The Ultimate Guide to Penile Implants for Trans Men.
If you are a trans man interested in phalloplasty, you most likely wonder which penile implant is right for you.
It can be challenging to decide which option is the best option for you, and the information on the internet is often scarce.
Additionally, each doctor has their own opinion on which implant is best, making the decision-making process all that much more complicated. Heck, picking a trans surgeon alone is complicated, and if you find yourself struggling, I recommend reading 11 Tips on How to Choose a Gender Affirming Surgeon!
As well know, penile implants, also known as penile prosthetics, are devices placed inside the penis to allow you to get an erection.
THE 3 TYPES OF PENILE IMPLANTS ARE:
The non-inflatable or semi-rigid implant.
The 2-piece inflatable implant.
The 3-piece inflatable implant.
BUT FIRST, LET’S LOOK AT WHAT DOES MEDICAL RESEARCH TELL US?
76 patients (58.9%) out of 129 still have their original implant in place as of the date of the study’s publication in February 2010, according to a long-term study of the outcome of neophallus after the implantation of an erectile inflatable prosthesis (Hoebeke et al. 2010)
Fifty-three patients (41.1%) out of 129 needed to undergo either removal or revision of the prosthesis due to infection, erosion, dysfunction, or leakage.
Despite high complication rates, the study authors concluded implantation of an inflatable erectile prosthesis remains the best option for achieving the possibility of sexual intercourse in FtM transgender (Hoebeke et al. 2010).
More than 80% of patients reported improved sexuality (De Cuypere et al. 2005).
Patients with penile prostheses were more able to attain their sexual expectations than those without prostheses, although the group with prostheses more often reported pain during intercourse (De Cuypere et al. 2005).
The study concluded that trans men reported masturbating significantly more and experiencing greater sexual satisfaction, more sexual excitement, and greater ease in reaching orgasm.
Now that you are familiar with the recent medical research let’s look at each implant in detail and consider each option's pros and cons.
#1 NON-INFLATABLE or SEMI-RIGID PENILE IMPLANT
Consists of one or two bendable rods inserted into the penis made of an outer coating of silicon and an inner stainless steel core of interlocking plastic joints.
It can be bent into different positions for erect and flaccid states.
Works simply by bending the penis into the erect position to achieve the look of an erection and by bending the penis down to end an erection.
Because non-inflatable implants are always firm, one should note that the look of a flaccid penis may appear as a semi-erection.
PROS
It can be conveniently used by individuals with manual dexterity issues
The most uncomplicated procedure to perform and is the least expansive
Less vulnerable to mechanical failure than inflatable implants and can last more than 20 years
CONS
The rigidity of erection is less
The downside of having a permanent semi-erection, which can feel and look awkward
Can be difficult to conceal even when beneath several layers of clothing
The two popular brands of semi-riding penile implants are Coloplast Genesis and AMS Spectra.
#2 TWO-PIECE INFLATABLE PENILE IMPLANT
Consists of a reservoir that holds salt water at the beginning of the cylinders (base of the penis), with the pump and release valve located in the scrotum.
Works by gently squeezing the concealed pump several times to move the saline solution from the reservoir into the cylinders.
As the cylinders fill, the penis becomes erect and firm.
To transfer fluid back into the reservoir to end the erection, one has to gently bend the penis down for 6 to 12 seconds.
PROS
Easy to use
Concealed in the body
More easily concealed under clothing
CONS
Likelihood of malfunctioning or developing leaks
The penis is not as rigid as a three-piece penile implant due to the smaller amount of fluid transferred into the cylinders.
The pump can be felt more in the scrotum by sexual partners compared to the softer pump of the 3-piece penile implant.
AMS Ambicor is a popular brand for a 2-piece inflatable penile implant.
#3 THREE-PIECE INFLATABLE PENILE IMPLANT
Consists of cylinders in the penis, the reservoir in the belly, and the pump and release valve in the scrotum.
To use, gently squeeze the concealed pump in the scrotum several times to move the saline solution from the reservoir into the cylinders.
To end the erection, press a “deflation site” on the pump, transferring the fluid back to the reservoir resulting in a flaccid penis.
PROS
Easy to use
Easier to inflate than a 2-piece device due to the larger, softer pump
Offers the best rigidity
Offers the best flaccidity when not in use
Totally concealed in the body
More easily concealed under the clothing
CONS
Highly vulnerable to leakage and dysfunction
Requires the user to have good skills for operating it
Most involved implant surgery and the most expensive out of the three options
It can last as little as three years before needing replacement
Highest complication rate
Popular brands of a 3-piece penile implant are AMS 700 Series and Coloplast Titan OTR and Titan.
Keep in mind limited research on post-op individuals makes it challenging to contemplate phalloplasty as part of one’s transition, not to mention deciding which penile implant to consider.
Combining a neo-urethra and penile prosthesis in a single neo-phallus remains challenging for medical professionals.
Of course, there is always the future. Animal studies have shown the potential implantation of tissue engineering for penile reconstruction, with bioengineered tissue being used for penile reconstruction in rabbits (Chen et al. 2010; Yoo et al. 1999).
Other options are the future use of tissue-engineered human cartilage rods as penile prostheses (Kim et al. 2002).
If you are considering phalloplasty, make sure to pick a skilled surgeon. And if you need help finding a good doctor, visit my gender resource page in the states I am licensed in to find a gender-affirming surgeon in California, Texas, New York, or Florida.
You may also find the following helpful:
Is There a Cancer-Risk Associated with Testosterone Therapy for Trans Men?
Thinking About Phalloplasty? Here is One of the Major Complications to Consider!
WATCH EXPERT VIDEOS ON GENDER DYSPHORIA
REFERENCES & SOURCES
Chen, K.L., Eberli, D., Yoo, J.J., & Atala, A. (2010). Bioengineered Corporal Tissue for Structural and Functional Restoration of the Penis. Proc. Natlk Acad. Sci. U.S.A. 107(8): 3346-3350.
De Cuypere, G., T’Sjoen, G. Beerten, R., Selvaggi, G., De Sutter P., Hoebeke, P., Monstrey, S., Vansteenwegen, A., & Rubens, R. (2005). Sexual and Physical Health after Sex Reassignment Surgery. Arch. Sex. Behav. 36(6): 679-690.
Hoebeke, P., Decaestecker, K., Beysens, M., Opdenakker, Y., Lumen, N., Monstrey, S. (2010). Erectile Implant in Female-to-Male Transsexuals: Our Experience in 129 Patients. European Urology. Volume 57, Issue 2, 334-341.
Kim, B.S., Yoo, J.J., & Atala, A. (2002). Engineering of Human Cartilage Rods: Potential Application for Penile Prosthesis. Journal of Urology. 168(4 Pt 2): 1794-1797.
http://www.trans-health.com/2013/penile-implants-guide/
http://www.aarp.org/home-family/sex-intimacy/info-12-2013/sex-erectoin-viagra-castleman.html