The surgical method accepted worldwide as the gold standard for advanced erectile dysfunction that does not respond to oral and injection therapies.
Erectile dysfunction (ED) has many causes — vascular disease, diabetes, nerve damage after prostate surgery, and psychological factors. Oral medications (PDE5 inhibitors), vacuum devices and intracavernosal injections are effective for the great majority of patients.
However, some patients — especially advanced diabetics, those who have had radical prostatectomy, and those with impaired vascular structure — do not respond to these treatments. In this case, the penile prosthesis is the clinically proven standard solution, performed over 530,000 times worldwide.
Assoc. Prof. Şenol Tonyalı performs penile prosthesis surgery in accordance with the guidelines of the European Association of Urology (EAU) and the American Urological Association (AUA).
There are two main prosthesis types. We decide together which one is suitable, based on age, manual dexterity, partner situation and expectations.
Consists of two flexible rods placed inside the penis. Bent up manually for intercourse and down for daily use. There is no hydraulic system; it is simple to use. Suitable for older patients and those with limited manual dexterity.
Consists of 3 parts: cylinders inside the penis, a pump in the scrotum, and a reservoir in the abdominal cavity. Filled by the pump, the system provides a natural-looking erection. When deflated after intercourse, the penis becomes completely soft. The highest patient and partner satisfaction is seen with this type. Applied with approved brands such as AMS 700 and Coloplast Titan.
The system consists of three parts: two cylinders in the penis, a pump in the scrotum, and a fluid reservoir in front of the bladder. When the pump is squeezed, fluid moves into the cylinders to provide rigidity.
A penile prosthesis is an irreversible decision; therefore, trying all previous treatments and a detailed discussion with the patient are essential.
History, physical examination, vascular assessment and analysis of psychological factors. Previous treatments and patient expectations are detailed.
The choice of a malleable or inflatable prosthesis is made together with the patient and partner. Brands, costs and features are explained.
Completed in 60–90 minutes through a hidden penoscrotal incision. A strict sterile protocol is applied. Tested at the end of surgery.
The use of the prosthesis is taught at weeks 3–4. Sexual activity is approved at week 6. Annual follow-up is planned.
There are two main prosthesis types: simple malleable rods, and the hidden 3-piece inflatable system that gives the most natural result.
Clinical results and patient satisfaction data shown in international studies.
No need for medication, injections or a vacuum. An erection is achieved at any desired moment for 10–15 years.
In international studies, patient satisfaction is over 90%. The same rate applies to partner satisfaction.
The prosthetic erection comes from a mechanical system. Sexual sensation and orgasm are fully preserved.
With the inflatable prosthesis, the penis looks natural when soft. A partner does not notice the prosthesis.
85% of patients prefer it over other ED treatments. The rate of those who would have it done again is 96%.
Positive effects on social life, couple relationships and self-confidence are reported after the procedure.
The cylinders are placed into the corpus cavernosum through a small incision between the penis and scrotum (penoscrotal). The scar is almost invisible.
The most frequently asked questions about the penile prosthesis, with honest answers at a scientific level.
Technically it can be removed, but it is strongly not recommended. When the prosthesis is removed, the corpus cavernosum tissue is damaged and natural erection does not return. Therefore the decision should be made very carefully, after first trying other treatments.
The prosthesis may trigger an alarm at metal detectors. A medical card from your doctor explains this. There is no problem at airport security.
No. The prosthesis only affects the erection mechanism of the penis. Sexual sensation, orgasm and ejaculation are fully preserved; these come from the nervous system, not the prosthesis.
In long-standing impotence, penile tissue may have shrunk. The prosthesis fills this tissue and gives a result close to the previous size. The prosthesis size is measured and selected during surgery.
The penile prosthesis may be covered by SGK for certain indications (organic ED, post-prostatectomy). We recommend getting in touch before your appointment for current coverage information.
All conversations are conducted within patient confidentiality. If desired, all communication can be done via WhatsApp only, without the knowledge of a partner or relatives.