In this segment, Dr. Mistry and Donna Lee are joined by Dr. Christopher Yang to discuss treatment options for erectile dysfunction when the pills aren’t working. Two types of penile prosthesis are available to help patients achieve an erection if other options have failed. The inflatable penile prosthesis is made of a silicon device implanted internally and completely concealed. It is inflated using a pump implanted into the scrotum which, when activated, transfers fluid from a reservoir in your abdomen into the silicon cylinders in your penis to add both length and girth to your erection. The inflated implant produces a rigid and satisfying erection, yet appears natural and soft when not in use. Dr. Yang explains that the inflatable penile prosthesis is an excellent option for addressing a variety of patient concerns from end stage ED to nerve damage from diabetes or neurologic issues. Importantly, long-term ED actually diminishes the length of the penis over time, so the penile implant can actually help ED patients maintain their size. If you or someone you love would like to learn more about the inflatable or malleable penile prostheses or have their prosthesis checked, please give us a call today!
Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Speaker 1:
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Speaker 2:
Welcome back to the Armor Men's Health Show with Dr. Mystery and Donna Lee.
Speaker 3:
Hello and welcome to the Armor Men's Health Show. This is Dr. Mystery , your host here with my co-host Donnelly. Hey,
Speaker 4:
Everybody. Thank you for listening to the show.
Speaker 3:
We love your feedback. Uh, we love your emails. Our , uh, radio and podcast overlords tell us that , uh, those of you that listen to this show in the car, then go home and remember to send us an email suggest a very high degree of engagement. And so we love our highly engaged listeners.
Speaker 4:
That's right. You know, we had that patient once who listened and she was super angry and said that we were losing respect in the community. But you made a good point. She had to listen to the entire show just to get the phone number or email address to call me.
Speaker 3:
That's a committed hater. Mm-Hmm, <affirmative> . Well, we're, we're
Speaker 4:
Still waiting, by the way, for her to call me .
Speaker 3:
We're , we're still waiting for her to calls . Our, our show is brought to you by NAU Urology Specialist , uh, which we started in 2007, and we are joined today by one of our fellow partners, Dr. Christopher Yang. Uh, Dr. Yang, thank you for joining us today. Yeah ,
Speaker 5:
Thanks for having me. Again.
Speaker 3:
We talked about , uh, what options we have for erectile dysfunction when the pills don't work or stop working. And in this segment we're gonna talk about a specialty procedure of yours called the inflatable penile prosthesis. Would you please explain what that is, how it's inserted, and , uh, who it's for? Yeah.
Speaker 5:
Well, first of all, there's different types of penile prosthesis. So inflatable is one of them. There's also one called a malleable or semi rigid . So I, I want to give some love to the malleable as well,
Speaker 3:
<laugh>. Okay . Gotcha .
Speaker 5:
But basically , uh, both of these , uh, implants , uh, are a surgical , um, implant that basically helps with erections. Uh, one of my mentors based would say that this is the only way to cure erectile dysfunction, where you can have intercourse whenever you want. Basically, there are two structures in the penis called the Corpus Csum that fill up with blood when you get an erection . And the idea behind these surgeries are to put something inside that can get rigid whenever you want. The malleable, there are semi-rigid penile prosthesis. Uh, those are simple. Those are basic . The structures that go inside the corpus cism , uh, that stay firm , uh, you can bend them up and down so you're not showing every , all the time, but they stay firm. The inflatable, that's kind of the, the next level, the the better type. Um, there are cylinders that go inside that inflate and deflate. So, you know, it's almost like the old Reebok pump shoe.
Speaker 4:
Nice analogy. Yeah .
Speaker 5:
Right. So when you want to, you can inflate it and you move , uh, saline into the cylinders. It is almost like blowing up a balloon. And then when you're done, you deflate it so that you are not walking around hard
Speaker 4:
And sensation's the exact same.
Speaker 5:
Yeah. It does not affect the nerves at all. It does not affect sensation. You can still have orgasm, you can still. Um, it just helps you with the erection itself.
