Bonus Episode: Use It Or Lose It: How An Inflatable Penile Prosthesis Can Stop Penile Shrinkage and Increase Satisfaction

In this segment, Dr. Mistry and Donna Lee answer a listener's question about problems with his existing penile prosthesis. This listener writes, "I had a penile implant put in several years ago and it actually made my penis smaller. When I pump it up, one of the implants in my shaft I'm concerned is going to break the skin or cause pressure problems, which are huge for me because I'm a paraplegic...Can another implant be placed and increase the size of my penis, and how can I fix the problem of too much pressure?" The penile prosthesis is an inflatable silicon device implanted internally and completely concealed. The device is inflated using a pump implanted into the scrotum which, when activated, transfers fluid from a reservoir in your abdomen into the silicon cylinders in your penis to add both length and girth to your erection.  The inflated implant produces a rigid and satisfying erection, yet appears natural and soft when not in use. Dr. Mistry explains that the penile prosthesis is an excellent option for addressing a variety of patient concerns from end stage ED to nerve damage from diabetes or neurologic issues. Importantly, he points out that long-term ED actually diminishes the length of the penis over time, so the penile implant can actually help those struggling to achieve erections--no matter the reason--to maintain their size. At NAU Urology Specialists, our surgical team can expertly place this device and help address any issues that may have arisen with older implants. In answer to this listener, Dr. Mistry says that yes, pressure ulcers can become a concern if the implant shifts and that yes, this is fixable! If you or someone you love would like to learn more about the inflatable penile prosthesis or have their prosthesis checked, please give us a call today! 

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Episode Transcript

Speaker 1 (00:00):


Speaker 2 (00:09):
Welcome back to the Armor Men's Health Hour with
Dr. Mystery and Donna Lee.

Speaker 3 (00:17):
Hello and welcome to the Armor Men's Health Hour.
I'm Dr. Mr , your host here, asalways, with my ever
resourceful , probablymore popular than me co-host
Donna Lee. That's

Speaker 4 (00:26):
Right. We set this show up anywhere in town,
especially in the K L B Jstudios. , I don't do
this alone.

Speaker 3 (00:33):
I'm a board certified urologist. This is a
men's health show. The show isbrought to you by the urology
practice that I started in2007. We are now called N A U
Urology Specialists, althoughwe've had a few names.

Speaker 4 (00:44):
We have had a few names. And n a U just sounds
like now,

Speaker 3 (00:47):
Now

Speaker 4 (00:48):
Butted North Austin Urology,

Speaker 3 (00:49):
Because we wanna see you now . And so the
show , uh, is really here toaddress a lot of those health
concerns that men might havethat they don't feel
comfortable bringing up withtheir spouses or friends or
their own doctors. We know it'son your mind, and we love to
share kind of our treatmentapproach. Our practice has four
offices. We have fourphysicians. We have five

(01:12):
physician assistants and a sextherapist. We do a sleep
medicine testing because weknow that sleep apnea has a big
impact on a number of medicalconditions, including
hypertension and lowtestosterone. And if you want a
more holistic approach to yourmen's health , uh, we're here
to give it to you. That's

Speaker 4 (01:26):
Right. You know, I hear my, my husband's snoring
more again. We need to get himback in. Pretty sure he has
sleep apnea.

Speaker 3 (01:31):
Yeah. Maybe when he's doing these two burger,
two martini lunches, we need toget 'em down to one burger,

Speaker 4 (01:36):
One burger , one martini,

Speaker 3 (01:37):
One Mar One Burger.
One Martin.

Speaker 4 (01:38):
That's , that is called in our house a diet.
That's right . So Correct .

Speaker 3 (01:41):
That's called , there's really no more
effective strategy that we'veseen than weight loss when it
comes to improving your sleephygiene. When you sleep better,
your stress levels go down,your cholesterol levels go
down, you're nicer . S spermcounts go up.

Speaker 4 (01:52):
You're nicer to people in general. I wouldn't
know that before . It's awin-win. I love sleep .
I fell asleep right now.

Speaker 3 (01:58):
Donna, how do people get ahold of us? How do people
get make an appointment.

Speaker 4 (02:01):
You can call us at [phone] to reach out to
us. You can ask for me if you'dlike. Our , a website is armor
men's health.com and our emailaddress is, would you like to
sing it with me? Arm [e-mail] . Com. Com
Okay. , we have someawesome questions, by the way.

Speaker 3 (02:18):
Uh, your questions are what keeps the show going.
We want you to never feel likea question is too silly, or
even if we've gone over thesubject material before , uh,
we do this show on the radio,even though it's available by
podcast form, it allows us togo over the same topic over and
over again every few weeks,just in case you're catching us
kind of in the car. Now thateverybody's driving around
taking their kids to sportsagain, we hope to get , uh,

(02:39):
even more listeners. Right.

