Prosthetic surgery can restore confidence and comfort.
Initial attempts at treating many common conditions that may affect a man’s urinary or reproductive system usually involve conservative options such as medication or lifestyle changes. In some cases, men may see better results with the use of specially designed prosthetic devices, especially when other treatment efforts aren’t effective.
For men with persistent urinary incontinence symptoms or erectile dysfunction (ED) issues, two of the most common prosthetic options are an inflatable type of penile implant and an artificial urinary sphincter (AUS).
Inflatable Penis Prosthesis
The most common type of penile implant that’s recommended for men with ED is an inflatable penis prosthesis. These prosthetic devices are designed to be inflated when an erection is desired and deflated afterwards. With a three-piece implant, a fluid-filled reservoir is inserted in the lower abdominal wall, a pump with an attached release value is placed in the scrotum, and inflatable cylinders are inserted directly into the penis.
An erection is achieved when the pump is used to send fluid from the reservoir to the cylinders in the penis. The process is reversed with the valve in the scrotum. Two-piece systems have both the reservoir and the pump implanted in the scrotum. Penile implants aren’t usually suggested for men with ED that’s situational and possibly reversible, or those with an underlying condition like diabetes that’s not under control. Typically, ideal candidates for an inflatable penis prosthesis are men with:
Usually performed under local anesthesia, a standard vasectomy is done with a small incision in the upper portion of the scrotum, which is numbed with a local anesthetic. The tube that carries semen from the testicles, the vas deferens, is pulled through the incision and cut. It’s then sealed with heat (cauterized), tied, or blocked off with surgical clips. Stitches are used to close the incision, unless it’s decided to leave the wound open to naturally heal.
A no-incision vasectomy is so-named because it’s done with a small puncture or hole in the scrotum instead of an incision. In order to reach the vas deferens to perform the necessary cut, the hole is widened with forceps. The tube is then seal or blocked after it’s separated. Men opting for this version of a vasectomy typically benefit from minimal infection risk and less discomfort post-procedure.
- Permanent erectile dysfunction
- Painful erections linked to conditions like Peyronie’s disease that may cause serve penile curvature
- Otherwise healthy men experiencing serious side effects from other treatment attempts
Artificial Urinary Sphincter
Leakage often occurs at the place where the bladder connects with the urethra that carries urine out of the body. If there aren’t other structural problems involved, the problem may be correctable by creating a tighter seal around the bladder neck to keep urine from leaking when it’s stored in the bladder.
An artificial urinary sphincter is a prosthetic device that includes a balloon and a control pump that’s inserted in the scrotum. A fluid-filled ring (urethral cuff) made of silicone is inserted around the bladder neck to keep the sphincter firmly closed until it’s time to urinate. A valve placed under the skin deflates the urethral cuff. During surgery, an incision is made in the area between the rectum and scrotum to insert the pump. Another incision is made in the abdomen for the artificial urinary sphincter and balloon.
A common reason for an AUS is urinary control issues related to an enlarged prostate. If this gland needs to be removed, an artificial sphincter may be inserted after the prostate is taken out. There may be some urine leakage following the insertion of an AUS, although this usually stops within a few months after the device is activated.
Results after a penile implant or an artificial urinary sphincter to correct urinary incontinence problems is inserted will depend on factors such as a man’s overall health and whether or not there are underlying health issues to consider. Because of the increased use of minimally invasive techniques by surgeons and specialists, patients often experience fewer risks when prosthetic devices are inserted and enjoy shorter recovery periods.