Penile Implants

surgery abroad price listThis treatment involves surgically placing an inflatable 3-piece device into the penis, allowing erection to occur as often and for as long as desired. These implants consist of an inflatable device or semi rigid rods made from silicone or polyurethane.

It offers a definitive solution to the patient with erectile dysfunction, and it carries very high percentages of patient and partner satisfaction. It is inserted through a very small incision in the midline of the scrotum and the penis, thus offering excellent cosmetic results. Through the same incision a small reservoir is placed next to the urinary bladder and the pump used to inflate and deflate the penis is hidden in the scrotum in position easily palpable by the patient.

The quality of the erections achieved with the prosthesis is excellent and the patient experiences the same level of sexual satisfaction and sensation as before. The prosthesis is also not obvious to the sexual partner and both can experience a healthy and normal sexual life. As with any surgery, there is a small risk of complications such as infection.

Penile lengthening pre and post op

Pre-operative assessment
Patients need to avoid certain medications, and in particular anticoagulants, prior to surgery. The patient will be assessed by the Cardiologist prior to surgery and counselled accordingly whether he is fit to undergo surgery depending on his cardiovascular status. Smoking needs to be stopped 1 month prior to surgery and at least two weeks post-operatively. Special instructions regarding underwear are given to patients for their post-operative period. Finally, all pre-operative necessary tests are performed and assessed by the physician.

The post operative instructions are tailored to every patient’s particular needs. They will be given in writing and fully explained to the patient prior to departure from the hospital. A compressive dressing is left in place for 2-3 days.

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diagram

Counselling

If stress, anxiety or depression is the cause of your erectile dysfunction, your doctor may suggest that you, or you and your partner, visit a psychologist or psychiatrist with experience in treating sexual problems.

Congenital curvature of the penis and Peyronie’s Disease

Peyronie’s disease is characterized by the formation of hardened tissue (fibrosis) in the penis that causes pain, curvature, and distortion, usually during erection. The penis is the male organ for reproduction and urination. It is composed of two columns of erectile tissue (the corpora cavernosa); the corpus spongiosum, which contains the tube that carries urine and semen from the body (urethra); and the sheath that surrounds the erectile tissue (tunica albuginea). In Peyronie’s disease, dense, fibrous scar tissue (plaque) forms in the tunica albuginea.

Because Peyronie’s disease involves deformity of an erect penis and may impair sexual intercourse, doctors have historically classified the condition as a form of impotence, currently referred to as erectile dysfunction (ED).

Incidence and Prevalence

According to a report published in 1995 by the National Institute of Health, Peyronie’s disease occurs in about 1% of men. It is most common between the ages of 45 and 60, but it also occurs in young and elderly men. Prevalence may be higher because of reluctance to seek medical attention for the condition and failure to report in cases with mild symptoms.

Peyronie’s disease may be mild or severe, and may develop rapidly or over time. Symptoms include the following:

Diagnosis of Peyronie’s disease involves taking a complete medical history, including any circumstances surrounding the onset of symptoms, and a physical examination. The hardened tissue caused by the disorder can be felt upon examination (palpable).

Sometimes, it is necessary to perform the examination with the penis erect. This is achieved by injecting a vasoactive substance that affects the blood vessels in the penis, causing erection. Photographs (digital or Polaroid) of the deformity may eliminate the need to produce an erection in the physician’s office. Calcified plaque can be identified using x-ray or ultrasound.

Treatment options for patients with Peyronie’s disease are limited. The goal of treatment is to reduce pain and maintain sexual function. Surgery is the only effective treatment, and because Peyronie’s may resolve on its own, physicians often advise waiting 1 year before choosing this option.

Nonsurgical treatment should be implemented within 6 months of the onset of symptoms and before the plaque has calcified. Vitamin E supplementation and para-aminobenzoate tablets (B- complex substance) may be taken for several months. Chemical agents such as a calcium channel-blocker (e.g., verapamil), an enzyme that breaks down connective tissue (collagenase), and steroids (e.g., cortisone) may be injected into plaque or delivered by iontophoresis. Tissue atrophy may occur with these treatments, and successful results are not well documented.

Surgical treatment

Surgical treatment may be used in severe, persistent cases of Peyronie’s that have not responded to nonsurgical treatment. Procedures involve the removal (excision) of hardened tissue and placing a graft in the deficiency created, the removal or pinching (plication) of tissue opposite the plaque to reduce curvature (called the Nesbit procedure), a penile implant, or a combination of these.

The removal of plaque requires a biological graft in order to cover the gap created from the removal of the plaque and the consequent lengthening of the short side of the penis and may result in a small number of patients in partial loss of erectile function (e.g., less rigidity). On the other hand, with the Nesbit procedure it is less likely to experience reduced rigidity post operatively but it is unavoidable that the patient has a reduction in the length of his erect penis, since the plaque remains in position.

In certain patients suffering both from penile curvature and erectile dysfunction a definitive treatment option is the concomitant placement of penile implant, in order to be able to achieve erections and the correction of penile curvature at the same time.
During the recovery period, patients are prescribed medication that prevents them from having an erection and are advised to avoid sexual activity. Antibiotics are also prescribed to reduce the risk for infection.

Pre-operative assessment

Patients need to avoid certain medications, and in particular anticoagulants, prior to surgery. The patient will be assessed by the Cardiologist prior to surgery and councelled accordingly whether he is fit to undergo surgery depending on his cardiovascular status. Smoking needs to be stopped 1 month prior to surgery and at least two weeks post-operatively. Special instructions regarding underwear are given to patients for their post-operative period. Finally, all pre-operative necessary tests are performed and assessed by the physician.

The post operative instructions are tailored to every patient’s particular needs. They will be given in writing and fully explained to the patient prior to departure from the hospital. A compressive dressing is left in place for 2-3 days.

 

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