Bonus Episode: Use It Or Lose It: How An Inflatable Penile Prosthesis Can Stop Penile Shrinkage and Increase Satisfaction

In this segment, Dr. Mistry and Donna Lee answer a listener's question about problems with his existing penile prosthesis. This listener writes, "I had a penile implant put in several years ago and it actually made my penis smaller. When I pump it up, one of the implants in my shaft I'm concerned is going to break the skin or cause pressure problems, which are huge for me because I'm a paraplegic...Can another implant be placed and increase the size of my penis, and how can I fix the problem of too much pressure?" The penile prosthesis is an inflatable silicon device implanted internally and completely concealed. The device 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. Mistry explains that the 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, he points out that long-term ED actually diminishes the length of the penis over time, so the penile implant can actually help those struggling to achieve erections--no matter the reason--to maintain their size. At NAU Urology Specialists, our surgical team can expertly place this device and help address any issues that may have arisen with older implants. In answer to this listener, Dr. Mistry says that yes, pressure ulcers can become a concern if the implant shifts and that yes, this is fixable! If you or someone you love would like to learn more about the inflatable penile prosthesis 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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Transcript

Speaker 1 0:00

<silence>

Speaker 2 0:09

Welcome back to the Armor Men's Health Hour with Dr. Mystery and Donna Lee.

Speaker 3 0:17

Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mr , your host here, as always, with my ever resourceful <laugh> , probably more popular than me co-host Donna Lee. That's

Speaker 4 0:26

Right. We set this show up anywhere in town, especially in the K L B J studios. <laugh>, I don't do this alone.

Speaker 3 0:33

I'm a board certified urologist. This is a men's health show. The show is brought to you by the urology practice that I started in 2007. We are now called N A U Urology Specialists, although we've had a few names.

Speaker 4 0:44

We have had a few names. And n a U just sounds like now,

Speaker 3 0:47

Now

Speaker 4 0:48

Butted North Austin Urology,

Speaker 3 0:49

Because we wanna see you now <laugh>. And so the show , uh, is really here to address a lot of those health concerns that men might have that they don't feel comfortable bringing up with their spouses or friends or their own doctors. We know it's on your mind, and we love to share kind of our treatment approach. Our practice has four offices. We have four physicians. We have five physician assistants and a sex therapist. We do a sleep medicine testing because we know that sleep apnea has a big impact on a number of medical conditions, including hypertension and low testosterone. And if you want a more holistic approach to your men's health , uh, we're here to give it to you. That's

Speaker 4 1:26

Right. You know, I hear my, my husband's snoring more again. We need to get him back in. Pretty sure he has sleep apnea.

Speaker 3 1:31

Yeah. Maybe when he's doing these two burger, two martini lunches, we need to get 'em down to one burger,

Speaker 4 1:36

One burger , one martini,

Speaker 3 1:37

One Mar One Burger. One Martin.

Speaker 4 1:38

That's , that is called in our house a diet. That's right . So Correct .

Speaker 3 1:41

That's called , there's really no more effective strategy that we've seen than weight loss when it comes to improving your sleep hygiene. When you sleep better, your stress levels go down, your cholesterol levels go down, you're nicer . S sperm counts go up.

Speaker 4 1:52

You're nicer to people in general. I wouldn't know that before . It's a win-win. I love sleep <laugh>. I fell asleep right now.

Speaker 3 1:58

Donna, how do people get ahold of us? How do people get make an appointment.

Speaker 4 2:01

You can call us at (512) 238-0762 to reach out to us. You can ask for me if you'd like. Our , a website is armor men's health.com and our email address is, would you like to sing it with me? Arm Mens health@gmail.com . Com. Com Okay. <laugh>, we have some awesome questions, by the way.

Speaker 3 2:18

Uh, your questions are what keeps the show going. We want you to never feel like a question is too silly, or even if we've gone over the subject material before , uh, we do this show on the radio, even though it's available by podcast form, it allows us to go over the same topic over and over again every few weeks, just in case you're catching us kind of in the car. Now that everybody's driving around taking their kids to sports again, we hope to get , uh, even more listeners. Right.

