Erectile dysfunction is not necessarily a consequence of age. It can, however, be the result of age-related physical disorders that cause narrowing of blood vessels in the penis. A penile implant is often a good option for men who have already made changes to their lifestyle and diet, considered psychosomatic causes, and tried medications such as Viagra or Cialis. Dr. Perito offers penile implants that can restore full sexual function to men of any age. The penile implant surgery is safe, effective, and discreet and can stop ED in its tracks before it has a further negative impact upon a man’s quality of life. Penile implants and penile implant surgery should be viewed as the last resort for restoring sexual function. It should only be considered when completely noninvasive options have all been exhausted with negative results. That being said, penile implants are extremely safe and effective and have very low failure rate. Dr. Perito’s minimally invasive penile implant surgery offers an expedient recovery and full restoration of sexual function, even if the patient has had ED for many years.

The fact of the matter is that most men experience at least temporary erectile dysfunction at some point in their adult life. The condition only becomes a problem when it begins to affect relationships or the self-esteem of the man with the condition. A healthy lifestyle, which includes avoiding tobacco and maintaining a healthy weight, may help minimize the instances of erectile dysfunction. Penile implants only come into play when the condition is chronic and pharmaceutical intervention is no longer sufficient.

An individual considering penile implant surgery should maintain an open line of communication with his primary care physician. Having an open and honest dialogue about symptoms – even if they do not seem related – may help to pinpoint the cause of the erectile dysfunction. The doctor will need to know specific medications, supplements and vitamins, as well as any herbal remedies that the patient may be using. It’s helpful to take along a spouse or partner to these early doctor appointments as they will have a unique perspective and may offer insight about the issue that the patient, himself, cannot.

Patients undergoing penile implant surgery should follow their pre- and postop patient instructions carefully, cautions Dr. Perito. This will help to ensure an expedient recovery and a quicker return to a normal sexual function. Read on to find answers to frequently asked questions about penile implant surgery.

ARE THERE ANY OVER THE COUNTER DRUGS THAT SHOULD NOT BE TAKEN BEFORE SURGERY?
Patients should abstain from taking aspirin for one week (7 days) prior to a penile implant procedure, says Dr. Perito.

HOW IS THE OPERATIVE AREA STERILIZED?
Perito Urology patients are given an antibiotic as well as a container of surgical soap that needs to be used beginning one day prior to surgery.

CAN I EAT PRIOR TO MY PENILE IMPLANT PROCEDURE?
No, patients are advised not to consume any food or drink after midnight the night before the penile implant surgery. This includes water. Doing so may delay the procedure.

IS POSTOPERATIVE BRUISING NORMAL?
Yes, as is swelling. Both will generally resolve between seven and fourteen days.

WHAT ARE THE PHYSICAL RESTRICTIONS AFTER RECEIVING A PENILE IMPLANT?
Since penile implants are a surgically implanted device, care should be taken to avoid overexertion in the days and weeks following the procedure. The first 48 hours post-operatively should involve minimal activity and ice on the groin. Perito Urology patients are advised to lift no more than 10 pounds for two weeks. Showers may be taken on day two. The patient should begin hot shower direct soaks at 5 days (7 days if diabetic).

WHAT PAIN MEDICATIONS ARE RECOMMENDED FOLLOWING PENILE IMPLANT SURGERY?
Aleve® is recommended for up to two weeks. Pain medications may cause constipation, which will put pressure on the area and should be taken only to provide comfort.

AFTER THE PENILE IMPLANT IS IN PLACE, WHAT HAPPENS TO THE STITCHES AND BANDAGES?
Dr. Perito uses stitches to close the incision that are absorbable and require no patient action. There are small strips that cover the incision. These will likely fall off unnoticed in the shower. Additional bandages require removal.

WHAT POSITION SHOULD THE PENIS REST AFTER SURGERY? ?
For the first three days, the penis should be kept against the abdomen using the scrotal support tape that is supplied. After 72 hours, all penile implant patients should gently pull down on the penis several times a day while massaging the incision.

WHEN CAN THE PENILE IMPLANTS BE USED?
By 4 to 6 weeks most of Dr. Perito’s patients report that a normal an active sex life has been resumed.

There are two basic types of penile implant: malleable and inflatable. According to Dr. Paul Perito, each has its benefits; it is up to the individual undergoing the penile implant surgery to choose which one is best for him. The inflatable implant is a device that allows the penis to rest in a natural state when not in use, whereas the malleable implant effectively offers a permanent erection that is manually positioned for sexual intercourse. The two devices are controlled differently, but both offer the same outcome – a functional sex life.

Dr. Perito utilizes Coloplast penile implants. The Titan OTR (one touch release) is a three-piece inflatable penile prosthesis. This device is comprised of a biopolymer material and filled with a sterile saline solution. The implant works by pumping the solution from a reservoir into two separate chambers that are located inside of the shaft of the penis. The pump mechanism is located in the scrotum and can be operated with one hand for ease of use, and also features a lockout mechanism which prevents unintentional inflation. This device is Dr. Perito’s implant of choice for his minimally invasive penile implant surgery. The Titan OTR shows significant improvement over previous, similar penile prosthesis designs and offers a controlled girth and a natural looking rigidity.

The Genesis is Coloplast’s flexible (malleable) implant. The Genesis penile implant consists of 2 rods that are surgically implanted into the penile chambers. The penis remains firm at all times and the patient simply needs to position the penis manually for intercourse. When an erection is not needed, the patient must return the penis to its original, resting position. This penile implant may be positioned by either the patient or his partner.

Both penile implants have withstood the test of time and offer the patient favorable results. It is a completely personal decision as to which device is chosen for the patient’s penile implant surgery. The pros and cons of each will be explained prior to scheduling the surgery. Historically, penile implants have a failure rate of 5% or less and both devices offer a lifetime warranty. Dr. Perito suggests careful research and numerous candid conversations between the patient and his partner as to which device fits into their lifestyle the best.

Dr. Paul Perito is the actuator of the minimally invasive penile implant surgery, The Perito Approach. To date, he has performed over 4000 penile implant procedures and has trained physicians across the globe. Dr. Perito offers a one-day training course on this revolutionary technique at Coral Gables Hospital near Miami, Florida. Participants are witness to the minimally invasive penile implant procedure, which utilizes an infrapubic incision of 1.5 cm and offers the patient an expedient recovery time and streamlines the steps the physician must make for surgical completion.

While penile implants have been popular among men with erectile dysfunction for nearly 30 years, Dr. Perito has made the procedure faster and safer, with a shorter recovery time than traditional scrotal incision methods. In this training, Dr. Perito’s focus is to help physicians conserve time and motion during the penile implant procedure, offering less time “on the table” for patients. Additionally, since there are fewer steps, there is a less chance of surgical error and infection.

The day before surgery, participants will arrive in Miami for dinner with Dr. Perito. The following morning physicians meet at Coral Gables Hospital to observe up to 10 cases. With proper paperwork and patient availability, surgeons may have the opportunity to scrub in with Dr. Perito while he performs the penile implants. A recap of the presentation is provided over lunch. Surgeons are encouraged to participate in an open discussion with Dr. Perito about his penile implant surgery technique.

The procedure is generally performed in less than 15 min. and can completely restore a patient’s sexual function. Dr. Perito holds great respect for the sexual medicine pioneers who performed and perfected the first penile surgeries in the 1970s. However, he feels that his method for installing penile implants is superior for its expedient recovery time and strong history of successful outcome.

Dr. Perito’s training program is supported by the Coloplast Corporation, makers of the Titan OTR inflatable penile implant.