Integrated-Reservoir Inflatable Penile Prosthesis

Hello and welcome to our special session on penile implants, today we are joined by three distinguished experts in the field of Urology who have made significant contributions to the advancement of Urological Prosthetics and Men’s Sexual Health. First, we have Dr. Paul Perito from the USA. Dr Perito, based in Coral Gables Florida is one of the leading experts in penile implant surgery and Men’s Sexual Health renowned for minimally invasive techniques and Global training programs. Next, joining us from Australia is Dr. Christopher Love. Dr. Love is one of Australia’s most experienced Urological surgeons specializing in penile implants and Peyronie’s disease.

He is regarded as a leading National expert in the field of prosthetic urology. Lastly, we are honored to have Dr. Mohammad Hamdan from Jordan. Dr. Hamdan is a distinguished urologist and high volume implanter in Jordan renowned for his expertise in male sexual health and urological surgeries contributing significantly to advancing urological practices in the region. Thank you all for joining us today to start our discussion. Let’s address some of the the key questions that patients often have about penile implants. Dr Perito could you explain how patients might determine if they are suitable candidates for a penile implant So the definition of erectile dysfunction is the inability to obtain or maintain an erection to the satisfaction of both you and your partner uh but when you’re not getting morning erections that’s a little clue that something is not right and then you’ll see guys that start to fail pills and you know the ones that fail pills at least 80% of them have a process called bino occlusive disease whether they’re 20.

I’ve operated on six 20 year olds and this is like blowing air into a balloon that’s got a hole in it and but what really brings people to all three of our offices is when they’re tired of gambling you know the if you play craps you don’t roll 11 every single time and one it gets to 49% and a guy wants something that’s 100% guarantee of a penetrating penis that’s when they move to get a penile implant so that’s what I believe is who’s a candidate those guys that are failing pills those guys that are um you know not getting morning erections and not being able to obtain or maintain that erection.

Thank you Doctor. Yes thank you Dr.Perito. Dr. Love, can you walk us through whether penile implants have any impact on orgasm or ejaculation? So a penile implant is a great way for a patient to get an erection. So penile implant is a great way for a patient to get an erection when other methods fail and uh it achieves a very good erection status if the patient’s able to have orgasm and ejaculation depending on their other medical conditions then a penile implant will not impact on that certainly should not make things any worse than they are and indeed in some men possibly enhances the orgasm because the man now has a guaranteed erection and it takes away some of the concern and anxiety he may have about being able to obtain an erection but realistically what I always say to patients is that this is a great way to be able to have a good erection have penetrative sex and all the other aspects of sexual behavior touch of the uh feel of the penis sensation warmth all those things are exactly as before.

Thank you Dr. Love. Dr. Hamdan could you discuss how a penile implant might affect the length and girth of a patient’s penis? Well after doing a penile implant uh especially with the new devices that provided by uh implant companies most of them are increasing the girth and some of them increasing the girth and the length of the penis but the patient must know that this result wouldn’t have it immediately after the surgery. He have to cycle his implant for many months to get increase in girth and sometimes a little bit increase in length and I always tell my patients every year with an erectile dysfunction, you will have decrease in your penis so sooner of treatment the better of the result of the surgery.

Thank you. Dr. Perito, one common concern is whether a partner will notice the implant and how it might affect their sexual relationship. Can you shed some light on this? Yeah yeah, my wife and I were reading these questions, this one made us giggle uh because you know how’s it going to affect your life. I have one of my patients that calls him the zero mile patient you know he had his engine taken out and had a 351 Windsor are put in, he’s back on the racetrack so you’re going from zero to 100 at least when it comes to a penetrating penis and then the thing that especially if they’re single and they’re in the dating field you know they’re worried about having an implant where you know they realize that they’re pumping and you know there’s all different things that you can you know tell them to describe why they might have a pump in their scrotum but in the end when you’re able to accomplish what you can with the penile implant, I don’t think partners really care that much but the one thing that absolutely has to be done and this is something that Dr.