Speaker 4 2:40

I have a quick funny story. We had a patient who listens. He wa he wasn't in Texas, but he wanted to know how to use the, the penile ring. And so he copied the podcast link. Yes. And he sent it to us through his inquiry on our website. And it was the podcast about how to use the penile link , uh, ring. Yes. And then he asked, how do I use the penile ring? So I was very confused by the whole thing, but I said, listen to the podcast again.

Speaker 3 3:02

<laugh>. And the podcast is a , is a plethora of information. So we it was, it was a good one. We, we encourage you to , uh, search for your favorite men's health topic.

Speaker 4 3:09

That's right. Just search the armor Men's health hour and whatever topic you'd like. But here , you ready for this one? I'm ready

Speaker 3 3:14

For a

Speaker 4 3:14

Question. This is a good one. I had a penile implant put in several years ago, and it actually made my penis smaller. When I pump it up, one of the implants in my shaft, I'm concerned is going to break the skin or cause pressure problems, which are huge for me because I'm a paraplegic. My question is, can I , can another implant be placed and increase the size of my penis? And how can I fix the problem of too much pressure and causing concerns? Those

Speaker 3 3:38

Are some great questions. Um , fully

Speaker 4 3:40

Loaded questions.

Speaker 3 3:41

So let , let's fully first talk about what a penile implant is. When is it appropriate for you and how you can come get one <laugh> ? The penile implant, the most traditional one is an inflatable silicone device completely internally implanted. So people sometimes ask about that. Nothing is external and nobody can tell except

Speaker 4 3:58

For that third ball.

Speaker 3 3:59

There is a third ball. So if she gets close enough, then you're both lucky and you have a third ball <laugh>. So , uh, there's a, there's a pump mechanism that's in the scrotum that will then transfer fluid that's in a reservoir placed in your abdomen to silicone cylinders mm-hmm . <affirmative> in your penis and give you more girth as well as more length , uh, to your erection. The benefit of that is that it is soft and looks normal when it's inactivated and is rigid and gives you great sexual pleasure when it's activated.

Speaker 4 4:28

But there's an implant. So if it's soft, is it the size of the implant that's bigger than your natural penis?

Speaker 3 4:34

It is never gonna be bigger than your stretch length. Okay . So you can't, you can't overstretch just whatever you have. So if , if you're looking for something longer, that's a different lecture. But when it comes to what can a penile implant do, it can make your normal stretched penile length, you know, fully girthy. The good news is for most men, the length is going to be perfectly adequate for you to have fun and for her to have fun. And so it's not going to affect your sexual performance in most cases. Now, this is a mechanical device, and although it can malfunction or have issues with placement mm-hmm . <affirmative> , for the most part, satisfaction rates are over 90%. Mm-hmm. <affirmative> , it's covered by many, both commercial and medical insurances. Because, because of why?

Speaker 4 5:16

Because white men make the decisions in Congress.

Speaker 3 5:19

White men, I don't know about color. <laugh> .

Speaker 4 5:22

Powerful men make decisions in

Speaker 3 5:24

Congress. Powerful men with erectile dysfunction make decisions about where money goes.

Speaker 4 5:28

Yeah . Of any color or creed, so, okay.

Speaker 3 5:31

Correct. And the penile implant is something that they wanted to make sure got covered by Medicare.

Speaker 4 5:34

Do you think they'd want the breast augmentation done as well? <laugh> , but no, not , not lucky ladies. They're

Speaker 3 5:39

Just , they're just gonna tip their wives off, but they're like something <laugh> . So , uh, the penile implant is covered as well as repairs, the penile implant. And this particular listener, it is the case that patients with spinal cord injury, patients who are , um, maybe diabetic people who have limited neurologic function will often get a penal implant because it , uh, gives them a more certain erection. So in the paraplegic man, we have to worry about fertility mm-hmm . <affirmative> , because oftentimes they can't. And we see a lot of those patients and erections. And interestingly enough, those men often get penal implants, not just to have sex, but also because when you're sitting in the chair all the time mm-hmm . <affirmative> , the penis can retract inside the body. Oh . And so if you're trying to grab it to pee or you're trying to catheterize through it to empty your bladder, it's nice to have a handle. So a lot of those patients never thought about that will get a , will get a penile implant so that they can have better, so that, especially if they have limited hand dexterity mm-hmm . <affirmative> , let's say their spinal cord injuries in their neck, their hands may not move as perfectly. So it's nice to be able to have that added handle. Okay . But if you have a penile implant and your penis is getting shorter, you have to think about what is the, what is the underlying condition that led to the problem. So if you've had a radical prostatectomy or you're a diabetic, these organs can shrink just from that. Then of course, there's you getting bigger and fatter. So if you're getting fatter, then your , the fat pad that goes on top of your penis will get bigger. And that will also make it appear like your penis is shrinking.

