Male Genital Surgery

Impotence is a widespread problem that affects many millions of men. It can occur at any age and at any point in a man’s sexual life. The myth of impotence as an "old man’s disease" has finally been shattered.

Impotence is a problem of men but also effects couples and families. Now, as a result of recent medical advances, impotence need no longer cause frustration, embarrassment and tension. New solutions are now available for an age-old problem. Impotence active and satisfying relationship. Every day more and more men are discovering that they, too, can overcome impotence.

What is impotence?

A man who is impotent is persistently unable to get or keep an erection that is firm enough for sexual intercourse. He usually still has the ability to have an orgasm and father a child, but he often has difficulty doing these things because he just can’t get or keep his erection. Impotence is not normal and is by no means an inevitable consequence of aging.

Most men in certain situations or at one time or another during their sexual life are unable to get or keep an erection. This is normal and does not indicate a problem, but millions of men of all ages experience this inability as a continuing problem. It is a problem which is frequently associated with a feeling of inadequacy and hopelessness, but a problem that in most cases can now can be overcome.

How Does an Erection Occur?

An erection is an involuntary reaction in response to sexual stimulation and excitement . A man cannot get an erection simply because he wants one. The sexual stimulation and excitement cause the brain nerves, heart, blood vessels and hormones to work together and produce a rapid increase in the amount of blood flowing into the penis. The blood becomes trapped and held in the two spongy chambers in the shaft of the penis. As the chambers rapidly fill with blood, they expand, and the penis becomes firm and elongated. The result is an erection.

What Causes Impotence?

A man’s inability to get and maintain an erection can be caused by many disorders. The cause can be either physical or psychological. For many years, it was believe that 90 percent of impotent men had a psychological cause for their problem; but as a result of recent medical research, it is now known that at least half of the men suffering from impotence can actually trace its origin to a physical problem. For most men, the cause of impotence can now be fairly easily identified. Once identified, proper treatment can be recommended to help them return to a satisfying sex life.

What is Psychological Impotence?

Psychological impotence caused by a man’s anxiety or fear that he will not be able to perform well sexually. This is often referred to as " performance anxiety" or "fear of failure." A man who is worried about getting an erection cannot relax and probably will not be able to get an erection.

Persistent psychological impotence often can be triggered by one incident of sexual failure caused by drinking too much alcohol, fatigue, anger, worry, guilt, or any number of other emotional factors. Emotional stress can lead to impotence just as it can lead to many forms of illness or exhaustion.

What is Physical Impotence

Physical impotence is impotence caused by a physical disorder such as an injury, a disease, a hormone imbalance or an operation. Examples of physical disorders, which can cause impotence, include arteriosclerosis, or hardening of the arteries, high blood pressure, diabetes, brain, or spinal cord injuries, surgical removal of the prostate gland bladder or rectum for cancer, and radiation treatments to the pelvis.

Such substances as alcohol, tobacco, drugs and certain medications also can interfere with erections and cause physical impotence. The medications that most frequently hinder sexual performance are those used to treat high blood pressure and depression.

How is the Cause of Impotence Determined?

The first step toward overcoming impotence is to determine whether the problem is psychological or physical. Doctors who are experienced in the evaluation of impotence can frequently learn a great deal about the cause through general conversation about the problem. Many men prefer to consult with their physician alone, but more and more couples are seeing their doctors together and sharing their sexual concerns.

Frequently the history of the impotence problem can lead to a determination of its cause. For instance, a man who regularly awakens in the morning with a normal erection is likely to have a psychological impotence problem. A man whose problem develops suddenly after a specific emotional event also is likely to have a psychological impotence problem. A man whose problem develops suddenly after a specific emotional event also is likely to have a psychological cause. A man who notices a gradual decrease in the firmness of his erections over months or years is more likely to have a physical problem.

Often it is suggested that a urologist experienced in the evaluation and treatment of impotence be consulted. He is able to utilize a number of testing methods that, together with information on one’s medical history and medications, help determine the problem’s cause . Usually a routine physical examination and blood test to determine hormone levels are required. Sometimes special tests such as a measuring the blood flow and nerve impulses to the penis also can be helpful.

An aid in determining whether impotence is psychological or physical involves checking erections experienced during sleep. All men who are physically able to get an erection will experience normal erections while asleep.

They occur during periods of dream sleep and the reasons for them are unknown. A healthy man can experience from one to five normal erections a night, each lasting fifteen to forty minutes or longer. The morning erection that men often wake up with is simply the last sleep erection of the night and has nothing to do with the need to urinate, as is commonly thought. If an impotent man has normal erections while sleeping, his problem is psychological. If he has only partial erections or none at all while sleeping, his problem is most likely physical. But, remember, alcohol and sleeping medication also can prevent normal sleep erections.