Goldstein really has driven into all of us the Mantra that the partner has to be ready too so if it’s a female and she’s you know premenopausal, menopausal or postmenopausal, you want to make sure that they’re ready um so if both partners are involved in it in the long run know it’s only a positive outcome um and is as long as they’re prepared uh and have set proper expectations going back to the length and girth that the only thing that’s happening while you’re experiencing erectile dysfunction is atrophy of your penis and the only thing that stops it is a penile implant so I think partners that work together on this, they’re your they’re your happiest patients.

Thank you. Dr. Love, what should patients expect in terms of recovery time following penile implant surgery? Look I think there’s some variability in patients recovery as there is with all surgical procedures typically a penile implant patient in Australia would be in hospital one night after the procedure uh they would be uncomfortable enough to not be doing much physical activity for the first 2 to 3 days and reasonably comfortable in doing gentle physical activity by the end of the first 10 days or two weeks and um more or less okay after that certainly I think most patients uh are uncomfortable in terms of pumping their device before four weeks even though we encourage them to try and do so um but I think if you set the expectation that they have approximately a week of restricted activity approximately a week of light activities and then move on from there and encouragement to inflate the implant as soon as they can but realistically I think four weeks is when most of the patients are comfortable to do so Thank you Dr.

Love. Dr. Hamdan, could you provide some guidelines on how patients should prepare for a penile implant surgery? Well first they should go to their uh physician or surgeon to tell them what to do before the implants but basically uh usually their doctor will check their uh blood sugar level and uh we’ll do some tests like urine samples and you know some blood test to make sure that there is nothing to prevent the surgery and if you’re taking yeah you know blood thinners uh some doctors will advise them to stop the blood thinners a few days before the surgeries and you know uh some guidelines will advise the patient to do a specific washing material before the at the night of the surgeries and basically that’s it you know it’s a one day procedure, it’s less than one hour surgery, it doesn’t like need a special preparation for it other than the thing I said.

Thank you Dr. Hamdan. Dr. Perito, are there different types of penile implants available and can patients choose the type they receive based on their specific needs? Well of course patients can choose and hopefully um going back Dr. Hamdan to how to prepare you prepare by going to a dedicated center right they need to find people like you, Dr. Love yeah and you know once they find people like that then they will have somebody with the fund of knowledge to describe the three implants that are available it’s the only triopoly you know in in the surgical devices so you know they need to be able to you know have all of the specifications of each implant and decide you know which one is going to be best for that anatomy that a patient that patient’s dexterity um so they have the entire realm you know there’s malleables which you bend them up you bend them down but you can’t they’re not physiologic but they’re great for guys with dexterity issues they’re great for guys that might get a little you know confused um there’s inflatables and there’s inflatables with different size cylinders and if you have a dedicated center which I’m sure guys you know 75% of implants are put in by people that do less than 10 a year that terrifies me absolutely terrifies me

and that’s one of the reasons that you know we haven’t seen this giant you know you know exponential increase in penile implants across the globe but if you go to a dedicated center, they’re going to give you every single option and they should and they should be well versed in it and you know that’s something that uh you know we’re trying to do you know across the globe with the Society of Prosthetic Surgeons which I know these guys are members of so um yeah there’s an implant for everybody and hopefully you go to a dedicated center and that um man or woman will be capable of you know being well versed in you know which implant is for you brother got it Thank you, that’s perfect.

Dr. Love, can you explain how a penile implant might affect the appearance and feel of the penis? So it depends a little bit on the type of implant as Dr. Perito was just alluding to um but if we’re talking about a three-piece inflatable implant essentially you would expect that to give a very good hard erection in fact in some devices it’s harder than a real erection but the penis will look full it will have good girth, it will be very rigid, the head of the penis the glands of the penis doesn’t fill by inflating penile implant and that needs to be explained to men because they uh sometimes get a little concerned about the appearance and indeed the length of their erection because they’re used to looking down and seeing an erection that’s both the shaft and the head filled so the head will engorge to some extent in a fair number of these men with sexual stimulation but the implant itself doesn’t fill the gland so that’s important to tell them but otherwise an inflated implant looks like a really good solid erection and somebody looking at that man would really not be able to tell any different when they’re deflated the common thing with inflatable implants deflated is the length of the implant stays the same even though it’s deflated so the penis

