Types of penile prosthesis

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Types of penile prosthesis: Malleable or Hydraulic

There are several types of penile prostheses. Each has its advantages and disadvantages.

Within the therapy of male impotence, penile prostheses are the only treatment that definitively solves the problem. These devices are relatively new and have shown excellent results, both in safety and ease of use.

Once diagnosed and assessed the penile implant surgery, we can talk about two main types of prosthesis, hydraulic and malleable. And in this article we will explore their differences, similarities, advantages and disadvantages.

Malleable penile prostheses or semi-rigid implants

Malleable prosthesis

A malleable prosthesis is composed of two cylindrical rods of silicone (with a metal shaft), a soft, elastic material that is inserted into the corpora cavernosa of the penis, the anatomical site where erection occurs in men.

These prosthetic cylinders have the ability to maintain the shape given to them. They are partially rigid and have a metallic silver and copper braiding inside . This provides flexibility but at the same time rigidity to allow penetration.

Newer models of malleable prostheses

A more modern subtype of this type of penile prosthesis consists of rigid silicone rods with a kind of “internal joint” that allows to simulate more easily the flaccid states when the man is not in the sexual act. There is another subtype of malleable implant that has an activating system of “tensioned cables”. The man who wears it only has to flex the penis at an angle of 120° and the member remains erect and, to deactivate the system, he only has to flex the penis in the opposite direction and thus, the penis bends downwards.

Advantages

Produce long-lasting and satisfying erections that are quite similar to natural erections.
They are the most economical prostheses on the market.
Very easy to manipulate by simply bending the penis in the desired direction.
The erection state of the penis lasts as long as the patient wishes.
Very simple surgery and practically free of complications due to mechanical failures.

Disadvantages

Two or three-component hydraulic / inflatable penile prosthesis:

Inflatable prosthesis

This type of penile prosthesis is the most popular in androurological surgery today, given its increasingly incredible performance, producing flaccidity and erection states in a completely natural way.

This type of inflatable implants consist of silicone rods that are filled with saline solution by means of a hydraulic mechanism that pumps the liquid when the patient activates it to have an erection.

The so-called “bulb” has a very long service life and in most cases does not require replacement. In addition, many brands offer a 10-year guarantee on the materials, so that in the event of reoperation, only the medical and operating room costs would have to be paid.

Advantages

Produce longer lasting and more satisfying erections.
The patient can manipulate the flaccid and rigid state of the penis at will with a pump that controls the erection.
Very easy to hide in a flaccid state.
These are the prostheses that most closely resemble a natural erection.

Disadvantages

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What are the benefits of having a penile prosthesis?

Sexual satisfaction

More than 90% of men who have had a penile prosthesis implanted claim that they have significantly improved their sexual health, even having two or more sexual encounters per week after five years. According to a very recent study (2023) published by experts from the University of Chicago, it was demonstrated that:

“At all levels, studies observed satisfaction rates of 50-90% and improved satisfaction and quality of sexual life compared to pre-intervention rates.”

Short recovery time

The recovery time from surgery is usually very short, between four to five weeks in which the patient will not be able to have sexual relations and avoid using the prosthesis.

However, the time needed to return to daily activities and work is much shorter. In less than seven days, the patient can be back to normal life, taking care of his or her health, diet and physical activities (avoiding running, excessive lifting or high impact exercises or sports).

Long service life

The average lifespan of penile prostheses is estimated to be about 20 years and even a little more. Although twenty years may not seem long to many men, in reality it represents a decade of an active and full sexual life, with the confidence of having effective erections, as and when the patient requires it, avoiding the need to take drugs or complicated procedures.

Safe and definitive treatment.

Penile prostheses are by far the only definitive solution to the very disabling erectile dysfunction (ED or male impotence) because it exerts its effect in situ, i.e. without waiting times for drugs or use of vacuum pumps.

