Penile Implants: When They're Needed and Costs Involved

About penile prostheses?

What situations require the implantation of a penile prosthesis, and what are the costs involved? Is there insurance coverage for this procedure? I have tried medications like Viagra without success, and currently, I can only achieve an erection through local injections, which is quite inconvenient.
Am I a candidate for a penile prosthesis?

Xiao Xie, 40~49 year old female. Ask Date: 2004/10/05

Dr. Xu Weikai reply Urology

Hello, regarding your question, my opinion is as follows.
First, erectile dysfunction requires a specialized physician for differential diagnosis to determine the exact cause and to provide appropriate treatment.
Generally speaking, after evaluating sexual function, if pharmacological treatment is not feasible or is ineffective, the option of penile prosthesis implantation may be considered.
Since penile prosthesis implantation is an irreversible procedure, meaning that once implanted, the penile corpora will be compromised, careful evaluation is necessary.
Some hospitals may even require patients to undergo psychological assessment.
As for medical expenses, current health insurance does not cover this procedure.
The cost of penile prostheses varies widely, ranging from tens of thousands to over a hundred thousand, and cannot be detailed individually.
Sincerely, Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2004/10/05

More Info

Penile implants are a surgical option for men who suffer from erectile dysfunction (ED) that has not responded to other treatments, such as oral medications like Viagra (sildenafil) or injections. The decision to proceed with a penile implant is typically made after a thorough evaluation by a healthcare provider, often a urologist, who specializes in male sexual health.

When Are Penile Implants Needed?
1. Severe Erectile Dysfunction: If a man has severe ED that does not improve with oral medications or other non-invasive treatments, a penile implant may be considered. This includes cases where the underlying cause is related to conditions such as diabetes, prostate cancer, or Peyronie's disease.

2. Psychological Factors: In some cases, psychological factors may contribute to ED. If these factors have been addressed and the patient still experiences difficulties, a penile implant may be an appropriate solution.

3. Surgical Options: Men who have undergone prostate surgery or other pelvic surgeries may experience ED as a side effect. If other treatments fail, a penile implant can restore erectile function.

4. Inability to Use Other Treatments: For men who cannot take oral medications due to side effects or contraindications, or who find injections inconvenient, a penile implant may be a suitable alternative.

Types of Penile Implants
There are primarily two types of penile implants:
1. Inflatable Implants: These consist of two cylinders that are placed inside the penis, a pump placed in the scrotum, and a reservoir of fluid implanted in the abdomen. When the man wants an erection, he uses the pump to transfer fluid into the cylinders, causing an erection.

2. Malleable Implants: These are semi-rigid rods that are inserted into the penis. The man can manually adjust the position of the penis for sexual activity.

Costs Involved
The cost of penile implants can vary widely based on several factors, including:
- Type of Implant: Inflatable implants are generally more expensive than malleable implants due to their complexity.

- Surgical Fees: The cost of the surgery itself, including the surgeon's fees, anesthesia, and hospital charges.

- Postoperative Care: Follow-up visits and any necessary medications or therapies after the surgery.

In the United States, the total cost for penile implant surgery can range from $15,000 to $30,000 or more, depending on the factors mentioned above.

Insurance Coverage
Regarding insurance coverage, many health insurance plans may cover the cost of penile implants if they are deemed medically necessary. However, coverage can vary significantly between plans, and it is essential to check with your insurance provider to understand what is covered. In some cases, prior authorization may be required, and documentation of previous treatments and their failures may be necessary to justify the surgery.

Conclusion
If you are considering a penile implant due to the ineffectiveness of medications like Viagra and the inconvenience of injections, it is advisable to consult with a urologist. They can assess your specific situation, discuss the potential benefits and risks of the procedure, and help you understand the costs involved, including what your insurance may cover. A penile implant can significantly improve quality of life and restore sexual function for men who have not found success with other treatments.

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