This involves harvesting dermis and fat from other parts of the body (mainly the lower abdomen or buttocks) and grafting it under the penile skin. It increases thickness by 4-5 cm and prevents retraction. The thickness can be adjusted with fat grafts. The surgery takes about 2 hours. Since it uses the patient's own tissue, the survival rate is higher, absorption is significantly lower compared to fat injection, and the effect is permanent. Recovery takes about a week, during which strenuous exercise should be avoided.
This method transplants commercially available tissue directly into the penis. The surgery time is short, wounds are limited to the penis, and recovery is fast. Various materials like Alloderm, Metridermis, and Terudermis are used. Materials that integrate well with surrounding tissues and maintain a natural shape long-term are preferred.
Enlargement alone does not change length. Combining it with lengthening surgery yields better results. This surgery releases the suspensory ligament and removes surrounding fat to bring the buried portion of the penis out, increasing length upon erection. The length gain varies by individual. When length is increased, the skin also needs to be expanded, which is achieved through simultaneous skin tissue surgery. The surgery is performed under local anesthesia and takes about 1 to 1.5 hours. Recovery is quick, daily life is not affected, and sexual intercourse is possible after three weeks.
Unlike the penile shaft, the glans has little subcutaneous space. Therefore, tissue cannot be inserted like in shaft enlargement. Instead, tissue is grafted along the border or injected in small amounts on the surface.
Glans injection enlargement is relatively simple, but the area increase is relatively less than shaft enlargement. After some time, a portion of the tissue may be absorbed, but re-operation is possible.
This involves inserting a silicone ring under the penile skin for girth. In the past, paraffin or Vaseline injections were used but caused severe side effects like skin necrosis. Medical-grade silicone rings are harmless and easy to remove if needed, but they only increase girth and do not affect length.
This surgery involves implanting an artificial device into the penis, allowing the patient to control erections at will. Sensation and ejaculation remain unchanged.
It is the most definitive cure for ED, safe, and has a low complication rate. Mechanical failure occurs in less than 3% of cases and can be fixed with a simple revision. The result looks natural, allowing public bath use and sports like hiking or golf without issues. The patient can create an erection whenever desired and return to a flaccid state at will.
Since the device can be used permanently, the choice of prosthesis should consider size, shape, presence of corpus cavernosum disease, mental health, ability to operate the device, age, economic status, and partner expectations. Consultation with a specialist is essential.
A bendable rod is implanted. It is bent down for concealment and straightened for use. It is a simple surgery under local anesthesia, allowing same-day discharge. It is inexpensive with few mechanical failures. However, the hardness is less than inflatable types, and since the penis does not thicken, it may look smaller than a natural erection. Also, the penis remains in a semi-erect state, which can be noticeable in public baths. Recently, with better prostheses available, this method is used only in special cases.
Contains a reservoir, cylinder, and pump within one unit.
Surgery is simple, performed under local anesthesia, and allows same-day discharge.
Pressing the pump behind the glans causes erection; bending the penis 90 degrees for 10 seconds drains the fluid back, causing flaccidity. Although satisfaction is higher than the malleable type, it is less popular now due to lower satisfaction in erection and flaccidity compared to the 3-piece type.
Introduced by Dr. Scott in 1973.
It consists of cylinders in the penis, a pump in the scrotum, and a reservoir in the lower abdomen.
Pressing the scrotal pump moves fluid to the cylinders for an erection. Pressing the release valve returns fluid to the reservoir. This type most closely mimics a natural erection and is the standard, used in about 90% of surgeries. It offers high satisfaction (95%) in terms of girth, hardness, and natural appearance.
Restores function by increasing blood flow to the corpus cavernosum via nitric oxide interaction.
Viagra helps speed up the response to sexual stimulation and prolongs its duration.
It is effective and generally safe, with no reports of death, myocardial infarction, or stroke directly attributed to it.
Injection of vasodilators directly into the corpus cavernosum using a fine needle. An erection begins about 3 minutes after injection and lasts 1-2 hours.
Suitable for almost all types of ED (vascular, diabetic, neurogenic, psychogenic, or post-surgical).
- Treatment Candidates
Any man who achieves an erection after a test injection can be a candidate.
Examples: Mild to moderate vascular ED;
ED from adult diseases like diabetes or hypertension, or nervous system abnormalities;
Drug-induced ED;
Adjunct treatment for psychogenic ED;
ED after major surgeries (prostate, rectal cancer, bladder surgery, etc.).
It is a common dysfunction affecting over 40% of adult men. It is defined as ejaculation occurring within 2-3 minutes or less than 5 minutes of penetration, or the inability to control ejaculation, causing dissatisfaction for the partner. Unlike ED, it affects men of all ages. It can cause significant distress and embarrassment. While there is no strict time definition, ejaculation before satisfying the partner (usually within 2-5 minutes) is often considered PE. In the past, it was thought to be purely psychological, but recent studies show that experience alone doesn't solve it. Treatment should be tailored to the individual's cause.
Classified generally into two types based on onset and cause.
Classified into three types:
Primary (Lifelong): Present from the first sexual encounter.
Secondary (Acquired): Develops suddenly after a period of normal function.
Mixed: A combination of both.
Primary PE is often seen in perfectionists or those with mental health issues. Secondary PE may be caused by depression or anxiety. Mixed PE varies with partners or environments.
Some patients have hypersensitive glans. Cutting selected branches of the dorsal nerve reduces sensitivity, prolonging ejaculation latency. The dorsal nerve transmits tactile sensation from the glans. By severing some of the many nerve branches, sensitivity is reduced.
Originally for enlargement, this procedure also delays ejaculation in about 30% of patients by dampening sensation, providing a dual benefit of enlargement and premature ejaculation treatment. It often boosts confidence, which also helps psychologically.
