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NYC’s Top Urology Practice

Specializing in the treatment of Erectile Dysfunction and Penile Implant Surgery.


Welcome to Fifth Avenue Urology, the practice of Drs. Michael S. Brodherson, Yaniv M. Larish, and Leonard Glickman. We specialize in Penile Implant Surgery & the treatment of Erectile Dysfunction, as well as general urological care of both men and women.

dr-yaniv-larish-fifth-avenue-urology-2Dr. Larish is an expert in penile implant surgery for advanced erectile dysfunction. He has trained and has extensive experience in performing these delicate and artful surgeries. He is an expert on all types of penile implants and the latest technology. He teaches resident doctors on urological surgery and therefore keeps up with all the latest advancements in penile implant surgery and the newest advancements in the actual implant technology.

Dr. Larish utilizes different types of penile implants based on his expert opinion and vast experience for each individual patient’s specific needs. He uses semi-rigid or inflatable implants. The pump inflatable implants come from different manufactures and are each slightly different in their application. He will use his experience in determining which implant is right for each patient.

penile-implant-specialist-nycDr. Brodherson has been the Interim Chief of Urology at Lenox Hill Hospital and Dr. Larish served as the former chief resident in the same department. Dr. Glickman is specialty-trained in robotic and minimally invasive surgery. We are focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. As physicians, we view the ability to practice medicine as a privilege, not a right. We treat our patients with respect, professionalism and compassion.

We are located in Manhattan, in New York City’s beautiful Upper East Side. We offer the most advanced state of the art diagnosis and treatment for all problems of the male and female urological and reproductive systems.

We emphasize discretion and compassion with all of our patients no matter how large or small their problems are. We understand the emotional and physical attributes of urological problems. We understand that problems of the urological system, from the kidney to the genitals, can be worrisome, embarrassing and sensitive. We provide a compassionate and safe atmosphere to discuss and treat problems in a comfortable and confidential environment.

dr-leonard-glickmanWe are experts in conservative and surgical treatments. We never rush patients and never push surgery when alternative, less invasive treatments are possible. We are proud to be ethical and altruistic physicians with a reputation and history to prove it.

We keep up to date with the most advanced technology and pharmacology as the field of urology changes with the times. New medications and procedures are introduced regularly. We are involved with doctor education and training allowing us to easily keep on top of all the new and exciting breakthroughs in the field of urology.

And lastly, we have a great back office team that is well versed in the ins and outs of insurance company procedures and rules to make sure your care and surgery are covered. We run our office with customer care in mind by trying to make sure every patient is comfortable and visits occur in a timely manner.

Penile Implant Surgery: Recovery after the Operation

Almost all males who are potential candidates for a penile implant procedure are eager to know the maximum time it will take to recover fully once the surgery is successfully performed. The recuperation happens faster than what most patients would like to believe, and the road to recovery is also less painful. Though the recovery period normally varies from patient to another, it generally takes a month and a half to completely convalesce.

You can start attending office or tend to your business 2-3 days after surgery and go back to engaging in sex from where you left off, within 4-5 weeks.

Recovering after penile implant surgery

Ypenile-implant-surgery-recovery-operation-info-01ou get better considerably within a couple of weeks following the surgical procedure. The incision area heals up to a great extent within a week of the surgery as does the discomfort and inflammation. You can also expedite the healing by following specific techniques like applying ice pack underneath the penis and scrotum.

However, you should be careful enough not to apply the pack directly on the penis or scrotum as it could lead to frostbite where the scar and fibrous tissues become injured or damaged permanently. For accessing the areas beneath the scrotum or penis, you’d have to raise them-it’d be best if you use a clean and dry towel positioned in between the thighs.

With the towel remaining where it is, take a brief or underwear, place it below the penis, and try to make it face your navel. Follow the same procedure for raising the scrotum.  Now, you’re in a position to press the cold pack comfortably on the undersides of both the scrotum and penis.

Also, make sure you do not perform any physically demanding or strenuous activity for the first two weeks after you are discharged from the hospital.

Making the most of the penile implant

post-op-male-implant-surgery-info-ny-specialist-md-02You should completely refrain from using the implant (i.e., activate or deactivate it) in the first couple of weeks post surgery. What you can do at the most is to mildly try to drag down the pump inside the scrotum to allow it to settle down comfortably. Once the pump is positioned firmly, you’ll be able to access it easily for compressing it when healing is complete, and you’re ready to resume sexual activity.