won’t retract into the body as it used to and the penis will never be quite as flaccid with an implant in place as it was previously some implants are made of material that’s rather thick walled and tends to create some creases or folds in the penis when it’s deflated other brands are more natural when they’re deflated because the material is a bit more physiological in that regard typically the pump should sit in the scrotum should not really be that visible to anyone visually as Dr. Perito was saying if you’re at a dedicated Center for implant surgery most surgeons would aim to make the pump not very visible have it sit in the scrotum perhaps an impression of a little bit of fullness but not really visible so I think the answer to all of that is it’ll look like a great erection when it’s inflated although the head will not be filled it’ll look a little fuller than it used to when it’s deflated but realistically not that visible to anyone else Thanks Dr.

Love. Dr. Hamdan, are there any concerns about penile implants interfering with urination or other bodily functions? Well the short answer is no. The long answer is you know with penile implant, it will not interfere with the urination okay it’s you know the urination comes in a different area from where we put the penile prosthesis we usually put the penile implant in something called the cavernosa of the penis and it’s a little bit away from the urethra so or where the people urinate from so it does not affect the urination but for sure before the surgery we would like to check the prostate size of the penis make sure that the will urinate well before the surgery so after the surgery he will not have any problems uh other than that it will not affect the urination and I don’t think it will affect anything in the patient body especially the inflatable implant, it’s mimicing of the normal tissue so it will not interfere with any of that things.

Thanks Dr. Hamdan. Dr. Perito, what is the typical lifespan of a penile implant and how likely is it that a patient will need revision surgery? A great question. Because I’m sure that everybody on this is seeing younger and younger men in their office and the younger men, they’ve, they’re doing their research and they’re reading the Mayo Clinic experience of revision surgery which the infection rates are can be terrifying as you go you know up the line after one two three revisions in general all implants all three companies and we don’t have long-term data yet with Rigicon but it by design it should be similar to the other two companies you’re looking at a one to two% failure rate per year now that blows away orthopedic implants right but because it’s a penis, it’s a big deal when one breaks it’s not a big deal if it was put in by somebody who’s accomplished because your chance of having these infections that Mayo Clinic reports is grossly diminished because of something that you know it’s called biofilm but that’s beyond the scope of talking to patients until you got them in your office but when it you know young guys they need to ask you know what do you know about a implant a,

b or c as far as longevity it should be 1 to 2% per year somewhere between a 15 year survival of somewhere between 60% and 75% and if it’s done well the revision is not going to be if it’s done well the first time revision is going to be a piece of cake and it’s just like you know like I said our zero mile patient who went from you know a four cylinder to a V8 Windsor so it’s an important question especially for young patients to ask and again in the hands of dedicated urologists, you’re not going to have to worry about the you know the infections that may increase with revision surgery.

Thank you Thank you doctors for your insightful answers before we conclude is there anything else you would like to add about penile implants or any advice for patients considering this option Yes Dr Hamdan’s description of length and girth before after a penile implant is spot-on, all I want to do is emphasize that penile implants don’t make a penis shorter, the only thing that makes a penis shorter is erectile dysfunction and while if you’re watching this, you probably have erectile dysfunction and you are experiencing atrophy as you speak, you need to understand the only thing that stops atrophy of a penis is, it’s not shots, it’s not pills, it’s not a vacuum device, the only thing is a penile implant and once it’s in place as Dr.

