Penile Implant Surgery

Penile Implant Surgery

Penile Implant Expertise

A/Prof Darren Katz is an expert in penile prosthesis surgery and is a "high volume" implanter.

He is the only Victorian Urologist to have undertaken a specialised fellowship in the USA in urological prosthetics which is accredited by the Sexual Medicine Society of North America.

He has co-developed a novel technique for penile implants called the “Minimally Invasive No Touch" approach or the “MINT” technique (see below)

He has presented the findings of the on MINT technique at multiple international conferences around the world and he is a sought after speaker at urological conferences on penile prostheses.

A/Prof Katz is the director of the only Australian Prosthetic and Micro-surgical Fellowship which trains overseas urologists in world leading procedures and operations such as the MINT technique for penile implants. A/Prof Katz has trained urologists from the USA, Canada, Israel and England. These urologists spend 1 year with A/Prof Katz and his colleagues learning about the latest treatments and operations in his sub-speciality field.

A penile implant in action:

If you would like to see a REAL penile implant being “pumped up” and then “deflated” please click on the link.  This is a video of one of A/Prof Katz’s personal patients who has given permission to have this shown. You will need a password to access it so please click here to access the password.

Penis Anatomy?

The penis contains two erection chambers called the corpora cavernosa, which run the length of the organ.

The corpora cavernosa is a spongy tissue that fills the chambers. The corpora cavernosa are surrounded by a membrane called the tunica albuginea.

The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.

What is a Penile Implant?

Penile implants are devices known as prostheses that can restore erections in virtually any man with erection dysfunction. Implants are surgically inserted into the penis.

Penile implants require a surgical procedure and it is the most common surgery performed for treating erection dysfunction.

They have an approximately 90% satisfaction rate for patients AND PARTNERS!

Why Consider Penile Implant Surgery?

Where conservative treatment measures for erectile dysfunction have been unsuccessful Penile implant surgery may be considered.

Penile implants can also be used to treat severe cases of a condition that causes scarring inside the penis, leading to curved, painful erections (Peyronie's disease).

Types of Penile Implants

There are two main types of implants are:

• Inflatable implant
• Malleable implants

Malleable Implants

Inflatable Implants

Inflatable implants:

These are the most common type of Penile implants inserted by A/Prof Katz

Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid (saline).

Tubes connect the cylinders to a fluid reservoir and a pump, which are also surgically implanted.

The patient inflates the cylinders by pressing on the small pump, located under the skin in the scrotum.

As opposed to malleable implants, inflatable implants can expand the length and width of the penis. They also leave the penis in a more natural state when not inflated.

Malleable Implants

Malleable implants usually consist of paired rods which are inserted surgically into the corpora cavernosa. The user manually adjusts the position of the penis and, therefore, the rods.

Adjustment does not affect the width or length of the penis. These implants are best suited for patients who may have limited hand dexterity.

Source: http://www.coloplast.com.au/genesis-en-au.aspx

How is Penile Implant Surgery Performed

A/Prof Katz performs most of his penile implants using the MINT technique - "Minimally Invasive No Touch" approach.

• "Minimally Invasive" means that all components (inflatable cylinders, pumps and reservoir) of the implant can be inserted via a 3-4cm incision hidden in the pubic hair region. As the cut is so small, patients can be discharged the next day and post-surgery recovery is enhanced.
• "No Touch" means the implant does not touch the skin – which is a potential cause of infection.
• A/Prof Katz has presented worldwide the findings of the MINT technique which has been shown to have some of the lowest infection and complications in the world.

A/Prof Katz has produced a video on this technique which has been published in a peer-reviewed video journal and he also presented the video at the World Meeting of Sexual Medicine in 2016.

Click here to watch the video.

This video was made to teach other urologists how to perform penile implant surgery and therefore involves footage of real surgery featuring A/Prof Katz which some people may find graphic.