The implant is usually activated after 4-5 weeks of the surgery, and the activation is generally conducted in the surgeon’s chamber for the first time. The physician or his assistant will demonstrate how to turn on and deactivate the device. You could also receive a sample or model pump for honing your squeezing skills.

You should practice inflating and deflating the prosthesis at home at least once daily to gain self-confidence. Regularly practice also contributes towards increasing the penis’s size during an erection. You can always consult your surgeon or doctor if you don’t feel confident about using the device.

Common side effects

Usual complications of the implant surgery include blood clot formation around the scrotal area, discomfort, and inflammation that could linger for 2-3 weeks. Chances of infection are less than 2%. Most side effects fade away on their own. Taking painkillers and antibiotics will help assuage the pain and minimize the risks of infection.

Better/improved patient satisfaction rate following surgery

You’ll be able to take full advantage of your penile implant for enjoying a fulfilling sex life if you follow the post-surgical instructions mentioned above. You can schedule an appointment with our surgeon if you want to more about penile prosthetic surgery and recovery.

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FIFTH AVENUE UROLOGY
4 East 76th Street
New York, NY 10021

212-541-6239

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References

How do penile implants work?

What is Erectile Dysfunction (ED)?

how-do-penile-implants-work-medical-01Penile Implants are used to treat Erectile Dysfunction (ED). They provide physical support to the penis so that the patient can achieve an erection. Broadly speaking, there are two types of penile implants available in the market today: semi-rigid (malleable) and inflatable implants.

Semi-rigid (Malleable) Penile Implants

semi-rigid-penile-implant-technical-medical-information-02Semi-rigid implants are by far the cheapest and simplest to use. They are composed of two flexible, silicone rods that are surgically placed into the erectile tissue of the penis. Whenever the patient is ready for sexual activity, all he has to do is bend his penis upward. When he is done, he can turn the penis downward for concealment.

            Pros of using the semi-rigid (malleable) penile implant

As with any medical device, there are pros and cons to the semi-rigid implant. The prosthesis provides a constant state of erection for the penis; therefore it is effortless to use primarily for men who have problems with manual dexterity. This also allows for spontaneous sexual activity because the patient does not need to wait for the device to be primed before using.

            Cons of using the semi-rigid (malleable) penile implant

However, due to its constant rigid state, this implant can promote the highest rate of penile tissue erosion as compared to the other implants. If the patient has other chronic diseases that affect the vascular system, such as diabetes, the semi-rigid implant could worsen the health of the penile tissue. The device also doesn’t offer any expansion or lengthening of the penis.

3-piece and 2-piece Inflatable Penile Implants

inflatable-penile-implants-info-nyc-01Inflatable implants are slightly more complicated to use than the semi-rigid implants. However, what they lack in simplicity they more than makeup for in functionality. As the name suggests, inflatable implants provide the patient with an erection when they are inflated. There are two types of inflatable implants: the three-piece and the two-piece inflatable devices.

            How does the 3-piece inflatable penile implant work?

The three-piece is composed of two cylinders that are surgically placed in the penis. These cylinders are then attached to a tube that is connected to the reservoir, which is situated in the lower abdomen. The reservoir contains saline which is delivered to the cylinders by a pump, which is placed in the scrotal sac. When the patient is ready for sexual activity, he presses the pump, which then delivers the saline from the reservoir into the cylinders resulting in inflation of the penis causing an erection. When the patient is finished, he presses the deflator valve located at the bottom of the pump, which then delivers the saline back into the reservoir causing the penis to deflate and return to its normal, flaccid state.

            How does the 2-piece inflatable penile implant work?

ed-erectile-dysfunction-penile-implants-nyc-urologist-03The two-piece inflatable implant works in much the same way as the three-piece except that the reservoir and the pump are combined into one unit. This reservoir-pump combo is placed inside the scrotum; therefore there are no parts placed within the lower abdomen, and the surgery is less complicated as compared to the three-piece implant. However, a significant disadvantage of the two-piece implant is that the reservoir is smaller, so there may not be enough saline to produce a full erection.

Inflatable penile implants vs. Semi-rigid (malleable) penile implant

By far the most significant advantage of using the inflatable devices instead of the semi-rigid implant is the ability to return to a flaccid state after sexual activity. With the simple push of the deflator valve, the patient can deflate his penis, which produces a much more natural feel and look as compared to the semi-rigid implant which prevents a return to a flaccid state.