Speaker 4 (02:40):
I have a quick funny story. We had a patient who
listens. He wa he wasn't inTexas, but he wanted to know
how to use the, the penilering. And so he copied the
podcast link. Yes. And he sentit to us through his inquiry on
our website. And it was thepodcast about how to use the
penile link , uh, ring. Yes.
And then he asked, how do I usethe penile ring? So I was very
confused by the whole thing,but I said, listen to the

(03:01):
podcast again.

Speaker 3 (03:02):
. And the podcast is a , is a plethora of
information. So we it was, itwas a good one. We, we
encourage you to , uh, searchfor your favorite men's health
topic.

Speaker 4 (03:09):
That's right. Just search the armor Men's health
hour and whatever topic you'dlike. But here , you ready for
this one? I'm ready

Speaker 3 (03:14):
For a

Speaker 4 (03:14):
Question. This is a good one. I had a penile
implant put in several yearsago, and it actually made my
penis smaller. When I pump itup, one of the implants in my
shaft, I'm concerned is goingto break the skin or cause
pressure problems, which arehuge for me because I'm a
paraplegic. My question is, canI , can another implant be
placed and increase the size ofmy penis? And how can I fix the

(03:35):
problem of too much pressureand causing concerns? Those

Speaker 3 (03:38):
Are some great questions. Um , fully

Speaker 4 (03:40):
Loaded questions.

Speaker 3 (03:41):
So let , let's fully first talk about what a penile
implant is. When is itappropriate for you and how you
can come get one ? Thepenile implant, the most
traditional one is aninflatable silicone device
completely internallyimplanted. So people sometimes
ask about that. Nothing isexternal and nobody can tell
except

Speaker 4 (03:58):
For that third ball.

Speaker 3 (03:59):
There is a third ball. So if she gets close
enough, then you're both luckyand you have a third ball
. So , uh, there's a,there's a pump mechanism that's
in the scrotum that will thentransfer fluid that's in a
reservoir placed in yourabdomen to silicone cylinders
mm-hmm . in yourpenis and give you more girth
as well as more length , uh, toyour erection. The benefit of

(04:19):
that is that it is soft andlooks normal when it's
inactivated and is rigid andgives you great sexual pleasure
when it's activated.

Speaker 4 (04:28):
But there's an implant. So if it's soft, is it
the size of the implant that'sbigger than your natural penis?

Speaker 3 (04:34):
It is never gonna be bigger than your stretch
length. Okay . So you can't,you can't overstretch just
whatever you have. So if , ifyou're looking for something
longer, that's a differentlecture. But when it comes to
what can a penile implant do,it can make your normal
stretched penile length, youknow, fully girthy. The good
news is for most men, thelength is going to be perfectly

(04:55):
adequate for you to have funand for her to have fun. And so
it's not going to affect yoursexual performance in most
cases. Now, this is amechanical device, and although
it can malfunction or haveissues with placement mm-hmm .
, for the mostpart, satisfaction rates are
over 90%. Mm-hmm. , it's covered by many, both
commercial and medicalinsurances. Because, because of

(05:16):
why?

Speaker 4 (05:16):
Because white men make the decisions in Congress.

Speaker 3 (05:19):
White men, I don't know about color. .

Speaker 4 (05:22):
Powerful men make decisions in

Speaker 3 (05:24):
Congress. Powerful men with erectile dysfunction
make decisions about wheremoney goes.

Speaker 4 (05:28):
Yeah . Of any color or creed, so, okay.

Speaker 3 (05:31):
Correct. And the penile implant is something
that they wanted to make suregot covered by Medicare.

Speaker 4 (05:34):
Do you think they'd want the breast augmentation
done as well? , but no,not , not lucky ladies. They're

Speaker 3 (05:39):
Just , they're just gonna tip their wives off, but
they're like something . So , uh, the penile implant
is covered as well as repairs,the penile implant. And this
particular listener, it is thecase that patients with spinal
cord injury, patients who are ,um, maybe diabetic people who
have limited neurologicfunction will often get a penal
implant because it , uh, givesthem a more certain erection.

