Penile Implants & Transplant

Penile Implant & Transplant Surgery In Hyderabad, India

Transplants have become a common surgical procedure in which an organ like kidney, lung, liver, etc is taken from a donor and placed in the body of the patient to replace a damaged or missing organ. Organ transplant is a boon for several patients who would otherwise not survive in the absence of these life-saving organs.  

Another organ transplant for which research has been ongoing for many years is a penis. Penis transplantation has now been performed a few times around the world and has seen some successes.  A penile transplant is very different from a penile implant. In a penile implant, a device is placed inside the penis to help patients with Erectile Dysfunction, Peyronie's disease, ischemic Priapism, and other such disorders.

Penile Transplant on the other hand is a surgical procedure in which the patient receives a new penis which is mostly an allograft from a human donor. Although research is also being conducted to transplant an artificially grown penis, it is still a complex procedure and needs more research and advancements in technology to become a more common and successful transplant procedure.

Who requires a Penis Transplant?

Penis Transplant can be done on candidates who suffer from reduced penile functioning or the absence of a penis due to injury, congenital absence, removal of the penis due to a disease like cancer, or severe micropenis. Since a Penis transplant carries risk factors like any other transplant and is not even a common procedure, the patient must undergo some conditions to be eligible for the transplant. These conditions include:

• The patents must be a cisgender male aged 18 to 69 years

• The candidate must not have a history of HIV or Hepatitis.

• The candidate should not have a history of cancer for at least five years before the surgery.

• The patient must not have any condition that prevents them from taking immunosuppressive drugs.

How does a penile implant work?

An inflatable penile implant is comprised of two cylinders, a reservoir, and a pump that is surgically implanted by a healthcare professional into your body.

The cylinders are inserted into the penis, and tubes connect them to a separate reservoir positioned beneath the lower abdominal muscles. This reservoir contains a fluid, and a pump is also connected to the system, situated under the loose skin of your scrotum, between the testicles.

To achieve an erection with the inflatable implant, you activate the pump in the scrotum. It's important to note that pressing the pump does not exert any pressure on the testicles. The pump moves fluid from the reservoir to the cylinders in the penis, inflating them to the desired level of hardness. Once erect, the erection can be maintained for as long as desired, even after experiencing an orgasm. To revert to a flaccid state, pressing a valve on the pump returns the fluid to the reservoir, deflating the penis.

In contrast, a non-inflatable penile implant consists of two solid, flexible silicone rods. This type of device does not require a pumping mechanism. To use the implant, you manually press on the penis to extend the rod into position. The hardness remains constant, allowing the implant to be used for as long as desired, even after orgasm. After using the implant, you manually press on the penis again to retract the rod.

The procedure of Penile Implants

Penile implants, also known as penile prostheses, are devices that are surgically implanted into the penis to treat erectile dysfunction (ED) that doesn't respond well to other treatments. There are two main types of penile implants: inflatable implants and malleable (bendable) implants. We will provide a general overview of the procedure for each type:

Inflatable Penile Implants:

• Preparation: 
  • Before the surgery, your doctor will conduct a thorough examination and may perform some tests to determine the most suitable implant for you.
  • You will be given instructions on how to prepare for the surgery, including any restrictions on eating or drinking before the procedure.
• Anesthesia: The surgery is typically performed under general anesthesia, meaning you will be asleep and won't feel any pain during the procedure.
• Incision: The surgeon will make an incision, usually at the base of the penis or in the lower abdomen, to access the erectile chambers.
• Insertion of Implant: For inflatable implants, two inflatable cylinders are inserted into the penis. These cylinders are connected to a fluid-filled reservoir and a pump placed in the scrotum or groin.
• Connection and Testing: The pump is connected to the reservoir, and the surgeon tests the system to ensure proper functioning.
• Closure: The incisions are closed with stitches.
• Recovery: After surgery, you'll likely need to stay in the hospital for a short period for monitoring. Recovery time varies, but most men can resume sexual activity within 4-6 weeks.

Malleable Penile Implants:

• Preparation and Anesthesia: Similar to inflatable implants, preparation involves a thorough examination, and the surgery is performed under general anesthesia.
• Incision: The surgeon makes an incision in the penis, typically at the base.
• Insertion of Implant: A malleable implant consists of two bendable rods that are inserted into the erectile chambers. These rods allow the penis to be positioned upwards for sexual activity and downward for concealment.
• Closure: The incisions are closed with stitches.
• Recovery: Recovery time for malleable implants is often shorter than for inflatable ones, and sexual activity can usually be resumed within a few weeks.

Risk Factors of a Penile Transplant

As with any other transplant, penis transplantation comes with its set of risk factors. Also since more successful transplants and research are required for a penile transplant, extra care must be taken to avoid risk factors. As more research gets done and more operations are conducted, new risk factors may also come to light. Common risk factors that are associated with a Penile transplant are:

• The major concern with a penile transplant is the rejection of the donor organ by the patient’s body. The patients are therefore required to take immunosuppressive drugs daily for the rest of their lives. These drugs suppress the immune system’s response against the donor organ. Since the immune system is medically suppressed, the patient may be more prone to other common infections. Also, immunosuppressive drugs do not guarantee that the body will not reject the donor organ. There is still a 6-18% chance of organ rejection.

• Another risk factor associated with penile transplant surgery is the narrowing of the urethra due to the scar tissue from the surgery.  The patient could therefore face problems during urination.

• Also, the scar tissue may cause some of the skin to not get a proper blood supply. This leads to the skin tissue in that area dying and coming off.

• A penile injury affects the patient mentally. Although a successful transplant may help patients live life normally, they may still face psychological issues in accepting the new donor organ and adjusting to the new normal.

What is the recovery time after a Penile Implants?

It's crucial to recognize that each individual's healing process is unique, so recovery times can vary. Typically, pain, swelling, and discomfort should diminish within a week, with possible tenderness lasting up to six weeks.

Your healthcare provider may prescribe antibiotics, pain relievers, or other medications, and it's important to follow their instructions. Some individuals manage pain with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, or naproxen, but check with your healthcare provider for alternative options if NSAIDs are not suitable for you.

To promote healing and prevent infection, gently clean and dry the affected areas regularly. Wash your hands before changing bandages and using the restroom.
For pain and swelling reduction, applying an ice pack to the affected areas for up to 10 minutes at a time, multiple times a day can be beneficial.

During recovery, it's advisable to refrain from heavy lifting or strenuous exercises that may exert pressure on your incisions.

How can CARE Hospitals help?

Reconstructive penile transplant at CARE Hospitals can help you regain the lost confidence and lead a happy life. We have a comprehensive care team and a world-class facility at your disposal. To learn more about the procedure and to check if you are the right candidate, get in touch with us today.