If you would like to know more about how penile implants can benefit you and your partner, contact us today at 212-541-6239 and schedule your free appointment.

To find out more about penile implants, visit our website at: www.FifthAvenueUrology.com/penile-implants/

Top Benefits of Penile Implants

top-urologist-for-penile-implant-benefits-01What is Erectile Dysfunction (ED)

To be diagnosed with Erectile Dysfunction (ED) is a massive set back for many men and their partners. Naturally, men will do anything to receive treatment for ED. When men are first diagnosed with ED, physicians start off by prescribing the least invasive treatment. If the first treatment does not work or the patient cannot or will not tolerate the side effects, the physician prescribes a different treatment.

Pros of oral medications

The least invasive treatments prescribed is the use of oral medications. One of the most well-known of these medications is Viagra. Viagra works by enhancing nitric oxide. This naturally-occurring chemical relaxes the muscle tissue to allow increased blood flow to the penis, resulting in an erection. It is easy and convenient to use.

Cons of oral medications

cons-oral-medication-pills-for-erectile-dysfunction-02However, there are drawbacks to using the oral medications. First, it takes at least 10-20 minutes for the drug to take effect entirely, and some men may find that the wait times do not allow for spontaneous sexual activity.  Another, more severe side effect is that Viagra can induce low blood pressure and is contraindicated for men who have heart disease or heart failure.

Penile Implant is superior to medications and pumps

The Penile Implant solves these problems. The prosthesis takes no time at all to use. When the patient is ready for sexual activity, he does not need to remember to take medication and wait 30 minutes for the medicine to take full effect. He and his partner can participate in sexual activity spontaneously. Since the implant works by providing physical support for the penis, this device is safe to be used by patients with heart disease and heart failure without risk of hypotension.

Indications for Penis Pump

However, if the patient is unwilling or unable to use oral medications, they can use a device called a penis pump. The pump induces an erection by creating a vacuum, pulling blood flow towards the penis which causes it to swell and become erect. The patient can then place a ring on the base of his penis to keep his erection for sexual activity. The problem with this approach is that the vacuum causes bruising to form on the penis. The ring placed on the base of the penis also hampers the force of the man’s ejaculation, since the ring constricts the ejaculatory pathway from the scrotum to the penis.

Penile Injections and Suppositories

Finally, there are penile injections and suppositories that are used to treat ED. These work by helping to increase blood flow to the penis, thereby inducing an erection. However, both treatments are cumbersome and are more painful to use as compared to the oral medications and the penile pump. Both methods work relatively quickly (about 5-20 minutes) but still require wait times before the patient can participate in sexual activity.

Penile Implant is superior to medications and pumps

inflatable-penile-implant-info-best-nyc-doctors-02On the other hand, there are no painful suppository insertions or injections needed when the man has a penile prosthesis. Although surgery is indicated to insert the device, it is a one-time intervention only. Recovery time is minimal, requiring only 4-6 weeks of healing time before the patient can participate in sexual activity again post-surgery. After the surgery, the patient can have a full erection and to have sexual intercourse whenever and wherever he and his partner desires.

If you would like to know more about how penile implants can benefit you and your partner, contact us today at 212-541-6239 and schedule your free appointment.

To find out more about penile implants, visit our website at www.fifthavenueurology.com/penile-implants/

Inflatable Penile Implant Types

If you’re considering having penile implant surgery, there are many things to consider. One of these things is choosing between an inflatable, rigid or semi-rigid implants. In this article we will briefly go over the basic inflatable penile implant types.

What is Erectile Dysfunction (ED)?

Penile Implants are used to treat Erectile Dysfunction (ED). They provide physical support to the penis so that the patient can achieve an erection. Inflatable implants are slightly more complicated to use than the semi-rigid implants. However, what they lack in simplicity they more than makeup for in functionality. As the name suggests, inflatable implants provide the patient with an erection when they are inflated.

Three-piece Inflatable Penile Implant

inflatable-penile-implant-types-info-01

There are two types of inflatable implants: the three-piece and the two-piece inflatable devices. The three-piece is composed of two cylinders that are surgically placed in the penis. These cylinders are then attached to a tube that is connected to the reservoir, which is situated in the lower abdomen. The repository contains saline which is delivered to the cylinders by a pump, which is placed in the scrotal sac. When the patient is ready for sexual activity, he presses the pump, which then delivers the saline from the reservoir into the cylinders resulting in inflation of the penis causing an erection. When the patient is finished, he presses the deflator valve located at the bottom of the pump, which then delivers the saline back into the reservoir causing the penis to deflate and return to its normal, flaccid state.

