In a recent interview with Interviewing Experts Blog, Dr. Paul E. Perito spoke candidly about the embarrassing side effects of erectile dysfunction and how penile implants can help.
Interviewing Experts: What type of procedure do you use when you perform a penile implant?
Dr. Paul E. Perito: The implant procedure that I have created is slightly different from ones done in the past. It’s an approach through the area just above the penis called the infrapubic area. And we call it the minimally invasive penile prosthesis, because in 10 min. the entire device can be put inside the body.
Interviewing Experts: So you can’t see anything?
Dr. Paul E. Perito: The entire implant is hidden inside the penis and scrotum. There are the cylinders that fill with saline. The pump goes inside of the scrotum. There’s a third part that I never describe because it’s inconsequential to patient, but that’s the reservoir that allows fluid to go out to the cylinders.
Interviewing Experts: So what does the implant do?
Dr. Paul E. Perito: It re-creates exactly what the patient used to have. Before, when he wanted to have sex, blood would fill the cylinders of the penis, called the corpora cavernosa. In this case saline fills the cylinders. When you want to have sex you pump the pump that is in the scrotum and it fills the cylinders.
Interviewing Experts: So it looks like a natural erection?
Dr. Paul E. Perito: These implants are the most physiologic replication of an erection. When you are done, there is a deflate mechanism and you squeeze and it allows all the fluid to go back into the reservoir.
Interviewing Experts: What does impotence do to the body; specifically to the penis?
Dr. Paul E. Perito: The one thing that you need to know is that the longer you remain impotent without treating yourself, the shorter the penis becomes. And there’s been excellent papers written where we render a guy impotent in a single day with a radical prostatectomy. You take his prostate out and he is rendered impotent in one day and then we follow his penis length in a process called the penile stretch test. A patient can lose anywhere from .5 to 5 cm every 14 months, that is one of the most reliable papers that I’ve seen.
Interviewing Experts: That is a significant loss in length.
Dr. Paul E. Perito: Yes it is. When I take patient measurements at the initial penile stretch test and I will tell them, “this is what you’ve got.” Then I’ll push their penis up against the pubic bone and I will tell them, “If you wait another year, this is where you will be.”
Interviewing Experts: Is there way to stop the diminishing effects of erectile dysfunction?
Dr. Paul E. Perito: Truly you need to initiate some form of therapy if you are concerned about penile length as soon as erectile dysfunction occurs.
Interviewing Experts: Now are the implants one-size-fits-all?
Dr. Paul E. Perito: No they are not. They can vary considerably in size.
Interviewing Experts: So once you measure the length that is how you decide what size of implant to use?
Dr. Paul E. Perito: Intra-operatively, we measure the length with a device called a Furlow. And with every guy you give them back exactly what they have at that moment.
Interviewing Experts: Will all men retain the same length?
Dr. Paul E. Perito: I just wrote a paper that showed that 75% of men will have the same length postoperatively as they did prior to the procedure. So there is a predictive index that we can utilize.
Interviewing Experts: And this is sometimes covered by insurance?
Dr. Paul E. Perito: Medicare pays for penile implant because the penis is a functioning organ. Studies have shown that ongoing intimacy does indeed lead to a longer, healthier life. Medicare pays for it, private insurance pays for it, and some HMOs pay for it. Often times it depends upon the cause of the impotence.
Interviewing Experts: Very informative, thank you very much.
Dr. Paul E. Perito: You are welcome.
Dr. Paul E. Perito graduated the University Of Maryland School Of Medicine in 1988. His Coral Gables, Florida, urology center, Perito Urology, draws patients from around the globe for its innovative and updated Erectile Dysfunction treatments. Having successfully performed over 3,000 penile implants since 2005, Dr. Paul E. Perito is considered a leader in the field. His signature minimally invasive technique, The Perito Approach, has been taught to surgeons worldwide through travel and at Coral Gables Hospital, where he is Director of Urology. Dr. Paul E Perito is has participated in countless medical studies in his quest to simplify the penile implant process and make the procedure safer for his patients.
The information contained in this article is provided by Dr. Paul E. Perito for educational purposes only. It is not intended to treat or diagnose any condition.