(06:01):
So in the paraplegic man, wehave to worry about fertility
mm-hmm . ,because oftentimes they can't.
And we see a lot of thosepatients and erections. And
interestingly enough, those menoften get penal implants, not
just to have sex, but alsobecause when you're sitting in
the chair all the time mm-hmm .
, the penis canretract inside the body. Oh .
And so if you're trying to grabit to pee or you're trying to

(06:22):
catheterize through it to emptyyour bladder, it's nice to have
a handle. So a lot of thosepatients never thought about
that will get a , will get apenile implant so that they can
have better, so that,especially if they have limited
hand dexterity mm-hmm .
, let's say theirspinal cord injuries in their
neck, their hands may not moveas perfectly. So it's nice to
be able to have that addedhandle. Okay . But if you have
a penile implant and your penisis getting shorter, you have to

(06:44):
think about what is the, whatis the underlying condition
that led to the problem. So ifyou've had a radical
prostatectomy or you're adiabetic, these organs can
shrink just from that. Then ofcourse, there's you getting
bigger and fatter. So if you'regetting fatter, then your , the
fat pad that goes on top ofyour penis will get bigger. And
that will also make it appearlike your penis is shrinking.

Speaker 4 (07:04):
That's not just paraplegic

Speaker 3 (07:06):
Patients , that's for everyone . That's for
everyone.

Speaker 4 (07:07):
Okay.

Speaker 3 (07:07):
And if you're not using the pen L implant, then
things are going to getshorter. And so, so men who get
erections regularly maintaintheir penile length . So that's
why patients who we know aregonna have erectile dysfunction
for a prolonged period of time,like our radical prostatectomy
patients or, and if you have ,if you're on dialysis out
there, oftentimes you'll havesevere erectile dysfunction.

(07:28):
Mm-hmm. , we havethem use the vacuum erection
device because it kind ofcycles blood through the penis
and keeps the penis nice andlong. And so if you're not
using it, you're gonna lose it.

Speaker 4 (07:38):
Oh, that phrase Yes . You don't use it, you're
gonna lose it.

Speaker 3 (07:41):
That's right. So tell Michael, nothing he's
doing is wrong . It's working.
You know what I'm saying? Likehe can ask, maybe refuse, but
he can ask, he can ask, he canask quite often. And then the
last part of the listener'squestion was about pressure
ulcers. And so , um, the , um,we like to think of aspects of
the body as being real solid.
You know, like our bones arereal stiff and our tissues are

(08:02):
real solid. Mm-hmm.
. But the truthis that if you put a foreign
body in almost any of ourstructures mm-hmm .
over time, eventhose we're real solid, that ,
that those solid structures canerode and get real weak. So
hernias are an example of whathappens in men or women as they
get older. Oh . Certain,certain areas that are weaker

(08:23):
and are , you know, organs thatare not supposed to protrude
can protrude, but with thepenile prosthesis in
particular, you can havemigration or movement of the ,
um, the actual structure , uh,in and , and if , if you feel
like your cylinders are rightunder the skin, then you should
definitely see a urologist. Andthe answer to your question is

(08:43):
we absolutely can fix it. Wecan put what's called a
gore-tex patch or a patch overthe , the area that's weak.
Mm-hmm. like,like a hernia repair almost.
Hmm . And reinsert the , um,uh, the cylinders. Do you have

Speaker 4 (08:55):
To replace the cylinders with new ones or you
just

Speaker 3 (08:57):
Use while you're in there? You might as well throw
some new ones in there, youknow? Right . No reason to put
old tires on a brand new car.
. Um, and as luck wouldhave it, we have a fellowship
trained mm-hmm . prosthetic surgeon. Right. In
our practice we do, Dr.
Christopher Yang spent anentire year doing nothing but
fixing these things. Can youimagine? Right . In Florida,
changing tires for a wholeyear. That sounds from some of

(09:19):
the experts in the world. And ,uh, if you have,

Speaker 4 (09:21):
To me, that sounds exhausting,

Speaker 3 (09:22):
But good if you have a malfunctioning penile
prosthesis or you want a newone that gets put in by an
expert Dr. Christopher Yang ,uh, in our practices,
exceptional at them. Uh, we putthem in for not only erectile
dysfunction, but also severePeyronie's disease if you have
spinal cord injury and wouldlike a better solution to your
erections. Uh , we not onlyhave the penile prosthesis, but
we also have other amazingthings that we do. Um , penile

(09:45):
vibratory , uh, stimulation.
Mm-hmm . , wehave , uh, use of pills, we
have injections. Um, you know,I , I kind of joke to men, if ,
if , if , you know, if you havethe will, we have a way
to get you a bone . It's true .
And so , Donna, how do peopleget ahold of us? You

Speaker 4 (10:02):
Can call us during the week at 5 1 2 2 3 8 0 7 6
2. And you can check out ourwebsite where you can see Dr .
Mystery Smiling handsome atarmor men's health.com. Check
out our podcast wherever youlisten to free podcasts that
are available to you all thetime. And thank you, Dr. Misery
free, Brittany .

Speaker 2 (10:19):
The Armor Men's Health Hour will be right back.
If you have questions for Dr.
Mystery , email him at Armormen's [e-mail].