Two-piece Inflatable Penile Implant

2-piece-inflatable-penile-implant-info-03The two-piece inflatable implant works in much the same way as the three-piece except that the reservoir and the pump are combined into one unit. This reservoir-pump combo is placed inside the scrotum; therefore there are no parts placed within the lower abdomen, and the surgery is less complicated as compared to the three-piece implant.

Benefit of using the inflatable penile implants

By far the most significant advantage of using the inflatable devices instead of the semi-rigid implant is the ability to return to a flaccid state after sexual activity. With the simple push of the deflator valve, the patient can deflate his penis, which produces a much more natural feel and look as compared to the semi-rigid implant which prevents a return to a flaccid state. Besides some small scarring located on the underside of the penis and the scrotum, the inflatable implants are discreet and undetectable to the naked eye. Patients report that there are no changes to the sensation and ability to ejaculate with the outfitting of the inflatable implant.

Disadvantages of using the inflatable penile implants

types-inflatable-penile-implant-nyc-top-surgeon-02

However, there are some disadvantages to using the inflatable implants. Since the two-piece implant reservoir is comparatively smaller, there may not be enough saline in the reservoir-pump combo unit to produce a full erection as compared to the three-piece repository. Complication rates also tend to be higher with the inflatable implants as compared to the semi-rigid devices due in part to the multiple different units comprising the implant.

Inflatable penile implants are superior to semi-rigid penile implants

In summary, the inflatable implants provide men with the highest rate of satisfaction. Unlike the semi-rigid, the inflatable implant has the ability to give an erect and flaccid state. This creates a more natural feeling to the penis and prevents the chronic pain and erosion that men with semi-rigid implants tend to experience. The inflatable implants also make concealment much easier to do.

If you would like to know more about how penile implants can benefit you and your partner, contact us today at 212-541-6239 and schedule your free appointment.

To find out more about penile implants, visit our website at FifthAvenueUrology.com

What is sex like after penile implant surgery?

sex-after-penile-implant-surgery-info-nyc-specialists-01If you’re considering getting a penile implant, you may be asking yourself how sex after penile implant surgery will be. In this article we will cover the basic process and some general expectations.

A penile implant is a medical device that is surgically-inserted inside of a man’s penis to allow him to achieve an erection.  Typically, physicians recommend penile implants when all other treatments for Erectile Dysfunction (ED) have failed.

After surgery, the patient will stay for a few hours in the recovery room to make sure that they are recovering well from surgery. While in the recovery room, the patient will be assessed often to make sure that they are “waking up” from the anesthesia. Afterwards, depending on how the patient is recovering, he may be sent home or he may be admitted for observation in the hospital.

After two weeks, the patient may return to their surgeon to have the stitches removed. At this time, the surgeon may also begin to instruct the patient how to properly use their newly implanted device. It usually takes about one week until the patient can return to work and 4-8 weeks until he can resume sexual activity. After the patient has fully recovered from surgery (4-8 weeks), the physician may ask the patient to inflate his implant daily.  This is done to make sure that the implant is working properly and to give the patient a chance to get used to the device. No inflation is needed to be done with the semi-rigid prosthesis. The implant typically lasts between 9-15 years.

Is the implant surgery detectable to others?

The surgical incision is about an inch long and is located underneath the scrotum, so there are no visible surgical scars on the penis. The small size of the incision also allows the patient to recover easier and faster from surgery.

Sexual performance with the penile implant

male-penile-implant-info-nyc-surgeons-02Patients report that there is no meaningful difference in sexual feeling after having the penile implant surgery. Ejaculation, penile sensation, and orgasm are not affected by the surgery. Patients also state that they did not notice a loss in the size and girth of their penis after the implant has achieved a full erection. However, shortening of the penis length due to ED that occurred before the surgery may not be reversible even after the implant has been placed. It is important to keep in mind that despite the use of the device, the head of the penis does not become stiff because it is not affected by the implant.

