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日帰り陰茎プロステーシス手術

What is Penile Prosthesis Surgery?

Penile prosthesis surgery is a procedure in which a simple, bendable (non-inflatable) prosthesis (implant) is implanted into the corpus cavernosum of the penis. Clinical data has proven that this is a safe surgery with low risk of complications and minimal discomfort.
After implantation, it is possible to maintain sufficient hardness for sexual intercourse by moving the position of the implant at the time when you want to have an erection. We will explain the details at the time of consultation.

Since our penile prosthesis surgery can be performed as a one-day procedure, some patients come from far away like the Kanto area to have the surgery. Also, since there are no age restrictions, we have had patients in their late 80’s who have undergone the surgery and have regular and satisfactory sexual intercourse.

In addition, some patients may be concerned about the thinness of the penis in this surgery compared to other surgeries. In such cases, we can use erectile dysfunction (ED) medications or implant additional prosthesis to reinforce the outside of the penile corpus cavernosum to make the penis thicker.

Types of Erectile Dysfunction (ED) treatment

ED treatment includes: ED medications, negative pressure erection aids (vacuum devices), penile corpus cavernosum injections of prostaglandin E1 (see note), male hormone replacement therapy, penile prosthesis surgery, and vascular surgery.

Penile prosthesis surgery is the last treatment for ED, so there is no going back if you want to try a negative pressure erection aid or penile corpus cavernosum injection. It should be done after careful consideration.

Advantages and Disadvantages of One-Day Penile Prosthesis Surgery

The advantages are that it allows for a natural flow of sexual activity, does not interfere with ejaculation or orgasm, and allows for satisfactory sexual intercourse almost 100% of the time.
The procedure is performed under local anesthesia and is relatively easy, taking only about one hour. In terms of cost, the running cost is lower than that of using ED drugs or penile corpus cavernosum injections for many years.

Although MRI is not a problem, cystoscopy may be an obstacle. Other disadvantages are that the one-time cost is high, and the procedure is prone to infection and may require revision surgery, such as removal if infection occurs. The risk of infection is particularly high in patients with uncontrolled diabetes.

The technique developed by our physicians has been successful in reducing the risk of infection and achieving good results even in patients with uncontrolled diabetes. Since complications and problems are common with this procedure, it is important to choose a doctor with experience and good treatment results.

Types of Prosthesis

Non-inflatable type Inflatable type

 

This penile prosthesis procedure is usually implanted within the penile corpus cavernosum, the place where blood fills in a normal erection.
There are two types of penile prosthesis: one is the inflatable type, which is pumped by water transfer. The other is a non-inflatable type that is rod-shaped and bendable.

The inflatable type requires hospitalization and general anesthesia. Materials are expensive, and when combined with the cost of the surgery, it is enough to purchase a car.

The inflatable type requires hospitalization and general anesthesia. Materials are expensive, and when combined with the cost of the surgery, it is enough to purchase a car.

In both cases, if the surgery is successful, sexual intercourse is possible almost 100% of the time, but in case of infection, it may be necessary to remove the infected material.

These materials are not approved in Japan, and the doctor will import FDA-approved materials from the United States.

Steps to Surgery

Medical Examination Interview and Penile Spongiosa Injection Test
*We do not recommend forced surgery, so we will test all possibilities first.
If the penile corpus cavernosum injections are not effective, we will give you a detailed explanation of the surgical procedure.
If the penile corpus cavernosum injections are not effective, we will give you a detailed explanation of the surgical procedure.

Preoperative examination Blood test for infection
*Diabetes test if necessary

Surgery Appointment
*Surgery may not be performed depending on the HbA1c (hemoglobin A1c) level.

Surgery Procedure

The following is the flow of penile prosthesis surgery.

Before surgery

Shave the day before or the morning of the surgery. Please shave clean with an electric shaver.

Meals 
Please eat at least 3 hours before your appointment.

Arriving at the Clinic
Please come to the hospital at the time of your appointment.

Explanation
We will explain in detail about postoperative precautions.

During the surgery

The surgery will take about one hour. The patient will be under local anesthesia and will be able to relax while having a pleasant conversation with the doctor.

After the Surgery

The next day, you can take a shower.
10 days later Bathing and drinking are allowed.
1 month later Masturbation
2 months later Sexual intercourse

Cost

The Surgery is performed at your own expense. The cost varies depending on the day and time of the surgery.
In order to thicken the penis and improve the instability of the glans,we recommend the implantation of an additional prosthesis for penile augmentation on the outer surface of the penile corpus cavernosum.

