Surgical Procedures for Erectile Dysfunction (Impotence)
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Surgery is an option when all other efforts to restore or bypass your erectile dysfunction have failed. In fact, there are several possible alternatives that will permit you to have satisfactory sexual intercourse.
Note that sensation in your penis comes from nerves other than the ones that cause erection. Those nerves may not be affected when the erectile nerves are, and those nerves are not damaged by prostate surgery. Therefore sensation is likely to be preserved, and orgasm is possible without erection. Restoring erections is sufficient to restore complete sexual function.
Penile Prostheses (Implants)
Penile Implant
Semirigid/Malleable
This prosthesis (implant) consists of one or two bendable rods that are inserted into the penis. Once installed and healed, the penis and the prosthesis can be bent into position—upward for intercourse or downward for clothing and urination.
Inflatable
There are three pieces to this device:
- A balloon-like cylinder that fits into the penis
- A pump that is placed into the scrotum
- A reservoir of liquid that is placed nearby, inside the pelvis
The penis is normally limp until the pump is repeatedly squeezed, filling the balloon from the reservoir. After intercourse, the balloon in the penis can be deflated.
Description of the Procedure: Under general or regional anesthesia, and in sterile conditions in an operating room, the surgeon will make an incision in your penis and insert the device. Additional incisions may be made to insert the accessory parts in their proper positions.
Vascular Reconstruction
If circulation is reduced to your penis due to vascular disease (usually following a traumatic injury to the penis), reconstruction of your arteries may restore erectile function. This is complex surgery which is performed only in a few hospitals in the US. Occasionally, in these rare cases, angiographic techniques can be successful at repairing the vascular defect, avoiding the need to consider surgical reconstruction.
References:
American Urological Association website. Available at: http://www.auanet.org/ .
Guay AT, Spark RF, Bansal S, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple’s problem: 2003 update. Endocr Pract. 2003;9:77-95.
National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www2.niddk.nih.gov/ .
National Library of Medicine website. Available at: http://www.nlm.nih.gov/ .
Sivalingam S, Hashim H, Schwaibold H. An overview of the diagnosis and treatment of erectile dysfunction. Drugs. 2006;66:2339-2355.
Webber R. Erectile dysfunction. Clinical Evidence. 2005;13:1120-1127.
Last reviewed November 2008 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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