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Hello, I am Prof. Dr. Volkan İzol.

A significant number of the men who come to my clinic tell me that they have been living with erectile dysfunction for years and that they often cannot bring themselves to share this with anyone.

Many patients ask me questions like these:

•“Doctor, the medications aren’t working anymore. What can I do?”

•“The injections didn’t help either—am I out of options?”

•“Is ‘happiness rod’ surgery very difficult?”

In this article, I will explain penile prosthesis (penile implant) treatment—which offers the most definitive solution for men experiencing erectile dysfunction—step by step and in the clearest possible way.

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Erectile dysfunction is the inability to achieve or maintain the firmness necessary for sexual intercourse.

It becomes more common with age, but it can also occur in young men.

Reasons

•Vascular Problems: Narrowing of the blood vessels that supply blood to the penis (atherosclerosis).

• Diabetes: It causes nerve and blood vessel damage and is the most common cause of ED.

•Prostate Surgeries: Nerve damage, particularly following radical prostatectomy.

•Hormone Deficiencies: Low testosterone.

•Medications: Antidepressants, blood pressure medications.

•Psychological Factors: Stress, anxiety, depression.

In the first stage, medication (PDE-5 inhibitors) is used. If these are ineffective or contraindicated, a penile prosthesis is considered.

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A penile prosthesis is a medical device implanted into the penis. Its purpose is to enable the patient to achieve a full erection whenever desired.

•Natural sensations: Ejaculation, orgasm, and penile sensation are not affected.

•Permanent solution: Once installed, it can be used for a lifetime.

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1️⃣ Malleable (Bendable) Prosthesis

•It consists of two semi-rigid cylinders

•It is always in a semi-rigid state

•Advantages: Cost-effective, simple surgery, short procedure time

•Disadvantage: A constant sensation of stiffness; cosmetic concerns in some patients

2️⃣ Three-Piece Inflatable Prosthesis

•The most popular prosthesis that provides the most natural-looking result

•It consists of a reservoir (inside the abdomen), a pump (in the scrotum), and cylinders

•The patient squeezes the pump, causing the penis to become erect; then releases the pressure to make it soft again

•Advantage: The most natural-feeling erection; the option that best mimics real-life sexual experiences

•Disadvantage: The surgery is longer and more expensive

3️⃣ Two-Piece Inflatable Prosthesis

•The reservoir is integrated into the pump

•The surgery is simpler, but it doesn't feel as natural as the three-piece implant

In my clinical practice, three-piece inflatable implants provide the highest satisfaction rates, particularly among young patients with an active sex life.

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•Blood tests, an EKG, and an anesthesia evaluation are performed

•A urine culture is performed to check for an infection

•Blood sugar levels in people with diabetes are regulated

•The patient and their partner are informed about how the prosthesis works

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•Anesthesia: Spinal or general

•Incision: A small 2–3 cm incision at the base of the penis

•Implantation: The cylinders are implanted into the penis, the pump into the scrotum, and the reservoir into the abdomen

•Duration: About 45–60 minutes

•Discharge: Usually after 1 night

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•Mild pain and swelling are normal

•The prosthesis is activated after 4–6 weeks

•Once the patient has become accustomed to the pump, they can resume their normal sex life

•The patient is given detailed instructions on how to use the prosthesis

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The cost varies depending on the brand and type of prosthesis used.

•There may be a copayment at private hospitals

•Three-piece dentures are more expensive but provide a higher level of satisfaction

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•Patient and partner satisfaction of up to 95%

•Sexual intercourse without the need to plan

•The complete elimination of the need for medication and injections

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•Enfeksiyon: Deneyimli cerrah ve antibiyotik profilaksisi ile risk <%2

•Mechanical Failure: The device typically needs to be replaced every 10 to 15 years

•Penis Shortening: This is more commonly experienced by men with severe erectile dysfunction

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A penile prosthesis addresses not only erectile dysfunction but also loss of self-confidence.

Patients often say, “I feel like I’ve been rejuvenated.”

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•You should avoid sexual intercourse during the first month

•Hygiene should be a priority

•Diabetes must be kept under control

•The pump should be used regularly (especially with inflatable prostheses)

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•Do you experience a natural sensation of erection?

Yes, it looks very natural, especially with a three-piece denture.

•Will my spouse notice?

No, you generally can't feel the prosthesis.

•Will I lose my feelings?

No, the sensations and orgasm remain the same.

•Will my sperm come out?

If hormonal and ejaculatory functions are normal after surgery, then yes.

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I tailor penile prosthesis surgery to each patient's individual needs.

I provide detailed preoperative information to each patient and their partner and clarify their expectations.

By exercising meticulous care in my surgical techniques, I minimize the rates of infection and complications.

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A penile prosthesis (penile implant) is the treatment method with the most lasting results and the highest success rate for erectile dysfunction.

With proper patient selection, an experienced surgeon, and modern prosthetic technologies, results that are both physically and psychologically satisfying can be achieved.

As Prof. Dr. Volkan İzol, my goal is to improve the quality of life for men and couples and help them regain their sex lives.