vascular damage - as seen in diabetes and cardiovascular disease. If considering this treatment, then both a full evaluation but pre-operative counselling with demonstration of the devices is essential.

There are a number of different types of penile prostheses, as illustrated below:

 

Inflatable penile prosteses generally carry the greatest satisfaction in terms of results, and consist of 2 or 3-piece devices filled with isotonic fluid (Normal Saline), which is pumped from a resevoir in the abdomen to the cylinders in the penis by activation of a pump sitting inbetween the testicles in the scrotum. 

The most commonly used penile implant is a 3 piece device consisting of cylinders that are placed within the penis, a pump that is placed under the skin of the scrotum, and a reservoir that is placed adjacent to the bladder.

Options include the AMS 700 penile prosthesis, manufactured by American Medical Systems, and the Titan penile implant, manufactured by Coloplast. The 3 pieces are connected by tubing that transfer’s fluid between the components. When a man wants to have penile rigidity, he squeezes the pump several times, and this causes a transfer of fluid from the reservoir to the cylinders leading to penile rigidity. The pump has a valve or button. When this is depressed, the fluid is then transferred back from the cylinders to the reservoir. The Coloplast and AMS penile implants are similar in overall appearance and function. However, there are differences. The Titan products are silicone penile implants with cylinders composed of a solid silicone elastomer called Bioflex. This features a hydrophilic coating, meaning that when immersed in fluid containing antibiotics prior to placement, the antibiotics will stick to the exterior of the cylinders, a feature that may prevent infections. The AMS product is already coated with antibiotics, and this is called Inhibizone.
 

Why not read this blog article about a patient's journey from before the operation, through to having the protheses fitted, recovery and eventual outcome.
 

Read the blog

Malleable penile prostheses are penile implants that have 2 separate cylinders that are semi-rigid.; These penis implants never change in size and are similar in some ways to a goose neck lamp as the neck of the lamp maintains a certain position when not manipulated, but can be bent or straightened. The malleable penile implant is generally maintained in a downward position, and then bent into an upward position prior to intercourse. The advantage of the malleable penile prosthesis is the technical ease of insertion, ease of use, and comparatively low cost. The disadvantages of the malleable penile implants include the semi-rigid appearance of the penis at all times, and an increased risk of discomfort and erosion. 

The AMS 700 Inflatable penile prosthesis:

The Coloplast Titan Inflatable penile prosthesis: 

The AMS Ambicor (2-piece prosthesis - no abdominal resevoir):