Penile implants (prostheses) play a significant role in helping men who suffer from weak or unsustainable erections.

Here are some key features of penile implants:

1. Enhancing erection by providing sufficient support to the penile tissues to achieve the firm and sustainable erection necessary for satisfying sexual intercourse.
2. Restoring confidence by achieving desired erections at any time and under any circumstances.
3. Improving the sexual and emotional relationship between partners.

Penile implants aim to provide an effective and safe medical solution for men suffering from erectile dysfunction (ED).

Penile prostheses are implants made of high-quality medical silicone or polyurethane. They are implanted inside the penis through a very small opening between the penile shaft and the scrotum. This incision is closed cosmetically and leaves no trace.

The procedure takes about sixty to ninety minutes, and the patient can leave the hospital on the same day. He can engage in sexual intercourse naturally after four to six weeks of recovery.

Who are good candidates for penile prosthesis as a treatment for erectile dysfunction (ED)?

The safest method to perform surgery is to perform it on a well-prepared candidate patient. To achieve this, the following must be done:
• The patient undergoes a comprehensive diagnostic process to efficiently diagnose the condition.
• If imaging tests indicate a chance for medical treatment, the patient is treated using traditional methods that address the causes of erectile dysfunction, such as hypertension and diabetes. Medications such as sexual enhancers like Viagra and its equivalents and medications that increase blood flow to the penis and raise testosterone levels are prescribed.
• Wait for a sufficient treatment period and follow the response of the previous steps.
• Patients who do not get a good response to medical treatment, including penile erection hardness and not just its swelling, or who cannot tolerate its side effects, become good candidates for erectile prosthesis implantation.

Professor Dr. Adham Zaazaa, a pioneer in prosthetic urology in Egypt and the Middle East, evaluates and studies the case, prepares the patient well before the surgery, provides follow-up care to ensure satisfactory results, and trains the patient on the correct use of the implant to achieve the highest satisfaction rates for both the husband and wife.

Types of penile prosthesis:

1. Inflatable Penile Prosthesis (IPP).
2. Malleable Penile Prosthesis (MPP).

1. Inflatable Penile Prosthesis:

What is a three-piece inflatable penile prosthesis?
The inflatable penile prosthesis consists of three main components: a reservoir, a fluid-pumping device, and two inflatable cylinders. Its purpose is to induce penile erection. Therefore, it is the optimal treatment for cases of erectile dysfunction that do not respond to medicinal treatment because it provides a strong erection due to the presence of a sufficient amount of saline solution in the reservoir.

The three-piece inflatable penile prosthesis is characterized by its ease of use, providing the maximum level of hardness and erection available for the patient.

The inflatable penile prosthesis is characterized by a hydrophilic coating that reduces surface friction, is easily customized to the patient’s needs, and has a surface saturated with antibiotics released during and after the surgery, which represents a safety factor for the patient during and after the surgery.

Does inflatable penile prosthesis negatively affect intimate relations?
Intimacy is not affected at all by the inflatable penile prosthesis, as sensation and ejaculation remain very natural. The penis maintains its warmth, hardness, and tumescence during sexual activity.

Additionally, the prosthesis improves sexual performance, as the man can continue sexual activity even after ejaculation. The inflatable penile prosthesis also maintains the natural appearance of the penis to such an extent that it is difficult to detect the presence of the penile implant.

What are the benefits of inflatable penile prosthesis surgery?
Inflatable penile prosthesis surgery has several advantages, including:
• It is a simple procedure that takes about 90 minutes, and the patient can return home afterward.
• The patient requires 48 to 72 hours of recovery time, after which Professor Adham Zaazaa removes all dressings, and the man can resume his daily activities.
• Freedom to wear clothing because there is no continuous erection.
• No or limited pain, especially when using cavernous tissue preservation techniques.
• No noticeable prosthesis, so the wife may not be aware that her husband has had an implanted penile prosthesis, as nothing unnatural can be seen.
• Over time, the thickness and length of the penis improve, especially with frequent use, as the hydraulic prosthesis works to expand the tissues, and within a year or two, 70% of patients feel they have increased length and thickness.
• It brings more satisfaction to the man and his partner than usual.

Is the inflatable penile prosthesis suitable for abdominal hernia patients or patients with a surgical mesh?
The three-piece inflatable penile prosthesis is suitable even for abdominal hernia patients or when installing a mesh. This is because the third piece is implanted under the abdominal muscles, not above them, in a place completely different from the position of the mesh.

What is the difference between the three-piece inflatable penile prosthesis and the two-piece inflatable penile prosthesis?
The three-piece inflatable penile prosthesis completely disappears when relaxed, while the two-piece inflatable penile prosthesis disappears by 80%. This is a significant percentage, and some men prefer to show a slight aspect of their penis in a relaxed state. However, two-piece inflatable penile prostheses are no longer used and have been discontinued since 2022.