Hamdan eloquently described, there is expansion with the penile implant we’re not selling a bigger fatter penis but expansion occurs so if you want to remedy if you want to recognize your penis get it done sooner rather than later that’s what I would add If I could just add something to that as well, I think the length issue and the girth issue a lot of it is about explaining to patients as Dr. Perito said they lose penile tissue, they lose length when they have erectile dysfunction and it’s very important in whatever way you need to you explain that to the patients when we put penile implants in, they do act as a tissue expansion device and the the newer implants, Rigicon for instance have very good girth, now they can expand to 23-24 mm so if the patient natural tissues allow expansion over time the device will act as a tissue expander even length which is the patient’s major concern usually implants even a non- lengthening implant will usually allow the penis to lengthen a little bit over time but it’s really about explaining to the patients beforehand that they have lost length,

an implant is not going to lose more length in fact if it’s done correctly, they should have good length and may indeed get some expansion over time but we can’t promise that it’s about really telling the patient you’re returning to function, you’ve got an unfunctional penis now we can make it functional and I think Dr. Hamdan said earlier that these patients are very happy and the one thing I think we haven’t necessarily discussed today is what it does to their mental state and you know these guys lose their sense of manliness they lose self-esteem, they lose confidence and to see them feel better about themselves as a man and be able to function is a really gratifying part of doing penile implants for men so apart from the physical stuff and all being able to have sex and all the great stuff and implant does, these guys feel better about themselves and that’s a really good outcome too Sure thanks, any other questions that need a second opinion probably not um I think we’ve you know I think the answers have been do you think guys that the answers have been pretty reasonable I think they’re great yeah I mean we can talk about a lot more stuff for a lot longer and you can get us arguing and all that but that’s not what

you want to see, I don’t think we argue about anything Chris, Paul and I did podcast when he was in Melbourne last year and to get 10 minutes of podcast, it took us an hour because of all the profanity we had to edit out no not true Paul true not true I didn’t use any profanity if I remember correctly we just talked for an hour and it was a great podcast because it was two guys that do implants just talking and comparing ideas but that’s not exactly what you want this has to be a bit more regimented and structured for patients or potential patients looking at it so yeah I think I think it’s cool we got Australia, Jordan USA yeah that’s really cool you know yeah absolutely do you think we’ve answered everything that you want I think so and I think it’s a great start to Rigicon talks and there’ll be opportunity for more sessions of course because you know Rigicon talks is an ongoing Series so you know we can you know expand on that moving down the track so it’s not something Rigicon intends on stopping in six months time sure I like the neon you see the neon that they use yeah it looks like a strip club,

it looks like I’m going to the strip club that’s awesome very good thank you to our esteemed panel for sharing their expertise on this important topic, this session has provided valuable insights into the world of penile implants and their role in improving patients lives Thank you to our audience for tuning in until next time stay informed and take care.

The text above is a transcript of the spoken content of this video, published for reference and accessibility. Wording may differ slightly from the recording. It is not medical advice and does not replace a consultation. Product availability and approved indications differ by country – ask your physician what applies to you.

Hello and welcome to our third session of Rigicon Talks. My name is Allen West, and I will be, your moderator today. today we’re addressing some common myths and facts about penile implants, a subject that is often misunderstood but critically important for men dealing with erectile dysfunction. I am super excited about our panel. Today, we are joined by three distinguished experts who will help clarify some common misconceptions about penile implants. First, we’re joined by Dr. Rafael Carrion. He’s a leading urologist and global men’s health expert and thought leaders specializing in sexual medicine and Peyronie’s disease are based at the University of South Florida.

Dr. Carrion has authored over 40 peer reviewed papers and is actively involved in various professional organizations. Welcome, Dr. Carrion. Okay, next we have Doctor Gupta. Doctor Gupta is a prominent urologist in India specializing in penile implants and male sexual health. He is well regarded globally for his expertise in high volume implants, surgeries, and his dedication to advancing urological practices and men’s health in the region. And finally, we have Mr. VB Modgil. Mr. Modgil is a respected urologist in the UK, known for his work in men’s sexual health and penile implant surgeries.

He practices at leading institutions in the UK and has made significant contributions to improving patient outcomes in urology. So let’s start with, Dr. Carrion. The first myth is, you know, implants are only for older men. Doctor Carrion, could you explain whether penile implants are suitable for older men or can be an option for younger patients as well? I think this one is, an easy one to tackle. because historically, we have this image that a grandfather like figure, is the ideal patient where the penis, function, such as erectile function specifically doesn’t work as good, or just naturally declines when when that’s actually false.