Sexual Satisfaction with penile implant

To be diagnosed with Erectile Dysfunction (ED) is a massive setback for many men and their partners. Most men may even suffer from anxiety and depression. Naturally, men will do anything to receive treatment for ED. By choosing to receive penile implants, the patient and his partner are able to regain control over their sexual lives again.

If you would like to know more about how penile implants can benefit you and your partner, contact us today at 212-541-6239 and schedule your free appointment. To find out more about penile implants, visit our website at FifthAvenueUrology.com.

Recovery after Penile Implant Surgery

Indications for Penile Implant Surgery

recovery-after-penile-implant-surgery-info-01A penile implant is a medical device that is surgically-inserted inside of a man’s penis to allow him to achieve an erection.  Typically, physicians recommend penile implants when all other treatments for Erectile Dysfunction (ED) have failed.

Is the implant surgery detectable to others?

The surgical incision is about an inch long and is located underneath the scrotum, so there are no readily visible surgical scars on the penis. The small size of the incision also allows the patient to recover easier and faster from surgery.

After surgery, the patient will stay for a few hours in the recovery room to make sure that they are recovering well from surgery. While in the recovery room, the patient will be assessed often to make sure that they are “waking up” from the anesthesia. Afterward, depending on how the patient is recovering, he may be sent home, or he may be admitted for observation in the hospital.

What to expect immediately after surgery

penile-implant-specialists-nyc-02It is common for the patient to experience bruising and swelling a few days after the surgery. Swelling is expected to subside after 7 to 14 days. Pain typically subsides at around the same time as well. The patient will be prescribed pain medications, as mild pain is expected to persist for a few weeks after the surgery. The pain is then expected to subside slowly. However, if the pain persists or worsens, the patient must immediately notify their surgeon. The patient may also experience some constipation due to the pain medications that he is taking. In order to avoid getting constipated, laxatives may be prescribed. Alternatively, the patient can also increase their fiber intake by eating more fruits and vegetables as they are recovering from surgery. There are no diet restrictions for patients recovering from penile implant surgery. However, he must keep in mind that his body is working hard to repair itself from surgery. Therefore, the patient must consume a balanced meal that will help to promote healing.

Aftercare at home

They will also be given an antibiotic to take at home for about a week to help prevent infection. While recovering, the patient may be asked by their physician to keep their penis bent upwards, towards their belly button to avoid a downward curvature of the penis.

The patient will most likely have to spend the first two days recuperating in bed but will be required to get up and do some light walking for at least three times a day. They will also have to refrain from vigorous exercise and any sexual activity until they have checked in with their doctor. After two weeks, the patient may return to their surgeon to have the stitches removed. At this time, the surgeon may also begin to instruct the patient how to properly use their newly implanted device. It usually takes about one week until the patient can return to work and 4-8 weeks until he can resume sexual activity.

If you would like to know more about how penile implants can benefit you and your partner, contact Dr. Larish today at 212-541-6239 and schedule your free appointment. To find out more about penile implants, visit our website at fifthavenueurology.com.

How Penile Implants Work

nyc-expert-surgeon-doctor-penile-implants-03Have you been asking yourself lately how penile implants work? A penile implant is a way to go if you’ve not been able to resolve your erectile dysfunction with the traditional treatment modes. Penile prostheses which are either semi-rigid or inflatable are installed within the scrotum and penis through a surgical procedure. Your doctor or surgeon will suggest a suitable penile prosthesis for you (inflatable or non-inflatable) after reviewing your medical history, the underlying cause of ED, and conducting a thorough physical examination.

You’d be an ideal candidate for a semi-rigid or articulated (non-inflatable) implant if your manual dexterity is limited (caused by a joint disorder or spinal cord injury). However, inflatable two-piece and three-piece prostheses are more popular than the non-inflatable types because of their handiness and effectiveness.

Aspects your doctor will consider before suggesting an appropriate implant

Apart from your personal preference, your doctor will consider several other factors before recommending a suitable penile prosthesis. These factors, amongst other things, include:-

  • Your partner’s and your ages
  • Your physique (height and weight)
  • Previous pelvic or abdominal surgeries (if any)
  • Dimensions of penis, glans penis (the tip or head of the penis), and scrotum
  • Kidney transplant surgery if any
  • Whether a penis is circumcised or not
  • History of colostomy
  • Life expectancy
  • Overall wellbeing

Mechanism of how penile implants work

how-semi-rigid-penile-implants-work-top-nyc-surgeon-specialist-02The inflatable penile implant, both the 3-piece and the 2-piece devices, have similar structures and operation mechanism. The components of a three-piece implant comprise dual cylinders, a pump with release valve, and a reservoir filled with fluid. These components are separate in the three-volume prosthesis while in a two-piece device-the pump and reservoir constitute one section and the dual cylinders or tubes make up the 2nd component.