2. Malleable Penile Prosthesis:

What is a malleable penile prosthesis?
The malleable prosthesis is suitable for patients with erectile dysfunction who have a poor response to medication, as it is easy to use and requires minimal effort to initiate sexual activity.

The prosthesis consists of two malleable rods made of silicone, which do not react with the body. It is internally supported by corrosion- and fracture-resistant silver wire core, providing the necessary rigidity for a strong erection.

Does the malleable penile prosthesis negatively affect penile function?
The malleable prosthesis provides a full erection sensation for the penis; both for the man and his partner, and does not negatively affect the penile sensation at all. Ejaculation is also natural.

The man only needs a simple movement to extend the penis forward before starting the sexual intercourse, and when finished, he bends the penis downwards with a simple movement as well.

What is the difference between a malleable implant and an inflatable implant?

There are no differences in terms of hardness and erection during intercourse between malleable and inflatable implants for erectile dysfunction. However, the difference lies in the rest periods. The malleable implant maintains a certain degree of rigidity, while the inflatable implant allows for more relaxation of the penis compared to the malleable implant.

Frequently Asked Questions and Answers about Penile Implant Surgery:

What methods does Professor Adham Zaazaa follow to reduce the risk of penile prosthesis surgery?
Thorough preparation: treating diabetes and hypertension cases and conducting comprehensive tests to ensure the general health of the patient before surgery. Additionally, patients over the age of 45 are referred to a cardiologist for a comprehensive heart evaluation to ensure full readiness for surgery.

Proper surgical preparation: administering antibiotics before surgery, along with preparing the operating room for this specific type of surgical procedure through special antibacterial covers and applying the “No-Touch Technique” to prevent any contact between the prosthesis and the patient’s skin.

What is the “No-Touch Technique” for erectile prosthesis surgery?
This technique ensures the highest level of sterilization and infection control during surgery, reducing the complication rate to nearly zero.

What are the expectations, and when do the results of erectile prosthesis surgery start to appear?
The feeling of satisfaction begins to appear a few months after surgery and men realize that they have healed and improved. Therefore, it is not expected for the patient to feel fully satisfied immediately after the surgery; rather, they have to wait patiently for some time and then feel satisfied with the result.

Is there a connection between penile implant surgery and ejaculation?
There is no direct relationship between penile implant surgery and ejaculation. Some patients may experience ejaculation problems due to diabetes, which may persist after penile implant surgery, but the surgery itself is not related to this issue.

Is it possible to regain the previous length of the penis after surgery?
Sometimes, a long time has passed since the patient had a natural erection before undergoing surgery, so he may has lost some tissues and length due to fibrosis, calcification, or tissue shrinkage.

During surgery, Professor Adham Zaazaa works to provide the maximum length and appropriate size for each case to achieve maximum satisfaction. In all cases, the rigidity of the erection with the prosthesis is the most important factor for the success of the erection and achieving satisfaction, which is accomplished by the penile prosthesis.

What is the expected lifespan of the penile prosthesis and its expiration period?
The official expected lifespan of a penile implant is 18 to 25 years. The penile prosthesis can perform its function throughout a person’s lifetime, provided that several factors are followed to prolong its lifespan. To learn more about the factors that can extend the lifespan of a penile implant, click here.

Is there a medical condition that prohibits the penile prosthesis surgery?
No disease prevents the penile prosthesis surgery if you are a candidate for the procedure. However, there are some precautions for patients with certain chronic diseases, such as diabetes and heart disease. To learn more about these precautions, click here.

What are the advantages of the latest surgical techniques developed by Professor Adham Zaazaa?
The advantages of the latest surgical techniques developed by Dr. Adham Zaazaa, Professor of Andrology and Male Fertility at Cairo University, are supported by scientific research and published in top scientific journals in the field of andrology and sexual health. One of the important techniques is the preservation of the cavernous tissue and its artery during penile prosthesis implantation, along with maintaining the maximum length and girth of the penis during surgery.

Zaazaa Caversonal Sparing Technique:

Dr. Adham Zaazaa’s technique for penile implantation preserves over 90% of the cavernous tissue, thereby maintaining natural erection function and penile tumescence during erection. This preserves the natural sensation for both the husband and wife and ensures the maximum length and girth of the penis, as well as its tumescence during sexual arousal and the warmth sensation for the wife, in contrast to traditional methods that destroy the cavernous tissue.

Furthermore, this unique technique preserves the artery which feeds the cavernous tissue, allowing the patient to benefit from several advantages, including avoiding penile shrinkage and tissue damage over time, maintaining the natural shape and texture of the penis, preserving the vitality of the penile tissues, and the possibility of using any medications that circulate through the blood vessels. To learn more about Dr. Adham Zaazaa’s technique for preserving cavernous tissue, click here.