So it’s a two part myth, actually, meaning that if you stay healthy enough, you can preserve function later in life. But for the most of us, we basically accumulate luggage, if you will, other conditions that we didn’t have when we were a teenager, 20s and 30s. And so our cholesterol goes up, we gain weight or we become a new new onset diabetes diabetic. And so conditions do pop up. And so that’s why you get that classic image that the older man is the only one suffering with it.

But not true. We do see younger younger individuals that suffer with Ed. And here’s the final caveat to link it all together for the question. When you really look at all the pros and cons of all the modalities to manage erectile dysfunction, it really is a good two way conversation with the providers, such as the ones you see on the screen today and the patients because you navigate the waters to find out what is the best move. So if you have a 42 year old or a 38 year old, or they have severe ED and really look at the pros and cons of each modality, penile implant is on the table of options.

Absolutely. It’s not an old man’s disease and modality of choice. It is everyone’s choice. You just got to look at the pros and cons of each modality being offered. I’ll pause there. Thank you very much Dr. Carrion. For our next myth, let’s go over to Dr. Gupta. Dr. Gupta, there’s a myth out there that penile implant surgery is only for severe cases of erectile dysfunction. Could you please address this common myth? So, I think, penile implants, we don’t really need to wait, for the erectile dysfunction to reach a stage where the man has no erections because it is not only about getting hard, it’s also about maintaining size.

It’s also about, maintaining the the desire to have intercourse. So many times, what happens is, if the man waits too long to go for an implant and his erectile dysfunction has progressed to a level, where he has no erections at all, he also ends up losing size. He also develops fibrosis in this in his in this group, he also ends up in stages where we are not able to get the implant all the way through to the glands. Plus, he also ends up in a situation where he has a lot of relationship issues and it develops a lot of problems in accessing intercourse or accessing sex.

So I think a penile implant is a good option when somebody has moderate erectile dysfunction, where he is not very comfortable with medications and really does not need to go for that completely bloodless penis, we do not need to wait for that stage to arrive, because when he chooses an implant earlier, the implantologist or the prosthetic urologist will always be able to give him better results, will always be able to give him a better sizing. Plus, many of the patients also get natural erections even after an implant by which they are able to, you know, have success in their sexual life more and maybe, you know, get much more satisfaction in the relationships as waiting too long.

Thank you very much, Doctor Gupta. under our next myth. And, this one is for Mr. Modgil. Our myth is that surgery requires a long hospital stay for penile implant surgery. Could you please walk us through a typical hospital stay for a penile implant surgery? And is it as extensive as some people believe? So I think there is a myth. There certainly is a myth that you have to come in for what is an extensive procedure and a really prolonged stay, simply not true to be honest with you.

It is also nuanced by where you have your penile implant and the the kind of service that that center offers. So it does depend on the infrastructure depending on the country and the institution that you’re in. But here, for example, where we perform our surgery, we have actually been known to send some people who we deem fit enough home on the same day as surgery. And the vast majority of the patients that we operate on are home within 24 to 36 hours following what is normally a one night stay in hospital, so that the need not be a concern, that a patient comes in for penile implant surgery and then ends up spending days in the hospital.

It’s simply not true. In fact, I would say that is very much the exception in terms of a normal patient journey. Excellent. Thank you very, very much. that’s very helpful. our next myth and this one’s going to go to Dr. Carrion Penile implants will make your penis shorter. So Dr. Carrion, is there a common concern that penile implants reduce the length of the penis? And can you address this, please? I would say the concern is there, especially if the patients surf the internet. Play active participants in the variety of blogs that are out there.

but I think it’s, part myth and part misinformation. Knowing the principles of the anatomic features of the phallus will show you that the implant just goes into the two paired, cavernous bodies, meaning that if you have a large glans, well, the implant doesn’t affect that doesn’t modulate, that it doesn’t go into the head of the phallus, if you will. And so for the most part, it’s simply education, knowing that expert prosthetic surgeons will maximize and make sure the sizing is 100% accurate in terms of fitting the paired cavernous bodies and then educating the patient.

