Surgical Management of Erectile Dysfunction

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Erectile dysfunction is a very common condition and I do believe the surgical option, the insertion of a penile prosthesis is underutilised. 

It’s a relatively straightforward procedure, there’s a small incision that we make, usually just above the penis or in between the penis and the scrotum.  The operation takes just about an hour or so. 

The penis you’ve got to remember is just two cylinders and basically when you have an erection blood flows into these cylinders. 

When your erection has gone the blood flows out. 

So what we do is replicate the natural system. 

We put two plastic sheets inside there which replace the cylinders. 

There’s a little pump that sits in between the two testes in the scrotum and there’s a little reservoir which has got saline in it which acts like blood and that’s tucked inside the abdomen. 

Now this is all done through a tiny little incision. 

Nothing is visible, no-one can tell that you’ve had the procedure and what patients then do is they squeeze this little pump in between the testes and the scrotum and as you squeeze this little pump fluid goes from the reservoir down into the prosthesis and patients then get an erection and they can have sexual activity whenever they like and in fact for however long they like and it’s got an over 95% satisfaction rate. 

When patients are finished they just squeeze another button and the erection comes down. 

So this device has been used for over 10 years now, the main complications are 1% risk of infection in which case the prosthesis has to come out and another prosthesis can get put in. 

Some patients have some discomfort from the scarring afterwards but this normally settles down and I do believe that really it’s a very unutilised treatment for patients with erectile dysfunction and the patients who have had this done have been extremely happy with the clinical outcomes and I do think that if patients have tried oral tablets such as Viagra, Cialis, or Livitra and perhaps tried the vacuum pump and injection therapy and are dissatisfied that this is an excellent option for them.