Surgical Procedures for Erectile Dysfunction (Impotence)

Surgery is an option when all other efforts to restore or bypass your erectile dysfunction have failed. In fact, there are several possible alternatives that will permit you to have satisfactory sexual intercourse.

Restoring erections is often sufficient to restore complete sexual function.

Penile Prostheses (Implants)

Penile Implant

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Semirigid/Malleable

This prosthesis (implant) consists of one or two bendable rods that are inserted into the penis. Once installed and healed, the penis and the prosthesis can be bent into position. It can be placed upward for intercourse or downward for clothing and urination.

Inflatable

There are three pieces to this device:

• A balloon-like cylinder that fits into the penis
• A pump that is placed into the scrotum
• A reservoir of liquid that is placed nearby, inside the pelvis

The penis is normally limp until the pump is repeatedly squeezed, filling the balloon from the reservoir. After intercourse, the balloon in the penis can be deflated.

Description of the Procedure: The device is implanted under general or regional anesthesia. An incision is made between your penis and scrotum so that the device can be inserted. Additional incisions may be made to insert the accessory parts in their proper positions.

Vascular Reconstruction

If circulation is reduced to your penis due to vascular disease (usually following a traumatic injury to the penis), reconstruction of your arteries may restore erectile function. This is complex surgery which is performed only in a few hospitals in the US. Occasionally, in these rare cases, the vascular defect can be repaired. This will help to avoid surgical reconstruction.

References

Guay AT, Spark RF, Bansal S, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple’s problem: 2003 update. Endocr Pract . 2003;9:77-95.

Erectile dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 25, 2012. Accessed September 14, 2012.

Erectile dysfunction. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/ED/index.aspx . Updated March 28, 2012. Accessed September 14, 2012.

Erectile Dysfunction. American Urological Association Foundation website. Available at: http://www.urologyhealth.org/content/moreinfo/ed-factsheet.pdf . Updated 2009. Accessed September 14, 2012.

Sivalingam S, Hashim H, Schwaibold H. An overview of the diagnosis and treatment of erectile dysfunction. Drugs . 2006;66:2339-2355.

Webber R. Erectile dysfunction. Clinical Evidence . 2005;13:1120-1127.