To achieve an erection, you’ll need to blow up or expand the implant. This you do by squeezing the pump positioned inside your scrotal sac. The mechanical action of the pump pushes the saline fluid out of the reservoir. The fluid drains into the cylinders (installed inside the penis) causing them to inflate, eventually giving you an erection that is strong and taut enough for satisfactory coitus.

When it comes to using the semi-rigid or articulated penile implant, you simply need to lift your penis to align it with your partner’s vulva for thrusting it inside the vagina.

Sex life post surgery

how-penile-implants-work-general-information-01

Most men have reported that on inflating the implant, they achieve an erection that is more or less identical to a normal erection, regarding firmness and girth. However, these men have also mentioned that the length of the penis when fully erect is somewhat shorter compared to a usual erection. The prosthesis does not in any way impede the capability to attain orgasm or adversely affect sensations felt on the penis’s skin.

Unfortunately, implantation of the prosthesis damages the natural reflex that triggers an erection. In other words, you may not be able to experience an erection if you do not inflate the device. On the other hand, you may never be able to have a normal erection if the prosthesis is taken out.

Concluding remarks

You can talk to our prosthetic specialist or urologist for a better understanding of the modus operandi of the different penile implants.

References

  1. https://www.medicalnewstoday.com/articles/320918.php
  2. https://prostate.net/articles/do-penile-implants-work
  3. https://www.webmd.com/erectile-dysfunction/guide/penile-prosthesis#1
  4. https://malecare.org/penile-implants-the-options-the-pros-and-the-cons-of-the-different-designs/

 

Different penile implants: Benefits and Side-Effects

types-penile-implants-benefits-negatives-top-nyc-surgeon-01What are the different penile implants? Erectile dysfunction is a typical male sexual disorder or syndrome that affects almost 50% of men. Statistically speaking, out of every two males aged between 40 and 70, one is estimated to be plagued by ED. What is more intriguing is the fact that most men suffering from the condition are loathed to speak or discuss about the same. Prescription pills including Viagra, Cialis, Levitra, and Stendra that generally serve as the primary mode of treatment for ED help resolve the issue in 75%-80% of the cases.

For men whom the first line of treatment proves ineffective fall back on vacuum constriction devices or penile pumps. And for those whom both the first and second-line treatment plans do not work, penile implants are the last resort.

The two basic categories of penile implants

Types of penile implants referred to as penile prostheses are bespoke prosthetic devices which are implanted inside the patient’s external sexual organs (penis and scrotum) using a surgical process. The main function of this implant is to stimulate or trigger an erection in the affected male which otherwise should’ve happened as a matter of course. There are two distinct kinds of penile prosthesis where one type is distinguished from the other regarding design and structure.

Inflatable penile implants

inflatable-penile-implant-prosthesis-general-information-02bAn inflatable penile implant, as the terminology indicates, is a penile prosthetic device that needs to be inflated for taking advantage of it. An inflatable implant has three components-a set of two cylinders, a pump with a release valve, and a small tank or reservoir filled with saline fluid.  There are again two different types of inflatable implants-two-volume and three-volume.

In a two-piece penile prosthesis, the pump and reservoir comprise one section while the cylinders make up another. In a three-piece, the cylinders, pump, and reservoir are separate parts or components.

Pros of three-piece implants

  • You get an erection that is extremely rigid and firm; the erections you get are the most natural amongst all types of implants
  • The implant stays soft, flaccid, and inconspicuous when deflated

Cons

  • Greater manual dexterity is required for operating it compared to all other implant kinds
  • Surgery for this implant is also the most complex, so chances of complications are also the highest
  • Highly vulnerable to malfunctioning and leakage
  • The three-piece implant is the costliest amongst all implant kinds

Advantages of two-piece implants

Pros

  • Easily operable
  • Surgical process is simple; an abdominal incision is not necessary
  • Deflation makes the implant soft and drooping

Cons

  • Erections less firm in comparison to three-volume implants
  • It is also susceptible to leak or dysfunction, like three-piece prostheses
  • Mechanically and structurally it is more complex than semi-rigid implants

Non-inflatable or semi-rigid penile implants

A non-inflatable implant chiefly consists of two metallic rods or cylinders that are sheathed in a silicone base. The rods or tubes which are not inflatable are inserted in the penis. One simply has to lift the penis to use the implanted rods that are always in a semi-rigid state.