As a definitive treatment it is not the first choice, but it is considered when drugs such as sildenafil are no longer sufficient or its use has taken a long time.

No more blue pills and suction pumps

One of the things that men with penile prostheses appreciate most is that they have stopped taking pills or using devices for inflate their penises. their penises. The confidence that comes with inducing erections when a man wants them is like nothing else.

Disclosure

Erections with penile prostheses are totally identical to those achieved naturally when there are no erectile problems and it is very difficult to distinguish between a penis with an implant and one without.

The newer devices (hydraulic prostheses) have the ability to enter and maintain a physiologic flaccidity, so the patient can not worry about it being noticeable .

Renovation/upgrade plans for malleable prostheses

In Andromedi we offer you the possibility to try a malleable prosthesis and if you are not happy or comfortable with the result, we subtract the difference in price to implant a hydraulic prosthesis, more modern and functional.

Although many men do not find the use of a malleable prosthesis uncomfortable or uncomfortable, since they are used to it, many others who agreed to it guided by the economic aspect, may change their mind and demand the benefits of an inflatable implant. In these cases, we help in the process by not charging several times for the prosthesis, subtracting the difference between one and the other.

NOTE: Personnel and operating room expenses are computed.

Brands and models that we work with at Andromedi Clinic

For each type of prosthesis, brand and model there is a complete catalog of different measures, to adapt to the size of each patient, both in length and thickness. That is, we seek to adapt to the erection that the patient would have naturally without “overdoing it” or “falling short”. Everything must always fit perfectly.

After years of experience in penile implant surgeries, we have selected the brands with the highest scientific endorsement and the support of the main European and international societies. Most of the brands of penile prosthesis we use in our operating rooms in Madrid, Seville, Malaga, Marbella and the Canary Islands, have a 10-year warranty, covering replacement due to deterioration or wear, as long as it has not been subject to misuse. However, the devices usually last, in most cases, for life. These are the two main prostheses we indicate today

Coloplast (Titan)
Boston scientific (AMS 700)
Presurgy (Infla 10)
Promedon

Differences between hydraulic and malleable prostheses: Comparison Table

Although indications of the main differences between a semi-rigid and a hydraulic implant have been given throughout the article. Below we summarize the main comparisons in the following table. Likewise, if you have any questions regarding the procedure or these devices, please do not hesitate to contact our team.

Comparativa: Prótesis Hidráulicas vs Maleables

Hidráulicas	Maleables
Estructuralmente son más complejas, pues poseen varios componentes, lo que aumenta el riesgo de complicación mecánica.	Su estructura es mucho más sencilla, lo que disminuye el riesgo de complicaciones y la necesidad de reintervenciones quirúrgicas.
Se pueden activar y desactivar cuando el paciente lo requiera. Tanto su rigidez como flacidez son fisiológicamente superiores.	Siempre estará en estado rígido, pero se puede acomodar de forma discreta mediante manipulación manual.
Son más costosas. (Te invitamos a visitar este artículo para que conozcas las mejores marcas).	Son más económicas, se ajustan mejor según el presupuesto del paciente.
La cirugía es más compleja, por lo que el tiempo de intervención es mayor.	Son más fáciles de implantar, por lo que la intervención dura menos tiempo.
Aunque no es una diferencia significativa, el dolor postoperatorio es más elevado.	Menor dolor postoperatorio.
La bomba se aloja en el escroto.	No hay nada en el escroto.
Un artículo de revisión de la Sociedad internacional de Salud Sexual sugiere que la prótesis debe inflarse y desinflarse con regularidad para su correcto funcionamiento.	No necesita procedimientos de mantenimiento.
Requiere aprendizaje y adquirir habilidad manual para poder activar la bomba de la prótesis.	No necesita entrenamiento ni curva de aprendizaje para poder utilizarlo.

💡 Información útil: Desliza horizontalmente para ver todo el contenido en pantallas pequeñas. Esta tabla compara las características principales de ambos tipos de prótesis.