Written by the UPGUYS Editorial Team
Published on July 18, 2022
Did you know that Canadians between 46 and 60 average 1.36 sexual encounters with their partner(s) weekly? While sharing an intimate night in with your loved one sounds romantic, you may be running into a few snags, so to speak. Erection difficulties can make it difficult for penetrative sex, harming relationships, or making you feel self-conscious.
Erectile dysfunction surgery is one option that many men have turned toward. But is the high cost worth the outcomes? Surgery is the most invasive measure and often the last option for men dealing with erection difficulties.
You might be a candidate if you have failed other treatments, such as medication. Even young men could benefit from vascular surgery, especially if there has been blunt trauma or damage to tissue.
In our complete guide, we will address all you need to know about erectile dysfunction surgery and what to expect. Keep reading for more information!
In this article, we talk about the following:
Erectile dysfunction surgery, or ED surgery, is an invasive surgical measure to improve your erection quality. Erectile dysfunction is a male sexual disorder entailing difficulty getting or maintaining an erection. Surgery aims to improve vascularity or the quality of erections.
Before diving into surgery, it helps to have a better understanding of what causes erectile dysfunction. There are two primary causes:
Psychological causes of erectile dysfunction can include anxiety or stress. Life changes or strained relationships might put you in this category. The best solution to improving your sex life is likely not surgery.
Physical causes include vascular problems, obesity, cardiovascular disease, or diabetes. These often limit blood flow to penile tissue, leading to declining erection quality. Surgery could focus on improving vascularity or providing a pump device that increases blood flow to the penis.
As mentioned earlier, erectile dysfunction surgery likely won't help psychological issues. Counselling and therapy might work better for long-term results, especially in younger men. You could benefit from surgery if you have medical conditions that limit blood flow.
For example, studies show that penile implant surgeries have an 86% success rate. Additionally, researchers find that there are low risks of complications. You should not need to replace or remove the implant after surgery.
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Before consulting an ED surgery physician, you should be aware of the surgery options available. As you already read, penile implant surgery is one option.
You may also hear about penile implants called penile prostheses. They are interchangeable and involve placing a rod into the penis.
Other types available include penile revascularization. Vacuum devices are not considered surgical procedures since they are devices placed on the outside of the penis.
Vacuum devices are electric or battery operated with the goal of drawing blood to the penis. In some situations, a surgeon may recommend a vacuum device after surgery or before trying surgical interventions.
Penis implants are devices inserted into your penis. There are three primary types of penis implants:
As the name sounds, an inflatable penis implant uses a valve to pump or release fluid. It closely mimics how an erection looks and feels. Your surgeon will also insert a reservoir in which the fluid is stored when not in use.
They come in two-piece and three-piece mechanisms. Three-piece inflatable devices are some of the more common ones. However, it does come with more parts, increasing the likelihood of it malfunctioning compared to two pieces.
Two-piece pumps include the pump as part of the reservoir, which is placed in the scrotum. While it is less complex than three-piece implants, it does require more pumping effort.
Semirigid implants do not use any form of inflatable mechanisms. Instead, they are placed into the penis as is, meaning you must bend it away from your body if you want to conceal your erection. It requires the least amount of work for an erection, but it can make some men self-conscious since it is harder to cover up.
Penile Implants Risks and Benefits
Penile implant surgery is invasive and comes with several risks, such as bleeding, mechanical failure, pain, or changes in sensation. Your surgeons should review the risks of undergoing surgery, including anesthesia.
On the positive side, it is a relatively short procedure and should only take one to two hours. Afterward, you will need around four to six weeks to recover. During this period, it is important you do not engage in penetrative sexual activity.
The primary benefit of penile implants is that they are effective and last several years. Research shows inflatable implants are still 78.2% to 85% effective after ten years.
Revascularization surgery focuses on improving blood flow to the penis. It is also called microvascular surgery and focuses on re-routing and improving penile blood flow.
You can think of it as cardiac bypass surgery. Your surgeon will make small incisions into the scrotum tissue where a dissected donor artery is placed. The surgeon threads the artery through to the inguinal ring.
From there, it is connected to other penile arteries. Typically, most donor arteries are from your femoral artery. This surgery is used for erectile dysfunction caused by arterial insufficiency.
It is more widely used (and recommended) in younger patients under 55. These patients typically do not have other comorbidities or issues. However, there is some controversy based on these studies over its effectiveness, which ranges from 36% to 91%.
