Killing Two Birds With One Stone With a Penile Implant
You’ve likely read elsewhere on this website that penile implants are a safe and effective way to help patients with severe erectile dysfunction or ED who no longer respond to medications or injections. But did you know that penile implants can also be an excellent option for patients suffering from Peyronie’s Disease alongside their ED? Let’s discuss when this is an option and see how a penile implant can solve two challenging problems with one straightforward surgery.
When we consider penile implants for Peyronie’s patients, it’s important to note that patients who suffer from PD are often in the sweet spot for ED as well – 55 and over. For some, penile implants can handle both concerns effectively.
Rather than getting into the reasons why one should have the procedure, which is a relatively narrow group of patients that have symptomatic Peyronie’s disease and severe ED, let’s talk about why we would not perform a penile implant on some Peroni patients.
The Patient Still Responds to Medication and Injections.
For some patients, moderate ED is not severe enough to consider a penile prosthesis. If patients can start and maintain an erection that is pleasurable for sexual activity with either medication like Viagra/sildenafil or Cialis/to tadalafil, or if they are responding well to tri- or quadmix for erectile function, a penile implant is likely off the table. Ultimately, it is our job to ensure that a patient receives the best, minimally invasive option, and we don’t want to fix something that isn’t entirely broken.
Not Painful or an Impediment
Alongside this, it’s important to remember that not all cases of Peyronie’s are painful; similarly, not every patient will experience impediments. For these patients, the effects of Peyronie’s are more psychological than physical. Yes, there is curvature, but if that curvature does not cause pain, and the patient can enjoy a normal sex life, it is simply an aesthetic concern that can be overcome by speaking to a men’s health specialist like Dr. Natale or even a mental health professional. It’s also important to remember that concerns about the appearance of the penis can lead to “stage fright,” which is often mistaken for intractable erectile dysfunction. Again, the specialist must get to the root cause of the problem and help patients understand what they are dealing with.
There are several possible options for Peyronie’s treatment. First is an injection known as Xiaflex, typically offered over 24 weeks. This injection, administered directly into the penis, helps loosen the plaque that causes the curvature. Xiaflex works in some patients, especially those diligent about their traction and other activities necessary to reduce or soften the plaque. However, not all patients will experience significant improvement.
Peyronie’s can also be treated with a plication procedure that essentially sutures the opposite side of the penis to straighten it out. While this is very effective and straightening the penis, it also causes some shortening, which is, to a degree, proportional to the curvature.
Lastly is penile grafting, which involves directly removing plaque from the penis in a surgical procedure. This is also very effective in eliminating Peyronie’s. However, the postop recovery can be somewhat uncomfortable or painful.
Similarly, we have a continuum of care for erectile dysfunction. That means we have lots of options before considering a penile implant. But that said, far too many men wait longer than they should, thinking that erectile dysfunction is an untreatable part of their lives.
This is certainly not the case.
Instead, men should call our office and schedule a consultation with Dr. Natale, who can go through the various permutations of care. We can discuss and ultimately choose a treatment option that best suits your needs.