One of the methods for checking sleep erections is the stamp test or the use of a Snap-Gauge® device. This simple mechanism will show whether at least one full erection has occurred during the night. A more sophisticated instrument that also cam be used at home is the portable nocturnal penile tumescence monitor. While it sounds imposing, this monitor simply measures changes in the circumference or rigidity of the penis, which occur if the penis become erect during sleep.

Another procedure often used with much success is the so-called "sleep and peek" technique. This requires a man’s sexual partner to remain awake for one or two night to observe the frequency, duration and rigidity of sleep erections. This is an inexpensive and reliable method of determination. A man also may choose to spend time in a sleep laboratory where his sleep erections can be more carefully observed and measured.

By using one or more of the methods mentioned above, the primary cause of impotence usually can determine. It also is possible that more than one cause may be found. But once the cause of the impotence has been diagnosed, a method of overcoming impotence can more readily be recommended.

How is Psychological Impotence Treated?

The preferred treatment for most men with psychological impotence is counseling or sex therapy. Such counseling can be sought from a clergyman, psychologist, licensed marriage and family counselor, psychiatrist, or other physician experienced in dealing with sexual problems. Psychological impotence that has existed for less than a year is generally more easily overcome than that which has existed longer, so the earlier treatment is sought, the sooner the impotence can be overcome.

How is Physical Impotence Treated?

There are many potential causes of physical impotence. Hormone problems and adverse side effects from medication account for perhaps ten percent of all impotence. Such problems often can be corrected quite easily. The use of pills or injections usually will restore normal erections in hormone related cases. If the impotence is a side effect of medication, the substitution of another drug under the supervision of a physician usually will allow normal erections to return.

Some forms of impotence may be treated with the use of vacuum constriction devices. A vacuum constriction system works by placing a cylinder with an attached pump over the penis and activating the pump. The pump creates a vacuum, which draws blood into the penis, creating an erection. A constriction ring is then placed at the base of the penis to maintain the erection by keeping the blood in the penis. Vacuum constriction systems have been safely used for years by thousand of impotent men.

Most physical impotence is result of permanent, physical damage and requires more extensive treatment. For examples more diabetes and hardening of the arteries are causes of impotence in a significant number of men, and successful treatment of the impotence frequently requires an operation for a penile implant.

For the majority of men who are physically impotent and for those who are psychologically impotent and do not respond to counseling, a penile implant may offer the only complete solution. It offers new hope for a return to satisfactory sexual activity and for the disappearance of the anxieties and frustrations of impotence.

What is a Penile Implant?

A penile implant is a device that is surgically placed into a man’s body and is designed to help him get an erection. Many thousands of men already have been helped to return to a full, healthy sex life following the relatively simple operation involved with a penile implant.

There are two basic types of penile implants: Inflatable implants and flexible rod implants. Both enable the impotent man to have a satisfactory erection for sexual intercourse and to experience the joys of sex again. The primary difference between the two types is that the flexible rods produce a permanently firm penis, while the inflatable types produce a controlled, more natural erection.

Mentor Alpha I inflatable Penile Prosthesis

The Mentor Alpha I inflatable Penile Prosthesis offers a dependable method of restoring satisfactory sexual function in a manner that resembles a natural erection. It is the result of advanced engineering and medical research and has been designed with the needs of its users in mind. It brings a new dimension to the reliability and control of the inflatable implant and offers new hope to the many sufferers of impotence

The Alpha I Inflatable Penile Prosthesis is surgically placed into the body, usually through a singly small incision either in the lower abdomen slightly above the base the base of the penis or on the undersurface of the penis where the penis and scrotum join. There are four parts: two penile cylinders, a pump, and a reservoir. Each part is interconnected by tubing, and once implanted, it is entirely within the body and is not visible. The penis appears relaxed and normal.

One penile cylinder is surgically placed into each chamber of the penis. The pump, which also contains a release bar, is placed into the scrotum where it can easily be operated. The fluid filled reservoir is placed behind the muscles of the lower abdomen.

The Mentor Alpha I inflatable Penile Prosthesis is a self-contained hydraulic system. When an erection is desired, the pump concealed in the scrotum is gently squeezed by hand several times. Fluid that is stored in the reservoir when the penis is soft is pumped into the penile cylinders, and as the cylinders fill, an erection develops. The firmness can be controlled for user and partner satisfaction.

The erection mimics the normal erection:

Instead of the heart pumping blood into the penis, the pump transmits fluid into the penile cylinders. The erection can then be maintained for as long as desired. When the release bar on the pump is activated, the fluid in the cylinders returns to the reservoir where it is stored again, and the penis returns to its normal, relaxed position. The Mentor Alpha I Inflatable Penile Prosthesis allows a man to get an erection whenever desired and to maintain that erection for as long as desired.

