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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.

What is sex like after penile implant surgery?

Nearly 90%-95% of men with penile implants have gone on record by iterating that they’ve had erections stiff and strong enough for pleasurable intercourse. To put it more accurately, almost 80%-90% of men with erectile dysfunction who chose a penile implant procedure said that they enjoyed having sex with their partners. These men also reiterated that they were so satisfied with the implant surgery that they’d again opt for the procedure if required.

Sex life post penile implant surgery

There is overwhelming evidence (backed by surveys and research) to guarantee that a penile implant could rejuvenate the sex life of a man with ED. The implant will enable the individual to have a robust erection where his penis becomes sufficiently tumescent, eventually allowing him to indulge in extensive foreplay and coitus that fulfills both him and his partner. When you compress the pump, the fluid from the reservoir flows into the dual cylinders fitted inside the penis causing the tubes to swell up.

The inflated cylinders lead to the penis becoming thick and rigid and thereby erect. The implant gives you an erection which is almost akin to the tumescence that men without ED experience. However, one significant drawback of using penile prostheses is that the length of your penis when fully erect might be less than the extent or span that was achieved before the surgery.

Anyway, if you opt for a latter-day 3-piece penile prosthesis, you could look forward to having an erect penis that is not only hard and thick but noticeably long as well. Nevertheless, the implant does not affect the pleasure sensations you feel on your penis’s skin surface. Neither does the prosthesis hinders or obstructs your instinctive capability to attain an orgasm.

This is so because the nerves that send signals for stimulating an erection are distinct from the ones that trigger the orgasmic process. Nor does the implant get in the way of your accomplishing an ejaculation. You need to realize that erectile function is completely different from the physiological function or process that causes orgasms.

But your ability to have a natural erection is compromised for good after the prosthesis is installed. Simply put, you’ll inevitably have to pump the device whenever you wish to have an erection. That, in essence, implies you may never be able to engage in sexual activity if the prosthesis is extricated.

The problem of penile shortening following the insertion of the prosthesis

A penile implant surgery, like any other kind of surgical procedure, is not without its complications and side effects. Though over 90% of men have expressed that their conjugal life received a huge boost after the operation, they found to their dismay that their penis was not as long (when fully erect) as it used to be before the implant. Development of fibrous and scar tissues following the surgery leads to penis shrinkage that ultimately prevents the organ from reaching its full normal length during erection.

However, the latest 3-volume inflatable penile implant devices that come with lengthy cylinders could go a long way in solving the above issue.

Outlook

The majority of men suffering from ED do not face any issues with orgasms or ejaculation. The insertion of a penile implant helps correct the problem of erectile dysfunction without negatively impacting orgasmic or ejaculatory functions. In case you are still thinking about the benefits, we recommend consulting one of our experts to get answers to all your queries.

Call today for a confidential consultation:

 

FIFTH AVENUE UROLOGY
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4 East 76th Street
New York, NY 10021
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212-541-6239

 


References

  1. https://www.ncbi.nlm.nih.gov/pubmed/4068047
  2. https://www.drelist.com/penile-implant-sensation/
  3. https://www.menshealth.com/sex-women/a19547727/penile-implant/
  4. https://www.edcure.org/articles/youve-made-the-decision-life-after-penile-implant-surgery/
  5. https://www.medicalnewstoday.com/articles/320918.php

Inflatable Penile Implant

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

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

The 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

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 a free consultation.

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

Indications for Penile Implants

How many men are suffering from Erectile Dysfunction (ED)?

According to the National Institute of Health, there are 30 million American men that are affected with Erectile Dysfunction (ED). Most men who suffer from ED are over the age of 40. However, the prevalence of ED increases with age. Chances are, you or someone you know is suffering from ED right now.

What is Erectile Dysfunction (ED)?