Speaker 4 7:04

That's not just paraplegic

Speaker 3 7:06

Patients , that's for everyone . That's for everyone.

Speaker 4 7:07

Okay.

Speaker 3 7:07

And if you're not using the pen L implant, then things are going to get shorter. And so, so men who get erections regularly maintain their penile length . So that's why patients who we know are gonna have erectile dysfunction for a prolonged period of time, like our radical prostatectomy patients or, and if you have , if you're on dialysis out there, oftentimes you'll have severe erectile dysfunction. Mm-hmm. <affirmative> , we have them use the vacuum erection device because it kind of cycles blood through the penis and keeps the penis nice and long. And so if you're not using it, you're gonna lose it.

Speaker 4 7:38

Oh, that phrase Yes . You don't use it, you're gonna lose it.

Speaker 3 7:41

That's right. So tell Michael, nothing he's doing is wrong . It's working. You know what I'm saying? Like he can ask, maybe refuse, but he can ask, he can ask, he can ask quite often. And then the last part of the listener's question was about pressure ulcers. And so , um, the , um, we like to think of aspects of the body as being real solid. You know, like our bones are real stiff and our tissues are real solid. Mm-hmm. <affirmative> . But the truth is that if you put a foreign body in almost any of our structures mm-hmm . <affirmative> over time, even those we're real solid, that , that those solid structures can erode and get real weak. So hernias are an example of what happens in men or women as they get older. Oh . Certain, certain areas that are weaker and are , you know, organs that are not supposed to protrude can protrude, but with the penile prosthesis in particular, you can have migration or movement of the , um, the actual structure , uh, in and , and if , if you feel like your cylinders are right under the skin, then you should definitely see a urologist. And the answer to your question is we absolutely can fix it. We can put what's called a gore-tex patch or a patch over the , the area that's weak. Mm-hmm. <affirmative> like, like a hernia repair almost. Hmm . And reinsert the , um, uh, the cylinders. Do you have

Speaker 4 8:55

To replace the cylinders with new ones or you just

Speaker 3 8:57

Use while you're in there? You might as well throw some new ones in there, you know? Right . No reason to put old tires on a brand new car. <laugh>. Um, and as luck would have it, we have a fellowship trained mm-hmm . <affirmative> prosthetic surgeon. Right. In our practice we do, Dr. Christopher Yang spent an entire year doing nothing but fixing these things. Can you imagine? Right . In Florida, changing tires for a whole year. That sounds from some of the experts in the world. And , uh, if you have,

Speaker 4 9:21

To me, that sounds exhausting,

Speaker 3 9:22

But good if you have a malfunctioning penile prosthesis or you want a new one that gets put in by an expert Dr. Christopher Yang , uh, in our practices, exceptional at them. Uh, we put them in for not only erectile dysfunction, but also severe Peyronie's disease if you have spinal cord injury and would like a better solution to your erections. Uh , we not only have the penile prosthesis, but we also have other amazing things that we do. Um , penile vibratory , uh, stimulation. Mm-hmm . <affirmative> , we have , uh, use of pills, we have injections. Um, you know, I , I kind of joke to men, if , if , if , you know, if you have the will, we have a way <laugh> to get you a bone . It's true . And so , Donna, how do people get ahold of us? You

Speaker 4 10:02

Can call us during the week at 5 1 2 2 3 8 0 7 6 2. And you can check out our website where you can see Dr . Mystery Smiling handsome at armor men's health.com. Check out our podcast wherever you listen to free podcasts that are available to you all the time. And thank you, Dr. Misery free, Brittany .

Speaker 2 10:19

The Armor Men's Health Hour will be right back. If you have questions for Dr. Mystery , email him at Armor men's health@gmail.com.