Penile implants – looking for an alternative to erectile dysfunction meds? - Cape Cod Healthcare

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Published on July 13, 2021

Penile implants – looking for an alternative to erectile dysfunction meds?

ED Meds

Penile implant, a surgery for men with erectile dysfunction that one patient describes as “life-changing,” is now available on Cape Cod.

“You get this done and it’s like, wow, the switch has been flipped back on, literally and then mentally. It’s part of your core identity and you feel like you get it back,” said the patient, who is in his 40s and traveled from Alaska to Cape Cod to have a penile implant done by Andrew Kramer, MD of Urology Associates of Cape Cod.

Dr. Kramer, who moved here from Maryland and joined the practice in March, does the implant surgery at Cape Cod Hospital. Since coming to Cape Cod Healthcare, he has done more than 40 implants, adding them to the 8,000 or so he estimates he has done in his career. He is a passionate and outspoken advocate for men with physical erectile dysfunction, urging them to do all they can to get back their sexual mechanics and confidence.

“You can imagine that men, when they cannot get an erection can feel so powerless,” Dr. Kramer said. “So, you’re treating them from a holistic standpoint. … It’s such an important physical and emotional thing for men.”

Men are hurt by the embarrassment and secrecy surrounding ED, both Dr. Kramer and his patient said.

“Put ED out in the open,” Dr. Kramer said. “You have organic erectile dysfunction. You’re not powerless. Take ownership and talk about it. … Fix it. Go through that week or two of recovery and turn your life around.”

A man can develop physical ED for a number of reasons, such as prostate cancer or diabetes, he said. Other treatment options include increasing the blood flow to the penis with oral medications, such as Viagra, and penile injections like Trimix. Dr. Kramer suggests that patients try at least one non-surgical method before considering implants.

“You don't want to operate on a guy that says, ‘Doc, look, I've never tried any Viagra, but I just want to be able to last longer,’” Dr. Kramer said. “His expectations are not in the right place. It's supposed to just treat the organic ED but not fix his mindset.”

The Alaskan patient, who asked that his name not be used, said he suffered side effects from medications, including headaches and flushing. Implants seemed a logical progression to him. “It had come to a point where if [treatments] are not working, you just go to the next step and you go to the next step,” said the patient, who is in a long-term marriage.

A 20-minute Procedure

There are several types of penile implants; Dr. Kramer does the most popular kind in the United States which relies on two tiny inflatable cylinders surgically inserted in the penis, a reservoir for saline in the pelvis, and a pump the size of a cherry tomato in the scrotum. Either the patient or his partner uses the pump to make the saline solution flow into the cylinders, causing an erection. The pump also has a release valve. It does not enlarge a penis or decrease sensation, Dr. Kramer said.

This type of penile implant is a 20-minute surgery, done under general anesthesia, and patients go home the same day, he said. The patient is able to use the pump for sex in two to three weeks. Risks include infection, which happens to about one in 200 patients and requires removing the device, Dr. Kramer said.

It sometimes takes men a bit of time to get use to the idea that the pump only causes an erection, not ejaculation. That part of sex depends on another important sexual organ -- the brain, Dr. Kramer said. “If he does spend the time on the foreplay, on the arousal, he can achieve orgasm,” he said. “You have to learn and train yourself to remember that the brain is still the largest sex organ in the body.”

The Alaskan patient had his surgery earlier this summer and is very happy with how the implant is working.

“The result has been excellent,” he said. “I figured if I was going to get something like this done, I wanted to not worry about infections, poor surgical outcomes or just not being in the best hands. I was not disappointed with my choice.”

His advice for other men is to stop suffering in silence, talk to friends and seek out the best professionals.

“Guys will talk about needing joint replacements or other health concerns. But when it comes to this it’s very much veiled in secrecy,” he said.

“I think that a lot of guys either just use the medications… but if those are not working, or if they are causing side effects, or if they just aren’t appropriate for you, an implant is the next logical step.”