ED (also called impotence) occurs when a man has difficulty achieving or maintaining an erection. There are many causes of ED. Some of the most common reasons include heart disease, vascular disease, diabetes, alcohol, drugs, surgical complications and Peyronie’s disease. Chronic heart and vascular disease, along with diabetes can severely impair the blood vessels of the patient, restricting blood flow to the penis. This can result in an inadequate erection. Alcohol, tobacco and drug use (even prescription drugs) can also limit blood flow to the penis, leading to ED.

What is Peyronie’s Disease?

Finally, Peyronie’s disease occurs when a man has developed scar tissue in his penis, preventing him from achieving or maintaining an erection. At this time, causes for Peyronie’s disease are not known although most researchers believe that it occurs due to repeated trauma to the penis. This can happen via sexual activity, sports or an accident. Besides having ED, other symptoms of Peyronie’s disease include a significant bend to the penis, shortening of the penis, and pain even without having an erection.

What are the treatments for Erectile Dysfunction?

There are currently only three treatments for ED: prescription medications, use of a penis pump, and penile implants. Most patients that are newly diagnosed with ED are prescribed medications by their doctors.

Oral medications for Erectile Dysfunction

The most commonly prescribed drug is Sildenafil, or more commonly known as Viagra. This medication works by enhancing nitric oxide, which is a naturally occurring chemical in the human body. What nitric oxide does is it relaxes the muscle tissue to allow increased blood flow to the penis, resulting in an erection. However, there are a couple of downsides to this medication. First, it does not provide an immediate effect. It takes an average of 10-20 minutes after taking the drug to achieve a full erection. Second, since Sildenafil only amplifies the effects of nitric oxide in the body, the patient must first be sexually stimulated before the full effects of the medication could be realized.

Penis Pumps

Penis pumps, on the other hand, works mechanically. A vacuum tube is placed on the penis. The vacuum pulls the blood into the penis, and a ring is set on the base of the penis to make the erection last. The downside to the penis pump is it does not allow for spontaneous sexual activity, and it can take between 5-10 minutes to get the penis erect entirely. The pump can also cause bruising on the penis. Finally, the band at the base of the penis can affect ejaculation.

Indications for Penile Implant Surgery

Most men can be successfully treated with either medication or through the use of a penis pump. But for men who are either unsatisfied with these treatment options or for whom these treatment options have failed, there is one last available treatment for them: penile implants. A penile implant is a medical device that is surgically-inserted inside of a man’s penis to allow him to achieve an erection.  This treatment option may be the most invasive, but most men who have had the procedure done reports that it is the most satisfying option for them. According to the Mayo Clinic, these devices last up to 10 years without the need for replacements 60-80% of the time.

If you or someone you know has Erectile Dysfunction and has tried other treatments and failed, 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.

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References

  1. Nunes KP, Labazi H, Webb RC. New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension. 2012;21(2):163–170.
  2. Mayo Clinic. Penile Implants. https://www.mayoclinic.org/tests-procedures/penile-implants/about/pac-20384916?p=1

What to expect before, during and after penile implant surgery

Indications for Penile Implant Surgery

before-during-after-penile-implant-surgery-02A 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. ED (also called impotence) occurs when a man has difficulty achieving or maintaining an erection.

Benefits of getting Penile Implant Surgery

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.

What to expect before Penile Implant Surgery

Before surgery, the physician will review the patient’s medical history with the patient, especially considering his history of ED. The physician will also consider the patient’s past surgeries and any medications he is currently taking (if any).

Next, a complete urological exam will be conducted to confirm the need for surgery. At this point, the patient’s manual dexterity will also be assessed to determine what type of implant will best serve the patient’s needs and ability.

What to expect the day of Penile Implant Surgery

after-post-penile-implant-surgery-01

The surgeon will discuss the entire operation with the patient to help them understand the procedure. They will also talk about complications; what kinds of implants will best serve the patient and how the surgery is permanent and irreversible. The surgeon will also want to make sure that there is someone who can drive the patient home after surgery and that they cannot eat or drink after midnight on the evening before their surgery.

