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What to Expect From a Penile Pump Implant

Posted Aug 24 2008 1:49pm
DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. For many men suffering from erectile dysfunction, the solution to their problem does not lie in medications or sex therapy, but rather in a surgically implanted device called an internal penile pump. Men who are thinking about this option have a lot of questions, so today we're going to try to answer them. We're going to talk to some people who know all about this device.

Dr. François Eid is a surgeon in private practice in Manhattan, and he's the Director of Advanced Urological Care. Thanks for being with us.

J. FRANÇOIS EID, MD: Thank you, David.

DAVID R. MARKS, MD: So, Dr. Eid, it's obviously hard to make the decision to have this implanted.

J. FRANÇOIS EID, MD: Yes.

DAVID R. MARKS, MD: But once the decision is made, what should people expect?

J. FRANÇOIS EID, MD: I think they should expect normal function, a feeling of normalcy and being able to make love whenever that individual wishes to do it.

DAVID R. MARKS, MD: There must be a lot of fears about the surgery -- if it's going to work, how it's going to feel. How do you prepare them?

J. FRANÇOIS EID, MD: It's not easy, David, and one has to spend time with the patient talking about the procedure itself, the device and what it can do for that particular patient. So I really start by showing a tape of a patient with a device and showing that patient actually activating and deactivating the device, and what the tape shows is that the person looks totally normal. That's number one.

Number two, when the person finds out that it's a fluid filled device, they have all sorts of questions. How do you put it in? Do you need to cut the whole penis? Does the pump stick out of the skin? Do I have normal sensation? Will I be able to reach orgasm? So all these concerns have to be explained to the patient, and very often we'll actually preempt the question and describe the device and what it does in a lot of detail.

I think it is very important for an individual who is thinking of this option to ask as many questions as possible, and we guys don't ask questions, and that's one of the things that limits, sometimes, our medical treatment options.

DAVID R. MARKS, MD: Tell us briefly about the operation.

J. FRANÇOIS EID, MD: Well, the operation, the way we do it, we do it through a small, one-inch opening in the scrotum, so we don't make any cuts, any opening whatsoever in the penis. We want to preserve the penile skin. That's the sensitive part of the penis, and we want to avoid that area. We put it through underneath from the scrotal sac area. That's where we make our little opening, and through that opening we first -- the operations is really three parts. The first part is putting the little sleeves inside the penis, and we do that through a tiny opening about a quarter of an inch in the penile shaft all the way down at the base of the penis underneath the sac where the testicles are.

The next part of the operation is placing the pump, and the pump is placed between the two testicles. There's a little area there where there is a little bit of fat, and we put that there in a way that is accessible, yet looks cosmetically appealing so that a patient can go to a locker room, be naked in front of other men and not look funny. We want to make sure --

DAVID R. MARKS, MD: Let me pick up on that point, because, obviously, cosmetics are very important. Do couples have unrealistic expectations? Do they have an idea of how this is going to turn out in advance?

J. FRANÇOIS EID, MD: I think some do and some don't. I think the most important thing is for a man to understand that what we will do is we'll make his penis functional again. He'll be able to make love and feel the regular feelings of lovemaking. The penis may not be as big as it used to, but what we want them to expect is that they'll be functional.

DAVID R. MARKS, MD: After the procedure, how long does it take to recover? How long does it take for a man to be able to make love?

J. FRANÇOIS EID, MD: Well, it varies. We've had patients -- for example, the other week, we did a patient on Monday, and on Thursday he was playing basketball one-on-one with his son. On the other hand, we did another patient two days after that, and that's over a month ago, and the patient hasn't yet been active. So it really varies. In general, it takes about two to three weeks to feel totally normal, and about four weeks before they're able to be sexually active.

DAVID R. MARKS, MD: Is this a normal thing, the partner-to-partner counseling, to some extent, patient-to-patient guidance? Is this a good thing? Does it happen commonly?

J. FRANÇOIS EID, MD: Yeah, it is extremely helpful for patients, and we have a list of patients who are willing to speak to possible patients who are interested in getting one of these.

DAVID R. MARKS, MD: Do a lot of patients ask for it?

J. FRANÇOIS EID, MD: A lot of patients ask for it. Some ask for it and they never call. They're a little bit shy. And when they call, John and Jim will tell you they're a little bit hesitant about asking the questions, and a lot of patients will say to me, "Doctor, I trust you. I really don't need to call." I say, "Well, you know, you're not calling to check on me. You're calling to become more informed and to educate yourself on how it's going to feel after you have this procedure, because once you have it, I want you to be perfectly happy with it." So it's important for patients to call.

DAVID R. MARKS, MD: It's a difficult thing to talk about.

J. FRANÇOIS EID, MD: It's a difficult thing to talk about, but one of the things I appreciate the most is very often patients will call, and they'll get the partner on the phone, and the partner will very often talk about how it is to make love to a person who has one, and what was the process that it took to get one.

DAVID R. MARKS, MD: Dr. François Eid, I want to thank you for being here.

J. FRANÇOIS EID, MD: Thank you, David.

DAVID R. MARKS, MD: And thank you all for being here once again. I appreciate it. Thanks for joining the webcast. I'm Dr. David Marks. Goodbye.

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