Before Penile Implant Surgery

Before penile implant surgery you might also need to:

• A/Prof Katz will enrol you in the “Men’s Health Melbourne Infection prevention pathway” which will involve specialised body washes and antibiotics.
• A/Prof Katz will meet you to discuss the surgery in detail. This is an extended consultation where you can ask as many questions as you want and A/Prof Katz can let you touch and feel the different implants available. He will go over the 3 page document for penile implants he has produced on all aspects of penile implantation.
• You may need to avoid certain strong blood thinning medications. But because of the minimally invasive nature of the MINT technique, A/Prof Katz can perform the surgery on patients taking Aspirin.
• Arrange for a ride home, typically after an overnight stay. But for patients coming interstate or from overseas, Men’s Health Melbourne can offer a concierge service to help with transportation and hotel bookings.

During Penile Implant Surgery?

Penile implant surgery is done in a hospital under general anaesthetic and usually takes 45 minutes to an hour.

• The surgery site will also be shaved immediately before surgery to reduce the risk of infection
• NO catheter is needed in most men.
• The spongy tissue in the penis called the corpora cavernosa that would normally fill with blood during an erection is stretched.
• Your surgeon will choose the correct size implant and place the implant cylinders inside your penis. All sizes are customized to your exact body measurements. But A/Prof Katz will place the largest device that your penis will accommodate.
• If your doctor is implanting a 3-piece inflatable device, a pump is placed inside the scrotum. For a three-piece device, your doctor will also implant a fluid reservoir into a hidden position deep in the pelvis (all done through the same 3-4 cm cut)
• Once the device is in place, your surgeon will sew the incisions closed with absorbable sutures so you will not need to come back to get the stitches out

After Penile Implant Surgery

A/Prof Katz will give you detailed written instructions about what to expect and what to do after the surgery

You will be given a mobile phone number to call for any questions which can be utilised 24/7, Seven days per week.

You will have some antibiotics to help prevent infection and medications to ease the pain.

Most men take some pain killlers for 1-2 weeks and return to work and light activities within this time frame.

Strenuous physical activity should be delayed for 4-6 weeks.

Once you are taught how to use the penile implant – generally at about 4 weeks post surgery – you can use it!

Are there risks of a penile implant?

As with any surgery, Penile Implant surgery carries risks but these are small risks, especially with the MINT technique. These include, but are not limited to, infection, bleeding, device malfunction.

But significant complications are rare and the vast majority of men have a uncomplicated post-operative recovery.

Before surgery you will have an extended consultation and A/Prof Katz will detail all relevant aspects of the operation with a 3-page informed consent document which goes through the operation in detail including all relevant risks.

You will also be able to “touch and feel” a real model implant in the clinic.

Can I have an orgasm with a penile implant?

You should be able to have an orgasm with a penile implant if you were able to have one before the implant.

What is the recovery time?

Most patients need to stay overnight after the operation and can then go home. Everyone is different and recovery time varies, but typically it’s between 4-6 weeks until you can resume sexual activity.2 A/Prof Katz will give you a detailed post-operative information sheet about what you can and can’t do during this time. Most men can get back to work within 1-2 weeks.

Will I lose any length after getting a penile implant?

Each penile implant is custom-fitted to your anatomy, and the implant itself does not lead to a loss in size. Depending on your medical history, changes in anatomy or atrophy can result in loss of penile length prior to the implant, and it may not be unusual to lose 1-2 centimeters from your original erect length.12 However, A/Prof Katz wil try and insert the biggest device your penis will accommodate.

Will anyone notice that I have an implant?

The implant is completely placed inside your body. The penis appears relaxed and near normal when in the flaccid state6, and it is not obvious by looking at a man that he has an implant.

How long does the penile implant last?

A study showed that 75% of initial implants would survive 15 or more years without revision or extraction.

Will I be able to have spontaneous erections with a penile implant?

Whilst you can get an erection anytime you want with an implant, after the surgery, it is not possible to have a “natural” erection as the erectile tissue has been replaced by the implant. Therefore, you should consider carefully whether or not an implant is the right choice for you.

Can I talk to a patient who has had an implant?

A/Prof Katz is a very experienced, “high volume” penile implanter. As a result he has a large number of very satisfied patients who would be able to talk to you about their firsthand experience with a penile implant. At your appointment with A/Prof Katz, ask him for contact details of patients who have kindly agreed to talk to other patients.

Penile Implant Video