Benefits

  • Can be conveniently used by individuals with manual dexterity issues
  • A lesser number of parts makes it less vulnerable to mechanical failure than inflatable implants
  • The surgery is also simpler compared to implantation of inflatable prostheses
  • Least costly

Cons

  • The rigidity of erection is less
  • Difficult to conceal even when it is beneath several layers of cloth
  • Always keeps the internal penis under pressure, so chances of injuries are high

Conclusion

If you need detailed information on penile implant types and the advantages and drawbacks of each, get in touch with the top penile implant surgeon Dr. Yaniv Larish at 212-541-6239.

References

  1. https://www.aarp.org/home-family/sex-intimacy/info-12-2013/sex-erection-viagra-castleman.html
  2. https://malecare.org/penile-implants-the-options-the-pros-and-the-cons-of-the-different-designs/
  3. https://www.mayoclinic.org/tests-procedures/penile-implants/about/pac-20384916
  4. https://zovon.com/hot-topics/sexual-wellness/penile-implants/ 

What to expect before, after, and during penile implant surgery?

pre-operation-info-penile-implant-02Today we will discuss what to expect during penile implant surgery, including pre-op, the surgery itself, and post-op. During a typical penile prosthetic or penile implant surgical procedure, the urologic or prosthetic surgeon will insert semi-rigid, bendable rods or inflatable cylinders inside your penis. If you’ve been recommended an inflatable penile prosthesis, then the surgeon will also place a pump (that is fitted with a discharge valve) and a fluid-filled reservoir in your scrotum and abdomen respectively. Once the surgery is complete and you recuperate fully (that could about 5-6 weeks), you need to inflate and deflate the device as per your need and convenience.

You normally opt for a penile implant operation when conventional modes of treatment, including oral or injectable drugs and vacuum constricted device (VCD or penile pump), have not helped in curing your ED.

Preparing for the penile implant surgical procedure

At the outset, your doctor or surgeon who’ll carry out the implant surgery will go through your medical background as well as perform a detailed physical checkup to ensure that you’re ready for the same. He or she’ll also consider whether your issue can be resolved via alternative treatment plans. Once the physician has given his or her nod for the surgery, you’ll be transferred either to the outpatient department or to a male ward where you’ll stay overnight.

You’ll be put on preoperative antibiotics that’ll you’ll keep taking until the surgery can start the next day.

The surgery: Modus operandi

what-expect-penile-implant-surgery-top-nyc-surgeons-01

The surgeon usually makes a penoscrotal or infrapubic opening usually about 3-4cm in size (for implanting an inflatable device). The incisions are usually created in the lower abdomen, right underneath the penis or below its tip (glans penis). The patient is either put on general anesthesia or spinal anesthesia before the surgeon can commence with the process.

Also, the entire that will be operated upon is clean shaved, and a cannula or catheter is inserted so that the same can collect urine. Additionally, an IV tube is installed as well for administering saline, antibiotics or other drugs. After that the penile tissues that become inflated with blood leading to erection are stretched out to facilitate the placement of the inflatable tubes.

Depending on whether you’ve been recommended a two-piece or three-piece penile implant, the surgeon will carry out the relevant placements. For instance, the reservoir containing fluid and the pump with the release valve of a two-volume prosthesis goes inside the scrotum. And for the three-piece valve, where the pump and reservoir are separate components, the former is positioned inside the scrotum, and the latter is instilled below the wall of the lower abdomen.

After the surgery is through, the surgeon sterilizes the entire area and sutures the opening or openings. Depending upon the type of implant, the operation usually takes 30-50 minutes. The surgery is normally conducted as an outpatient mode.

Recovery after surgery

penile-implant-surgery-post-operation-info-recovery-nyc-03Following the completion of the surgery, your physician walks you through instructions and tips on taking care of the operated site as well as on the procedure of using the device. You’ll need to take painkillers and anodynes in the first couple of weeks for getting relief from pain as well as have to take antibiotics for lessening the chances of infection. Though it could take many weeks to recuperate fully, you may be able to resume your normal activities within a week or two.