We make a small, informal joke here in Tampa that if you have a small glans, that patient automatically brings a gift saying you have totally matched the size of my natural erection. But if you have that patient that has a medium or large glans, that’s the patient you educate a little more because that’s a low hanging fruit in terms of educating them that, no, I haven’t shortened it with foreplay, with stimulation, with natural vascular engorgement of the glans. Now your phallus looks quote on quote normal again.

So it’s mainly a misinformation and just education helps navigate the waters in terms of allowing the patient to appreciate. No, you haven’t shortened anything actually. It’s just a different type of erection. Excellent. Thank you very much. okay. On to our next myth, penile implants affect ejaculation or orgasm. And for that myth, we’re going to go over to Doctor Gupta. Doctor Gupta, do penile implants affect a man’s ability to ejaculate or achieve an orgasm? So I feel this is actually this comes from the patients suffering from erectile dysfunction.

So many times when the men are suffering for a long period from rectal dysfunction. So erectile dysfunction is just not about getting heart. Erectile dysfunction also affects their ability to enjoy sex. Ability to last long. Ability to, you know, enjoy the sex completely. So many of these men have been living with this problem for so long that they actually forget how good an orgasm can be, how much they enjoyed it when they were younger, and they used to have good erections. And many men, when they get an implant and they get back to the same stage now for the implant, they come back in the same doctor.

I enjoyed my sex again like I was 18 because now he’s not getting soft. He’s able to insert fully, he’s able to do things to his partner that he always, you know, kind of dreamt of. He’s able to stay hard longer. He is able to hold his erection longer. And that’s why many men actually, are happy with the quality of orgasm that they achieve after an implant. In terms of ejaculation, definitely a penile implant will not increase the acquisition time, may or may not cure your premature ejaculation.

But definitely many men are confusing erectile dysfunction, which is ejaculation time. So many men don’t stay hard that long to discharge over a period of time. So many men who are suffering from erectile dysfunction notice they’re holding longer. This staying harder. And that’s why many men say that after I implant, they’re able to last longer as well as get a more complete orgasm for both, for both partners, for themselves, as well as for the partners, because now the partners also feel the full stiffness. They also know that, you know they can enjoy sex better and longer.

Thank you very much, Doctor Gupta. Again, our next myth, penile implants need frequent replacement. So, Mr. Modgil, how often do pill implants need to be replaced? And what’s the typical lifespan of these devices? So I think one of the main things to remember is the evolution of penile implants in the last 20 to 30 years. it’s when you really drill down and think about this, it’s quite remarkable just how good penile implants are now. they’re cycled sometimes thousands of times even before that, put into a patient to ensure that they’re robust and that the qualities that for the patient to have a positive experience, it simply isn’t true that they need to be replaced.

Often, if they are replaced, it tends to be because there’s either been a complication, which thankfully is pretty rare actually, if you look at all the figures. So they can be replaced to things like infection or erosion of an implant for example. and those unfortunately are, unknown complications of implant surgery, albeit very rare. When you start thinking about things like device malfunction. Well, that’s lower than it’s ever been in the history of penile implants, because manufacturers of penile implants have worked so tremendously hard on making the products so good.

So I always tend to say to patients, you know, if all goes well and you is uncomplicated and you don’t have any complications, I expect you to have your implant for a decade, maybe even up to up to 15 years. Is there some variability in that? Well, yes there is. It’s like any device. Right. So it depends on how much you use that device, how you use that device, etc.. But in in essence, do they need to be replaced regularly? Absolutely not. Are they better than they’ve ever been?

Absolutely. Excellent feedback. Thanks so much for that. All right. Onto our next myth, which is very near and dear to my heart. As Doctor Carrion knows. And, this question here’s our myth. Inflatables are superior to malleable penile implants. Doctor Carrion, Is there a significant difference between inflatable and malleable penile implants? And is one superior to the other? Well, that’s a quick and easy one to answer. Superior is such a vague, non descriptive, term when it comes to this subject topic. So superior would be absolutely false because it’s simply fulfilling two different prototypes and two different itemized lists of pros and cons.