Penile Revascularization Risks and Benefits
Penile revascularization is ideal for young males who receive penile or pelvic trauma. It can be an excellent alternative to other treatments for long-term results. In many cases, trauma can occur from everyday activities such as biking.
Sitting on a bike places pressure on the perineum, where nerves and arteries help supply blood flow to the penile tissues. The constant pressure can reduce blood flow or cause damage. Like penis pumps, there are surgical risks, like:
Most risks are mitigated by a qualified and reputable surgeon. Additionally, if you have ongoing vascular issues such as diabetes or cardiovascular disease, you may want to talk to your surgeon first about the risks.
Out-of-pocket surgical costs can range from $10,000 to $15,000 for penile implants. You can expect similar prices for revascularization. The higher expenses are tied to:
Having an erectile dysfunction surgery performed in an outpatient facility could save you some costs. Because of the higher costs, your surgeon may recommend less invasive options first. These include things such as lifestyle changes, medication, or vacuum pumps.
Based on studies from 2019, Medicare was the most common insurance provider that covered penile implants. Approximately 48% of men in this study were unable to obtain coverage for their erectile dysfunction surgery.
Unfortunately, there is no clear answer on whether insurance will cover ED surgery. It depends on your provider, medical necessity, and annual deductible.
Even with coverage, you should still plan on paying for 20% of the costs, which would equate to $2,000 or more. Some clinics might offer payment plans that allow you to split your payments into monthly installments.
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Most surgeries follow similar aftercare protocols. For more specific recommendations, you will need to talk with your doctor. Your activity will likely be limited after any invasive penis surgery for around six weeks.
You may also experience swelling or pain, which is typical. Your surgeon will likely prescribe pain medications to manage your pain levels and ensure a smoother recovery.
After receiving clearance, you shouldn't have any restrictions on penetrative sex, orgasms, or sensation. If you do notice changes in sensation, difficulty urinating, or extreme pain, call your physician's office.
Lastly, you will need to follow up with your surgeon. Some might wait until the six-week mark. Others could see you sooner to remove any stitches.
They can provide you with any guidance on dressing changes or showering. If you perform heavy weight lifting or frequently ride your bike, you will also want to hold off until you've received clearance.
Read more about different therapies for ED:
Is surgery for erectile dysfunction right for you? Ultimately, it depends on a couple of considerations, such as:
If you have a medical history of cardiovascular disease and are on blood thinners, there may be more risks than benefits to undergoing elective surgery. Additionally, age can play a factor. For example, someone at 70 years old might have several more risks undergoing anesthesia than someone who is thirty with no significant medical history.
Lastly, your success with other erectile dysfunction treatments could impact your risk versus benefit scale. If you have tried medications or lifestyle changes in the past with no success, you might find the benefits outweigh the risk in your case.
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Some patients also have uncomfortable side effects with medication. Common side effects of PDE5 inhibitors are:
These issues primarily arise with using medications too frequently. However, some men might not respond favourably to medication and would prefer to try other interventions.
First, determine which type of doctor you need. If you are dealing with high stress or depression that may be contributing to your erectile issues, talk to a mental health professional. You may also visit an endocrinologist or urologist to rule out other diagnoses.
These are essential steps before seeing an erectile dysfunction surgeon. Why? Most of these specialists have referrals that can help you narrow down your choices.
Next, read online reviews and ask about insurance coverage. Even if your insurance does not cover your surgery, it helps to have your bases covered. Last, ask questions during your appointment.
Inquire about your case, options, costs, aftercare, and more. A qualified surgeon will have vast experience working with several cases. They should be able to easily answer your questions and put you at ease.
Yes! There are other erectile dysfunction treatments that do not require surgery. You have likely heard of Viagra, the little blue pill that has caused a whirlwind for decades. It is arguably the most popular PDE5 inhibitor.
Viagra and other PDE5 inhibitors help with vasodilation. They primarily act on penile tissues, relaxing smooth muscle cell walls and promoting improved blood flow. These medications are usually taken before sexual intercourse.
Unlike surgical interventions, you will need to follow stricter timing and remember to take the medication. It also doesn't result in spontaneous erections - you will still need stimulation.
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If you have tried other treatments in the past, you may wonder if erectile dysfunction surgery is right for you. Erectile dysfunction surgery primarily includes implants and revascularization. Both surgeries are time-intensive and costly.
You need a qualified and experienced surgeon that has performed several similar surgeries. This will reduce your anxieties and reduce the surgical risks involved.
However, if you have not tried medication or other non-invasive treatments, you may want to give them a shot. Talk to a practitioner today and see if PDE5 medication is right for you!