Erectile Restoration Surgery
At Men’s Health Manhattan, we provide world-renowned care and definitive management of ED through Erectile Restoration Surgery (ERS). Commonly known as a penile implant or penile prosthesis surgery, ERS is a gold standard surgical treatment performed to permanently treat erectile dysfunction and to provide for a natural appearing and feeling erection for spontaneous sexual activity. ERS/penile implant surgery does not affect a man’s sensation and generally does not have any effect on a man’s ability to achieve an orgasm. In most men, it takes about 45 minutes to perform, and is performed in an outpatient setting, meaning patients go home the same day. The vast majority of insurance carriers cover this surgical approach.
ERS or penile implant surgery is performed in men who have failed medical management options for ED, including pills and injections, or in men who have grown tired of the medical treatment options due to suboptimal reliability or expense.
There are two primary types of penile implants/penile prosthesis. At Men’s Health Manhattan, the vast majority of our patients opt for and receive an inflatable implant. Others will choose a malleable implant.
What are the surgical risk ?
As with any surgery, ERS/penile implant surgery has medical risks common to all surgeries as well as surgical risks specific to penile implant surgery. You will have a complete discussion of all of these risks at Men’s Health Manhattan prior to scheduling. Thankfully, these risks are rare and uncommon. Surgical risks include the mechanical breakdown of the implant. The average lifespan of the implant is about 15 years, after which the implant can either be left in place or changed through a surgical procedure. Please keep in mind that this is an average - in some patients it will last a shorter period of time and in others a long period of time. Other risks include a rare risk of device infection, which may require a surgical procedure to resolve, and can very rarely erode through the skin. Injury to the urethra may also rarely occur, and may require surgical repair.
Is it covered by insurance ?
Given that ED is a clear medical condition, very often insurance providers will provide coverage for ERS/penile implant surgery. Any patient thinking seriously about scheduling ERS will have an in depth conversation with our surgical scheduler, who will determine insurance coverage and eligibility. No patient will walk into surgery without knowing whether the surgery is covered. Copays will vary based strictly on your insurance provider. Once we have determined coverage, we will often be able to help you to determine your out of pocket costs, which we ask you to confirm with your insurance provider.
What is an Inflatable Penile Implant/Prosthesis?
Inflatable implants consist of paired, easily concealed cylinders which are surgical implanted directly into the erectile chambers of the penis, as well as a pump which is surgical implanted within the scrotum and between the testicles to inflate and deflate the device. The pump is completely concealed and hidden - somebody looking at a patient with an implant from the outside would not know that the patient has an implant. Operating the device is completely painless once it has completely healed. When inflated, an erection is achieved, and after completion of sexual activity, the patient simply deflates the implant when he is ready and goes back to a normal, flaccid state.
What is a Malleable Penile Implant/Prosthesis?
Malleable implants consist of paired, easily concealed firm but bendable rods which are implanted directly into the erectile chambers of the penis. There is no pump component. The penis is always firm enough for sexual activity. The rods, however, can be bent to easily adjust the position of the penis so that the implant remains inconspicuous and completely hidden when not in use.
What is the Surgical Procedure Like?
All patients undergoing ERS/penile implant surgery are sent for a complete medical, and sometimes cardiac clearance, prior to undergoing surgery - similar to any other surgical procedure which we perform. A history of other medical conditions, including diabetes, heart disease and previous radical pelvic surgery are not contraindications to this surgery. In fact, most patients requiring implant surgery have these conditions.
Following either general anesthesia or an epidural (similar to that given to women undergoing childbirth), the implant surgery is performed in the ultimate of sterile conditions, with the experienced and extremely efficient Men’s Health Manhattan team. An approximately 1 inch incision is made just above the penis, through which all components are placed. This incision is very well hidden within the crease between the penis and pubic bone and scars are often imperceptible. The entire surgery takes about 45 minutes, where the patient is precisely measured. The implant components are placed and connected after being washed in antibiotics throughout the surgery in order to prevent infection, and the patient is sent home with a fully functional penile implant.
Most men are seen back in the office within 48 hours for a 5 to 10 minute checkup. Following a recovery period of between 1 to 4 weeks depending on the patient, over 90% of our patients have fully resumed sexual activity by 6 weeks postoperatively.
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