The penile implant does not change sensation to the penis; but if left inflated all the time, it would cause pain or decreased sensation. I always tell my patients ironically that a deflated penis is a happy penis. The glans are not part of the implant, meaning glans engorgement is depended upon your anatomy. Infrequently the glans may be floppy and will never be like they used to be. But in the event you need something extra for swelling of the glans, we could try pills, gels, or even surgically tacking the glans down. New techniques have reduced the incidence of this complaint.
Some patients ask me “Will I be able to get an erection after surgery?”. Remember, the reason they are undergoing an implant is that they don’t have an erection. I never quite understand this question from my patients.
Many men feel something like an erection when aroused, but the reality is that you can have an erection without arousal, using the implant. This can be a difficult hurdle for some couples, and this should be addressed before implantation.
The pump is visible to any groping partner whether or not placed appropriately. Patients must learn how to deal with this issue if not in an ongoing relationship. Thankfully, many implant cylinders are so physiologic; the partners should not notice the difference in the phallus.
You must understand that impotence leads to shortening of your penis. Once evident, your penis loses both length and girth. How? When you stop having erections during the day or night, your penis becomes hypoxic or low in oxygen. This leads to a process called fibrosis or scarring, and this leads to a smaller penis. The only thing that stops this atrophy is the penile implant. When a patient comes to my office, I perform the penile stretch test, meaning I put my boot on their foot, and I pull hard on their penis. This will be the length of your penis after a penile implant. I’ve studied this extensively, and there’s no better way to set expectations for patients. Realize, the longer you wait to have your penile implant, the shorter your penis. If you enter into the implant with this reality, you’ll be pleased with your outcome. Most specialists will push the limits in sizing without putting you at risk. Any procedures offering a longer penis may have significant accompanying risks, and you should discuss them with your surgeon. The silver lining to an implant is if used often, your penis will grow. Once again, the only thing that stops penile atrophy is the penile implant.
Patients must understand penile implants may be the only medical device in existence. By not discussing the advantages and disadvantages of both companies I will avoid any appearance of corporate influence, but I recommend you research this well. Any experience the implantor will have his or her reasons for their recommendations. Avoid any sites that offer only one product because there are applications for both companies.
When the patient complains about their pump being too hard, they must understand that any vessel at end filling will require higher pressures to continue filling. Get two thumbs on it and make it your business to make your penis as hard as possible.
During your postoperative course, you may have significant bruising, a swollen scrotum, and/or difficulty urinating. Unlike orthopedic surgeons, we do not have rehab centers. If we did, they would be erroneously considered brothels. Like orthopedic operations rehab is essential and any major implantor will have his or her protocol. My advice: stay off it until advised and suck it up and follow instructions.