A semi-rigid penile prosthesis is a medical device surgically implanted to treat erectile dysfunction (ED), considered when other treatments are ineffective or unsuitable. The device provides a permanent solution for achieving an erection sufficient for sexual activity.
It consists of two bendable rods placed inside the chambers of the penis. Unlike inflatable prostheses that require a pump, semi-rigid implants maintain a constant state of firmness, allowing the user to manually position the penis for intercourse or conceal it.
Candidacy and Device Function
Men with severe erectile dysfunction from conditions such as diabetes, vascular disease, or complications from prostate cancer surgery are often considered for this procedure. It is a viable option when less invasive treatments, like oral medications or injections, have failed to produce satisfactory results.
The device is beneficial for individuals who have limitations with manual dexterity. Conditions like severe arthritis can make operating the pump mechanism of an inflatable prosthesis challenging. The straightforward operation of the semi-rigid device offers a more manageable alternative in these cases.
A semi-rigid prosthesis functions through a pair of malleable rods implanted within the corpora cavernosa, the two chambers in the penis. For sexual activity, the user bends the penis upward into an erect position, and for concealment, it is bent downward against the body. The rods are made of silicone with a coiled metal wire core, allowing them to be bent repeatedly without breaking. This simple mechanism contrasts with inflatable devices and reduces the likelihood of malfunction.
The Implantation Procedure
The surgical implantation of a semi-rigid penile prosthesis takes between 45 minutes to an hour and is performed under general or spinal anesthesia. Before the operation, the surgical area is cleaned with an antibiotic solution, and an intravenous line is started to administer antibiotics to prevent infection.
Surgeons make a small incision to insert the device, located either at the base of the penis where it meets the scrotum, or just below the head. Through this opening, the surgeon stretches the tissues within the two erectile chambers, known as the corpora cavernosa.
Once the chambers are prepared, the surgeon measures the internal length of the penis to select the correctly sized prosthesis cylinders. Each rod is then inserted into one of the chambers. After both rods are in place, the surgeon closes the incision with sutures. A urinary catheter may be placed but is usually removed within 24 hours.
Recovery and Healing Process
Immediately following surgery, patients can expect some pain, swelling, and bruising in the genital area. A long-acting local anesthetic injected during the procedure helps manage discomfort for the first 48 to 72 hours. Oral pain medication and ice packs can help control pain and swelling as the anesthetic wears off.
The initial recovery phase requires a hospital stay of one to two days, during which the penis may be bandaged to reduce swelling. Patients are advised to wear loose-fitting clothing to avoid pressure on the surgical site after returning home. Taking prescribed antibiotics for about a week is an important part of preventing infection.
Full healing and the ability to use the implant for sexual activity take several weeks. Most men can resume light, non-strenuous activities within a few days, but strenuous physical activity should be avoided for about a month. The surgeon will clear the patient to resume sexual activity approximately four to six weeks after the procedure, once the area has sufficiently healed. Some discomfort can persist for up to six weeks as the body adjusts to the implant.
Living with a Semi-Rigid Implant
The primary benefit of a semi-rigid implant is its constant state of readiness, allowing for spontaneous intimacy without the need to operate a pump. This ease of use contributes to high satisfaction rates among both patients and their partners due to its reliability and simplicity.
A consideration for this type of implant is concealment. Because the penis remains permanently firm, it can be more noticeable under tight-fitting clothing or swimwear. Careful clothing choices, such as wearing less restrictive underwear and pants, can help manage the appearance. This is a trade-off for the device’s straightforward function.
Long-term outcomes are positive, with low rates of device malfunction due to the simple design. Sensation in the head of the penis and the ability to achieve orgasm are not affected by the implant, as the procedure does not interfere with the nerves responsible for these functions. The implant provides rigidity for intercourse but does not change libido or the physical sensations of climax.