Mentor Mark II Inflatable Penile Prosthesis

The Mentor Mark II Inflatable Penile Prosthesis is a simplified modification Mentor Alpha I Inflatable Penile Prosthesis. It is also a self-contained hydraulic system and represents the most recent advancement in Mentor Prostheses in attempting to restore sexual function in a manner that mimics a natural erection.

The Mentor Mark II Prosthesis combines the reservoir, pump and release cap into a single unit. This unit, called the Resipump^TM, is filled with fluid and is concealed within the scrotum. The Surgical procedure associated with placement of the mark II prosthesis is similar to that used for the Alpha I Inflatable Penile Prosthesis but is less complicated because it does not require entry into the lower abdomen.

As with the Alpha I Inflatable Penile Prosthesis, a penile cylinder is placed into each chamber of the penis. An erection occurs when the Resipump is squeezed in a firm continuous motion-no pumping is necessary. Squeezing the Resipump displaces the fluid into the penile cylinders producing an erection. To return the fluid to the Resipump, and bring the penis back to a relaxed position, the release cap located in the upper portion of the Resipump is squeezed.

Mentor Acu-Form Penile Prosthesis

Mentor Acu-Form Penile Prosthesis is simpler in design and use than the inflatable implants, while the surgical procedure for implantation is a more minor one.

The flexible silicone rods are implanted into the penis, one in each chamber. The rods are malleable, so the penis is rigid enough for penetration, yet flexible enough that it can be moved into a position for concealment.

A variety of surgical procedures may be used to implant the Mentor Acu- Form Penile Prosthesis. The skin incision is usually small and unnoticeable.

Who Can Have an Implant?

The primary reason for implanting a penile prosthesis is to enable a man to get an erection satisfactory for intercourse. For many men, a penile implant offers the only possible solution to the problem. The choice is whether to remain impotent and unable to have intercourse or to undergo a surgical procedure and return to normal sexual activity.

A man who is considering a penile implant operation should be emotionally stable, have a normal sexual desire and believe that sex is an important aspect of his life. He should not have any severe health problems that would hamper sexual activity. Age itself generally is not a factor. Successful implant procedures have been performed on men in their teens and in there eighties.

It is important to remember that most impotent men do not lose the ability to have an orgasm, ejaculate or father a child. If these abilities are present before the implant operation, they should remain afterward. A penile implant can give a man a great deal of physical and emotional pleasure. By no means is it solely designed for his partner’s pleasure.

Whenever possible, it is best for a man’s sexual partner to be involved in the decision to have a penile implant. His partner will have questions and concerns about the procedure and also will have to adjust to this new physical relationship. Open communication between sexual partners is just as important to the implant’s success as the operation itself.

Penile prosthesis offers a new dimension in reliability and sexual satisfaction to the impotent man and his partner. Sex is the ultimate in human sharing, transcending all other experiences. Penile prostheses allow one to return to that world of sharing.

Which Implant is Best for Me?

The mentor Alpha I Inflatable Penile Prosthesis, the Mentor Mark II Inflatable Penile Prosthesis and the Mentor Malleable Penile Prosthesis are well accepted for restoring sexual function. The decision as to which implant would be best for a particular man depends upon such things as manual dexterity, general health, anatomy, and personal preference. Each of these implants has advantages and disadvantages and these should be thoroughly discussed with your physician or urologist before a final decision is reached.

Can an Implant Malfunction?

Mentor Penile Prostheses have an excellent record for patient safety and satisfaction. However, all implantable devices have certain risks and potential complications associated with their use. These are more likely to occur with the inflatable implants because of their more functional design and construction. In some cases, additional surgery may be necessary to achieve optimal results. Before surgery, any potential problems are discussed by the doctor.

When Can Intercourse be Resumed?

Intercourse frequently can be resumed within six weeks following the implant procedure. Mild discomfort may be experienced initially, particularly in couple who have not had intercourse for an extended period of time. Position changes and the use of lubricants often prove helpful. The penile implant will not injure the vaginal above all else; the return to a satisfying sexual life requires couples to be patient and to communicate.

Who Performs Penile Implant?

Penile Implant operations generally are performed by Plastic Surgeon / urologists who are experienced in the evaluation and treatment of impotence.

Will Insurance Cover this type of Operation?

The Costs of implanting s penile prosthesis are variable depending upon such factors as the length of hospital stay and room charges, physician charges and type of implant. Most major insurance companies and Medicare usually will provide benefits to the extent of the individual insurance contract when the underlying cause of the impotence has been documented to be physical.