Speaker 3:
Hmm . So , um, I think there's a lot of psychological barriers that men have to overcome. Uh, and unfortunately, I feel like a lot of those psychology , uh, barriers prevent them from having good and healthy sex lives. Um, what are some of the more common psychological barriers that you've seen men encounter?
Speaker 5:
Yeah, I think we've talked earlier about , uh, different , uh, issues with libido, testosterone, and things like that. So, number one, you know, we need to have men who are interested, who, you know , still want to have intercourse. Uh, sometimes there's partner issues where, you know, the men want to have intercourse, but their, their wife, their partner aren't really willing. Mm-Hmm . Yeah. Once <laugh> it , it's not the case for everyone. But I did not tell you
Speaker 3:
To bring up my home life, but go ahead,
Speaker 5:
<laugh> . You know, once we have a , a patient, a man who is interested in having erections and, you know, have willing partners, then we need to work on, you know, them getting their erection. Now there's a pretty big psychological component in erectile dysfunction in that if a man is, has erectile dysfunction and they're thinking about it, they're worried, concerned about it, you know, they can definitely snowball. So that's where some of the other like medications and less invasive type treatments sometimes fail because it doesn't address the psychological part.
Speaker 3:
I think a lot of men are holding on to false hope that their erections are gonna come back <laugh>. Mm-Hmm . <affirmative> and I, I don't like seeing that. I mean, if you are a, you know, 62-year-old man and you haven't gotten an erection in two years, and you're a diabetic on three high blood pressure medicines, Hmm . You need diet, exercise, and prayer . You need to be realistic about what the chances are that your erections are gonna come back. Mm-Hmm. <affirmative> . And if you don't use it, you're gonna lose it. Meaning, if you get out of the habit of having sex, if you get outta the habit of approaching your partner, these are things that are going to negatively impact your long-term continuation of sexual activity. And so that's why I think addressing and overcoming these psychological barriers is so critical. So once somebody kind of gets to that point where they say that, okay, penile prosthesis is something that I would want to consider. Why is going to a high volume experienced fellowship trained surgeon like you something that they should consider?
Speaker 5:
Basically it's a tricky surgery. You know, the surgery itself takes only about an hour, sometimes two hours max. Um, so it's a fairly straightforward surgery. But you know, you definitely want to have a surgeon who does a lot of them because of the potential side effects , uh, mainly infection. And it definitely has shown that, you know, surgeons who do more of them have, have , uh, in general lower risks of infection. When we're putting in a implant, a prosthesis, if it were to get infected, then, you know, then we run into trouble.
Speaker 3:
So a high volume surgeon that's experienced is less likely to get an infection. And I think that's a , a very important thing for our, our , our listeners to remember. So , uh, you want to go to someone who specializes in prosthetics in urology. That may not be something that you're too familiar about looking at, but that's the term that we'd be looking for prosthetics in urology. And if somebody's going to get one of these , um, what can they expect in terms of recovery and , uh, when , when can they start using their new
Speaker 5:
Toy? There's no way to sugar cut it. It's a pretty sensitive area to have a surgery done. Mm-Hmm . <affirmative> . So , you know, I'd say you probably can't expect to have quite a bit of pain, quite a bit of discomfort, but typically that lasts for the order of, like, on the order of days to maybe a couple of weeks at most. Uh, we have patients walking around moving around the next day. Um , but you probably would not be doing, you know, strenuous activity for a week or so.
Speaker 4:
No
Speaker 5:
Sex. Yeah, no, no sex <laugh> , uh, you would have, you know, stitches that typically dissolve on their own. So, you know, you definitely don't want to have sex while you still have those stitches. Uh, depending on the type of prosthesis you could probably expect to be using again , about a month to two months afterwards. Uh , so don't plan on the honey bad like the next week.