Surgery fee 550,000 yen
Material cost 350,000 yen
Additional transplantation of penile prosthesis for penis reinforcement (to stabilize the glans and make the penis thicker) 220,000 yen (for the same day)
330,000 yen (in case of another day)
Anesthesia fee 22,000 yen
Additional fee for weekends and holidays 22,000 yen (every 1.5 hours)
Additional fee for after-hours (after 5:00 p.m.) 55,000 yen (every 1.5 hours)
Medical certificate US$200/page

Complications and Risks

Complications and risks of surgery include the need for revision surgery due to infection, erosion, and instrument failure. The risk of infection is particularly high in cases of poorly controlled diabetes.

Choosing a reliable doctor is important.

Once penile prosthesis surgery is performed, there are no other treatment options afterward.
Postoperative problems are common, and it is necessary to have the surgery performed by a doctor with a proper facility and proven results.
The penile prosthesis used in our clinic is a non-inflatable type. More than 90% of our patients are satisfied without infection, prolapse, or persistent pain.
Our doctors have already performed this procedure on more than 200 patients and have never experienced any problems or complications.

Frequently Asked Questions

  • Is the surgery cost covered by insurance?

    No. The surgery is performed at your own expense.

  • Is it possible to have a natural erection?

    Yes, it is possible. It is possible to have an erection and almost 100% of patients have satisfactory sexual intercourse.

  • What is the difference from other treatments such as injections?

    The difference is that there are no needles or aspiration, so there is no pain. It also allows the patient to have an erection whenever he/she wants, to sustain an erection for as long as he/she wants, and to have natural sexual intercourse without disrupting the mood. This surgery has a very high patient satisfaction rate.

  • What is penile prosthesis?

    Penile prosthesis is the last resort in erectile dysfunction treatment when all other treatments are ineffective. It is a procedure in which an artificial prosthesis is inserted into the corpus cavernosum of the penis, where blood is stored during erection. There are two types of prostheses: a bending and extending rod type and a pump that moves water type. The bending and stretching type of rod can be done as a day surgery with local anesthesia.

  • Who undergoes penile prosthesis?

    It is an option when other erectile dysfunction (ED) treatments such as ED medications, cavernosal injections, and erection aids are not available or effective. Surgery may also be considered for patients with diabetes, arteriosclerosis, those who have undergone surgery for rectal or prostate cancer, ED associated with penile sclerosis (Peyronie’s disease), and venous ED.

  • If I have surgery, will I be able to get an erection naturally?

    After surgery, it is possible to get an erection when you want one. The hardness is sufficient for sexual intercourse. It does not interfere with ejaculation or orgasm because you can have sexual intercourse naturally without disturbing the mood.

  • It sounds like a day surgery, but how long does it take?

    The day surgery for penile prosthesis at Ginza Repro Surgery takes about one hour. It is performed under local anesthesia and does not require hospitalization.

  • What is the cost of one-day penile prosthesis surgery?

    Insurance does not cover the procedure and is at your own expense. The cost of the surgery, materials, and anesthesia is about 900,000 yen. Additional costs will be incurred if additional penile augmentation prosthesis is implanted or if the surgery is performed after hours.

  • What are the advantages of one-day penile prosthesis surgery?

    It is a highly satisfying procedure that allows you to have an erection at any time you want without disrupting the mood and without any obstacles to orgasm.

  • Are there any disadvantages to day case penile prosthesis surgery?

    It does not allow blood to enter the penis and cause an erection as a result it is cold, thin (reinforced prosthesis insertion can be used as a countermeasure), and 0.5 cm penile shortening. There is a risk of infection, and if infection occurs, re-operation is required. It may also impair cystoscopy but MRI is not affected.

この記事の執筆医師

永尾 光一 先生

永尾 光一 先生

東邦大学 医学部教授(泌尿器科学講座)
東邦大学医療センター大森病院 リプロダクションセンター
東邦大学医療センター大森病院 尿路再建(泌尿器科・形成外科)センター長

昭和大学にて形成外科学を8年間専攻。その後、東邦大学で泌尿器科学を専攻し、形成外科・泌尿器科両方の診療科部長を経験する(2つの基本領域専門医を取得)。得意分野はマイクロサージャリーをはじめとする生殖医学領域の形成外科的手術。泌尿器科医の枠を超えた細やかな手術手技と丁寧な診察で、様々な悩みを抱える患者さんから高い信頼と評価を得ている。

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