If you were to put on one side quicker surgery, less components, less components means less risk. I’m never going to injure bowel, bladder, major vessels. it’ll never have mechanical malfunction. You can start to see how the itemized list on a malleable looks like. And then inflatable more natural physiology and inflate it when I want. I can deflate it. Whatever. So you could see there’s simply a difference between the two. Superior. Not at all. I stand by that, I defend it. I think it’s two niche items where good dialog with the patient, you find out what’s best for that patient.

I think they’re both excellent options for the management of ED. Dr. Gupta how natural do modern penile implants look and feel, both for the patient and their partner? So there have been now, a number of studies would say that the satisfaction with the penile implants is not only about the look, but also about the function. So when the patients functionally become normal, they do are satisfied and also their partners are very satisfied. Definitely, the penile implants are not going to be as good or as looking as a natural selection.

But what many men forget over what many doctors forget to tell their patients is that the penile implant acts as a support. And many times these patients will continue to have a natural reaction that fills out the penis when they are aroused and when they’re having sex. So even without an arousal, even without an erection, the penile implants look natural, feel soft, and feel feel good to the partners. But the functional improvement that it provides to the patient is so much adds so much to their quality of life that even if there is some difference between a natural penis and an a non natural penis, I think it’s okay.

What men need to realize is that, a functional, hard penis that can give you good sex is always much better than a natural looking one that doesn’t get hurt. That’s great feedback, Dr. Gupta, thank you very much. And onto our last myth for our, session today. And this one is penile implants prevent men from enjoying oral sex. So for that myth, we would like to go to Mr. Modgil. can men with penile plants still enjoy oral sex, or does this interfere with the sensation of the penis?

Look, to me again this is a pretty easy and quick one to respond to. So in theory, there should really be no difference in how a man feels with a penile implant during intercourse versus what, oral sex should feel like. So I think you have to be quite realistic with patients. And one of the things that I personally am not a fan of is describing, a man with a penile implant as having an erection. As such, because an erection is an organic phenomenon which involves the cavernous body filling with blood and an implant doesn’t give you an erection.

It gives you uniformed shaft rigidity when you want for as long as you want, as many times as you want. So if you then accept that, then that there need not be any particular little difference in sensation during oral intercourse versus penetrative intercourse or any other form of intimacy. And I think that’s probably the best way to answer that question. And of course, it varies from patient to patient as well. Thank you very much. So, before we conclude our session, I would like to ask our panel members, for any final comments they have regarding any of the questions that we asked today or if they would like to make any concluding comments to our audience regarding penile implants.

So let’s go in reverse order and start with Mr. Modgil. Is there anything else you would like to add? Yeah. So I think if I was to sort of summarize, a couple of things, I think the first one would be to reiterate one of the points that Doctor Carrion made at the start of this conversation. You do not need to earn your implant, you know, 10, 15, 20 years ago, there used to be conversations about taking patients through an exhaustive, regime. You know, have you had your tablets?

Have you had them for a year or two years? Did you try injections? How long did you do your injections? Did you try a vacuum device? How long did you do that for? It’s not a test. We don’t do that with any other disease process. You know we don’t. A diabetic doesn’t have to take tablets for an X number of time before they qualify for injections or any other form of intervention. So this is the same in my mind if a patient comes along. Yes. Admittedly, the vast majority of patients should have tried tablet therapy because it’s simple and it’s got a relatively limited side effect profile and it’s easy to do.

But if a patient comes along and says, I don’t really want to inject the penis every time I have intimacy, I don’t want to have a vacuum device every time I have intimacy, because I don’t want to put it in my luggage for a weekend away or whatever it may be. It kills the spontaneity. Well, that’s okay. As long as they made an informed choice, they’re appropriately consented. Then it goes back to that thing that the Dr. Carrion was talking about. It’s not just an old man’s disease.