Speaker 4:
I mean , 'cause we had Dr. Dellinger in a previous segment , um, in the past, and he said, you shouldn't use your penis for
Speaker 3:
<laugh> 30 days, 30
Speaker 4:
Days after fillers .
Speaker 3:
He said , he has a lost , no patient has died because of no sex for 30 days. Oh ,
Speaker 4:
That's true. Good point. <laugh> <laugh> , you will survive.
Speaker 3:
And so , um, uh, you know, cost of these things is something that is , uh, you know, worried about. Uh , and this sounds on its surface to be a completely cosmetic issue, but , uh, our listeners might be surprised to, to, to note something when it comes to the , uh, the coverage of these things.
Speaker 5:
Yeah, yeah, definitely. The, for the most part, insurance companies do cover this. You know, Medicare covers this now, you know, this is in 2023, like five, 10 years from now, who knows, but right now it is covered , uh, for the most part by most.
Speaker 4:
Yeah. Yeah . We had one patient who found out it was not, but for the most part, yeah,
Speaker 5:
It's , yeah , for most insurance companies,
Speaker 3:
NVA patients also, it's covered for , uh, for , for the most part. So if you're a veteran and you can get into the community care program , uh, for your erectile dysfunction, that's something that we can help you , uh, kind of navigate as well.
Speaker 5:
Yeah, definitely. There's one high volume implanter, actually, the, the person who implants the most in the world, his name is Paul Preto out in Miami. And he likes, he has a saying that he wants to make like. Basically he , he thinks that there should be as many penile prosthesis surgeries as , uh, as breast implants. Exactly .
Speaker 3:
I can't wait to find the logo for that one.
Speaker 4:
Yeah , let's make one.
Speaker 3:
I think we're gonna get in trouble. Those shirts we're gonna have trouble wearing in public <laugh> . Yeah.
Speaker 5:
It depends. The other, the other interesting thing about that comparing penile prosthesis surgery to , to breast augmentation is that for when we put in a penile prosthesis, it's for an organ dysfunction. You know, a man has an organ that actually is not working, whereas breast augmentation is for the most part, cosmetic, you know, there's some psychological issues, but you know, it's more of a cosmetic thing than a organ dysfunction.
Speaker 4:
But both are for the men's enjoyment. Well ,
Speaker 3:
Right. <laugh> , I think, I think I , they like shoes. I think women get breasts for other women.
Speaker 4:
Oh , I think you guys like them . I don't know. <laugh> just , just occurred to me the other day. I don't, just thinking,
Speaker 3:
Just occurred to me the other day . <laugh> . So when it comes to penile prosthetic surgery , um, you're looking for a high volume surgeon and you want to make sure that all of your other erectile dysfunction options have been exhausted because it is a one-way operation. Once you do the penile prosthetic operation, the pills, the injections, those other kind of modalities are not likely to work. Is that correct?
Speaker 5:
Yeah, that's correct. And that's why we wanna make sure that patients are, you know, are sure that they want it. We want to make sure that they have, you know, tried other things, that they're sure that they don't want to try anything less invasive first before going to that step. But for the most part, patients who do well, who heal well, they're very happy after they have the prosthetic because, you know, it fixes their organ dysfunction. They can have intercourse whenever they want without having to take a pill or inject or, or use a vacuum device
Speaker 4:
And they get a big penis. Yeah.
Speaker 3:
And they get a better looking penis. You're welcome. It also works very effectively for erectile dysfunction and Peyronie's disease in terms of the curvature. So , uh, Dr. Yang, thank you so much for joining us and sharing your expertise , uh, on erectile dysfunction. Donna , uh, how do , uh, patients , uh, connect with us and make an appointment to see Dr. Yang for their erectile dysfunction?
Speaker 4:
You can call Dr. Yang at (512) 238-0762. If you have specific questions, you can reach out to us to armor men's health.com and remember our podcast, they're amazing, they're fresh, and they're free.
Speaker 2:
Dr . Mystery wants to hear from you. To submit a question, visit armor men's health.com. We'll be right back with the Armor Men's Health Show.