Significantly enough, you could go back to enjoying sex with your partner 5-6 weeks after surgery.

Concluding remarks

Approximately, 90-95% of inflatable penile implant surgical procedures are effective in that they enable men to have erections robust enough for fulfilling intercourse. If you want to know more about penile implant surgery, call Dr. Larish today at 212-541-6239.

References

  1. https://www.healthline.com/health/erectile-dysfunction/penile-implant-surgery#recovery
  2. https://www.edcure.org/articles/after-penile-implant-surgery-what-to-expect-following-infrapubic-inflatable-penile-prosthesis-ipp-placement/
  3. https://www.edcure.org/articles/recovering-from-penile-implant-surgery/
  4. https://www.medicalnewstoday.com/articles/320918.php
  5. https://www.urologicalcare.com/penile-implants-prosthesis/penile-implant-post-op-care/

Benefits of penile implants

benefits-of-penile-implants-nyc-specialist-surgeon-01Are you someone beset and overwhelmed with erectile dysfunction but simply recoil at the mere mention of the disorder? Have you thought about it but you’re not sure of the benefits of penile implants? You can take some solace from the fact almost all males suffering from ED would prefer to avoid discussing the condition whenever the subject is broached. Going by findings of studies and surveys on erectile dysfunction, approximately 52% of males aged between 40 and 70 are diagnosed with ED.

Though individuals with ED issues opt for first-line and second-line treatments, like medications and penile pumps, the corrective techniques prove ineffective for a significant proportion. For these males, choosing a penile implant surgery, is more often than not, is the best and only option for reclaiming their sex life.

Top reasons why men with ED should go for a penile prosthesis

what-are-benefits-of-penile-implants-surgery-02Penile implants, since they first became commercially viable and available circa 1973, have come to the aid of an almost countless number of men who became affected with ED because of hypertension, diabetes, CAD, obesity, depression, and other medical conditions. However, the penile prostheses that were developed initially were not as effective as the present-day versions.

Technological progress made in the area of prosthetic surgery has facilitated the designing of topnotch semi-rigid, inflatable and non-inflatable penile prostheses which not only guarantee a better satisfaction rate but also long-term use. Experienced urologists and prosthetic experts can complete the surgery for a penile prosthesis within 45-50 minutes, and the risk of developing an infection following the operation is less than 5%.

Following are some top reasons why you should go for a penile prosthesis surgical procedure:

  • Firm and natural erections: You can expect to have a tumescent erection that’ll be as natural as those experienced by men without ED
  • Faster recovery time: Though the recovery time might vary from one individual to another (depending upon the type of implant or the patient’s health condition), the period is generally 4-6 weeks in most cases. Once you’ve fully recovered, not only will you be able to lead a normal lifestyle but also go back to making the most of your sex life.
  • The advanced surgical procedure makes the implant discreet: The penile implant will remain largely inconspicuous when your penis is in a downward position and not in an erectile state. Depending upon the effectiveness of the surgical procedure, your wife or partner will never be able to figure out that you have a prosthetic implant till you spill the beans.
  • Modern-day penile implants are usually insured: You do not need to worry about the cost implications of a two-piece or three-piece penile prostheses. Since your prosthetic expert will recommend an appropriate implant for you, you can take it for granted that it’ll be covered or backed by an insurance plan.
  • Very high satisfaction rates: Over 95% of men who opted for penile implants have reported that they were satisfied with their choice of device as the same enabled them to maintain an active conjugal life.

Major benefits of inflatable penile implants

  • statistics-results-penile-implant-surgery-nyc-surgeons-03Penis appears normal when flaccid
  • Increased circumference leading to improved firmness
  • Easy deflation using only one hand
  • Long-lasting
  • Lower risks of infection

Concluding remarks

The benefits of selecting a penile implant nowadays outweigh the drawbacks. If you wish to more about penile prostheses and their inherent benefits, you can send us an email or make a call to our surgeon.

References

  1. https://www.coloplastmenshealth.com/treatments/erectile-dysfunction-treatment/penile-implants/
  2. http://www.alarconurology.com/blog/erectile-dysfunction-penile-impotence/penile-implant-benefits/
  3. https://www.menshealth.com/health/a19547700/cure-for-erectile-dysfunction/
  4. https://malecare.org/penile-implants-the-options-the-pros-and-the-cons-of-the-different-designs/