All the options are on the table, and it’s our job to speak to patients and make sure that they’re aware of them, and then come to a mutual decision about what’s best for them. If that’s penile implant surgery, then so be it. Excellent feedback. Thank you so much. I think that was invaluable. Doctor Gupta, any closing comments for the audience? Yes. So, I want to take the question that, Dr. Modgil talk about replacements. So many times I get patients who are carrying the latest iPhone asking about replacements, and I tell them that you change your iPhone every year, and, you know, and the phones are built to last for many, many years, but you just change them every year.

But you are so concerned about the penile implant, which will most probably outlive your iPhone by another ten years, right? Or maybe your car. So you buy a car and you change it after five years. But the construction quality of the implant is so good, they’re going to last for 15 years. And when you buy a car, you never ask a salesman to guarantee you that will never, never, never go down or never need repairs. And you still go ahead and invest in it. But the penile implant is going to give you a better ride than any car you buy, right?

So I think, the replacement or the repairs will be there with any mechanical device. But if you are, if you know what you’re getting into and these implants are built to last, I think, one should go ahead and look at the positive aspects of them lasting many years rather than get, you know, scared about them maybe needing a repair. And even if they need a repair, they can be repaired easily. A good high volume implant knows how to do revise implants. So I think that’s that’s something I wanted to think about the replacement question.

And one question that Doctor Carrion talk about malleables vs inflatables. So in India, in, Southeast Asia, malleables are done more than inflatables. And many of the patients here who have been constantly, getting information from, social media and from reports from the West, but there is a lot of tilt towards inflatables. Many of these patients believe that the inflatables are a much better option than a malleable one. I tell them this is that if you have a family of four, then a van is going to be a better choice of a car than a Porsche.

Right? So you need to take or do you need to get what suits you and your affordability and your usability more than just going with the fancy Porsche, because those two seats are not going to fit your child. So that’s what I tell my patients, and many of them understand the point. And then they go about choosing something which is good for them, then just aping or seeing something that they don’t understand. Thanks, Doctor Gupta, that’s great feedback for audience. And then finally, Dr. Carrion the closer.

any final comments? I thought, outstanding session. I wanted to go ahead and give commentary on the final premise. The final aim of what this is all about. A patient wants a model that brings me as close to what I had and what I lost. So they did great commentary right now saying you get a natural reaction. That’s not what an implant is. You just heard that excellent, excellent reminder that this is done by expert hands. And you could see global experts around. Now they’re not in every street corner of every country, but they’re out there.

So I challenge the patients, do your homework, find out who does this. And high volume. You’ve heard that terminology. Just now because a penile implant either prototype put in well healed well outstanding satisfaction, outstanding return of function. And that’s what it’s all about. So that’s what I wanted to give. One final reminder. It is an excellent modality, but it has to be done in very able hands because of course we’re concerned about some of the suboptimal outcomes that are potential. And that’s what I wanted to remind the crowd.

Yeah. That’s it. Thank you very much. I’m so sorry. But, I think it’s such a brilliant point that I’d simply like to second it because, you know, it goes back to very similar rules to anything that anybody wants to be particularly good at. You know, people will have heard about the 10,000 hour rule. So really important as Doctor Carrion says that the patient does their homework, you know, so implant surgery is best done like most surgery in high volume centers. That’s where the best outcomes are reported.

So I totally agree with this point. Excellent, excellent. So in closing, I would like to thank our distinguished panel for sharing your expertise and thoughtful insights and helping to debunk some of these myths about, you know, implants. your insights have certainly been invaluable in helping mental health patients throughout the world make informed decisions about penile implants. And of course, thanks to our audience for joining us for this session of Rigicon Talks. We hope you found it informative, educational and entertaining. And until next time, stay informed and please know there are options available to help improve your sexual quality of life for you and your partner. Thank you very much.

The text above is a transcript of the spoken content of this video, published for reference and accessibility. Wording may differ slightly from the recording. It is not medical advice and does not replace a consultation. Product availability and approved indications differ by country – ask your physician what applies to you.