What to expect during Penile Implant Surgery

The surgery will occur at a hospital or surgery center. Right before surgery, the pubic area will be shaved, and an antiseptic soap will be used to scrub the surgical site clean. The patient will then be put under general anesthesia, and a catheter will be placed to empty the bladder of urine. The surgeon will then make an incision on the base of the penis, and set the implant into the corpora cavernosa, the two hollow chambers in the that are responsible for achieving an erection in the penis.

The implants will be customized precisely to the specific measurements of the patient. If a 2-piece implant is to be used, the combined reservoir and pump unit will be surgically placed in the scrotal sac. If it is a 3-piece implant, an additional incision will be made in the lower abdomen to put the reservoir in that site. The entire surgery could take between 45 minutes to 1 hour.

What to expect after Penile Implant Surgery

male-implant-surgery-best-nyc-03After surgery, the patient may stay for a few hours in the recovery room to make sure that they are recovering well from surgery. The patient will be prescribed pain medications, as mild pain is expected to persist for a few weeks after the surgery. They will also be given an antibiotic to take at home for about a week to help prevent infection.

The patient will have to refrain from vigorous exercise and any sexual activity until they have checked in with their doctor. It usually takes 4-8 weeks until the patient can resume sexual activity.

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/


FIFTH AVENUE UROLOGY

4 East 76th Street
New York, NY 10021
212-541-6239

Semi-Rigid (Malleable) Penile Implants

What is Erectile Dysfunction (ED)?

semi-rigid-malleable-penile-implant-surgeon-01Penile Implants are used to treat Erectile Dysfunction (ED). They provide physical support to the penis so that the patient can achieve an erection. Semi-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 Semi-rigid Implant

Effortless and Simple to use

semi-rigid-penile-implant-info-top-nyc-specialist-02As 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. Because of the relative simplicity of this implant and its installment, there are fewer components that can individually malfunction over time.

Mechanical Implant vs. Oral medication

There is no difference between the sensation, erection, and ejaculation of the patient with the use of the implant as compared to before the implant. Once surgically placed, the device is almost undetectable save for a few small surgical scars located on the underside of the penis. Oral medications such as Viagra work by enhancing nitric oxide already present in the patient’s body, before achieving an erection.

Since the implant is a mechanical device, it does not rely on the chemical makeup of the patient’s body to help the patient achieve an erection. Therefore there is a much lower failure rate with the implant as compared to the oral medications. Complications rates with semi-rigid implants are also lower as compared to inflatable implants.  Finally, the malfunction rate is less than five percent in the first five years, and the device lasts from eight to twelve years before it needs to be replaced.

Cons of Semi-rigid 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. The inability to return to a natural flaccid state can also cause some pain to the patient. 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.

If the patient requires repeated urethral catheterization, he may also experience faster erosion of the penis and may do better with an inflatable implant instead. Placement of the device can also remove the patient’s natural ability to have an erection. Finally, the device doesn’t offer any expansion of the girth or lengthening of the penis.

Satisfaction with Semi-Rigid (Malleable) Implant

penile-implant-satisfaction-after-surgery-ny-nyc-03Despite all of these issues, satisfaction rates continue to remain high (91%) for patients who have undergone semi-rigid penile implant surgery. The malleable implants continue to be an excellent choice especially for men who have difficulty with their hand and finger dexterities or who have limited mobility. Today, with many patients demanding higher quality and safer medical devices, there is continued research being done to improve upon the semi-rigid penile implants currently available on the market.

If you would like to know more about how penile implants can benefit you and your partner, contact us today at
(212) 370-4170 and schedule your free appointment.

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

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References

  1. Montague DK, Lakin MM. Early experience with the controlled girth and length expanding cylinder of the American Medical Systems Ultrex penile prosthesis. J Urol. 1992;148:1444–6.
  2. Mayo Clinic. Penile Implants. https://www.mayoclinic.org/tests-procedures/penile-implants/about/pac-20384916 

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

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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

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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