Penile Prostheses are materials made of silicone that are implanted into the penis to provide natural-like and rigid penile erections for individuals who are unable to achieve normal penile stiffness (erection) and have not benefited from other treatment methods such as tablets, injections, shock therapy, stem cells, etc.

What are the Types of Penile Prostheses?

There are four types of penile prostheses made entirely of silicone materials:
1. One-piece bendable
2. Two-piece inflatable
3. Three-piece inflatable (lengthening only)
4. Three-piece inflatable (lengthening and girth expansion)

One-Piece Bendable Penile Prostheses

These are suitable for patients with good hand coordination or anatomical problems that prevent them from fully using their hands.
They are inserted into the penis and the prosthesis is not visible from outside the skin.
Erection is continuous and fixed.
The penis can be bent downward or towards the abdomen to hide it.
When engaging in sexual intercourse, it is straightened forward.
The satisfaction rate is lower compared to inflatable prostheses.

Two-Piece Inflatable Penile Prostheses

These prostheses provide a more natural appearance compared to the one-piece prostheses.
Patient satisfaction and erection quality are lower compared to three-piece prostheses.
Patients can achieve erections in their penises whenever they desire.
They are inserted into the penis, and no part of the prosthesis material is visible from outside the skin.

Three-Piece Inflatable Penile Prostheses

Three-piece prostheses have two types: lengthening only and lengthening with girth expansion.
They are the most natural-looking prostheses.
Patient and partner satisfaction is approximately 90%, which is quite high.
Patients can achieve and deflate erections in their penises whenever they desire.
There are no visible parts from the outside.
Scientific studies have proven that these prostheses are the most ideal in terms of satisfaction and functionality.

Who is a Candidate for Penile Prosthesis?

Any age group of patients who experience serious difficulties in achieving erections through natural means, have not benefited from medication and other alternative treatments, and are willing to have a penile prosthesis implanted are candidates for this surgery.
Penile prosthesis is not the first treatment option for men with erectile dysfunction.
First, non-surgical methods such as medication, ESWT (shock therapy), vacuum, or penile injections are evaluated.
If none of these methods provide sufficient benefits, penile prosthesis is the definitive treatment method.

Penile prosthesis can generally be applied to:

Patients with a history of prostate cancer who have had their prostates removed
Patients with advanced diabetes
Patients with severe erectile dysfunction due to serious cardiovascular disease
Patients who have undergone radical abdominal surgery (such as rectal cancer)
Patients with erectile dysfunction due to pelvic region damage caused by an accident
Patients with erectile dysfunction resulting from spinal cord injury
Patients with Peyronie’s disease (severe penile curvature)

Choice of Penile Prosthesis Type

In order to determine which prosthesis is most suitable, it is necessary to evaluate it together with the patient and the urologist.
While all types of prostheses can restore penile stiffness, the appropriate prosthesis is determined based on the patient’s preliminary assessment.
However, if we need to answer the question of “which is the best penile prosthesis,” the answer can be three-piece inflatable prostheses.
Because with this prosthesis, the penis remains in its natural state, and the prosthesis can be easily inflated and hardened by using the pump implanted into the scrotum before sexual intercourse.
After the intercourse, the penis can be returned to the resting state by pressing the button on the pump.
This process takes place within seconds and provides great comfort in the individual’s daily life.

Problems That May Occur During Penile Prosthesis Application

There is a risk of developing an infection between 3% and 5% after the penile prosthesis procedure.
Modern prostheses are coated with antibiotics, so infections rarely occur.
If an infection occurs, it can be easily treated with medication, but in rare cases, the prosthesis may need to be removed.
Possible complications that may occur at a minimal level include erosion of the prosthesis over time, causing it to come out through the skin or into the urethra.

Doctor Appointment

If the patient is considering penile prosthesis implantation, they should make the decision together with their partner.
If possible, it is beneficial for the partner to accompany them to the preliminary consultation.
The effectiveness of the treatment and the expectations of the patient and their partner should be clearly communicated.

Determining Factor in the Decision for Penile Prosthesis

The patient’s overall health history is taken, and initially, penile Doppler ultrasound and papaverine testing are conducted to determine the persistence of the problem.
After it is understood that penile prosthesis is the only effective method, pre-anesthetic tests such as blood biochemistry, chest X-ray, ECG, etc., are performed.
In some cases, a psychiatric examination may be necessary.

Briefly, Penile Prosthesis Surgery and Hospital Process

The surgeries last an average of 1-2 hours, and patients are discharged the next day.
Single-piece prostheses can be implanted in a short time, around 45 minutes.
All prostheses are placed through a single incision of 3-4 cm between the penis and the scrotum, and the surgical incision remains hidden in a difficult-to-notice area.
There are no visible parts from the outside in all surgeries.
After discharge, dressing may be required 1-3 times, and patients can travel by land, sea, or air.
They can fully integrate into daily life within one week.
Patients can conceal their penis (in the case of a single-piece prosthesis) by bending it under their pants. Before intercourse, the penis is manually straightened to engage in sexual activity.
In other types of inflatable penile prostheses, the penis remains in its natural state. With these types of prostheses, patients can prepare for intercourse by inflating the penis by pressing the pump implanted in the scrotum 8-10 times. After intercourse, pressing the button on the pump allows the penis to deflate. Patients and their partners are often very satisfied with the results.

Timing of Sexual Intercourse after Penile Prosthesis Surgery

Generally, patients can resume normal sexual activities after 4 to 6 weeks following surgery.

FAQs After Penile Prosthesis Surgery

If desired, the penis can be made erect at any time, allowing for sexual intercourse whenever desired.
Sexual intercourse can continue for as long as desired after orgasm (ejaculation).
Even in older age, quality sexual intercourse becomes possible, and the problem of erectile dysfunction is completely eliminated.
The sexual satisfaction, pleasure, and satisfaction of the partner increase. A healthy relationship is established between the man and his partner, leading to self-confidence and an improved physical, mental, and social well-being.
For those who did not have any obstacles before the procedure (such as absence of sperm, previous prostate or major abdominal surgeries, etc.), it is possible for them to have children.
In cases where semen was present before the procedure, it can still be present after the prosthesis is implanted.
Urination is not affected and does not pose an obstacle.
Penile prostheses can be used for a lifetime. One of the determining factors here is the quality of the prosthesis used. In our hospital, the best and highest-quality prostheses in this field are used.

Does Social Security Cover Penile Prosthesis Surgeries?

If the patients meet the criteria determined by the Social Security Institution (SGK) and the procedure is performed at contracted hospitals, the social security institution covers a certain percentage of the costs.