Penile implants: Treatment of erectile dysfunction in men with diabetes

If you’re a diabetic man, then you’re more likely to suffer from erectile dysfunction. And if you’re a diabetic man and you have erectile dysfunction, it’s more likely that things like pills and penile injection therapy won’t be effective. So, if you’re a diabetic man and you’re going to move on to penile implant surgery to treat your erectile dysfunction, then you have a higher risk for infection.

Over 100 million men in the United States have diabetes, and about 95% of these have type 2 diabetes. Type 2 diabetes is diabetes that’s associated with advancing age and associated with increased body fat and increased body weight. Diabetes is the abnormally persistent elevated levels of blood sugar. This elevated level of sugar in the blood can damage the arteries that carry blood to the penis during an erection.

Penile injection therapy

The elevated blood sugar levels will damage the nerves involved with erection and the nerves involved with carrying sensation to the penile tissue. And the elevated sugar levels will damage the tissue in the penis that fills with blood during an erection.

So, diabetes can absolutely cause erectile dysfunction. In fact, diabetes and hypertension are the two most common causes of erectile dysfunction.

We know that penile implants have the highest patient satisfaction in the treatment of ED. Penile implants are very safe and reliable. Patients and their spouses or partners love penile implants as a treatment for ED, but there is going to be an increased risk of infection in diabetic males.

Dr. Christine from Urology Centers of Alabama told us about the details of the surgery:

When I have a man who has diabetes who’s looking at penile implant surgery, I’ve got to do everything that I can do and encourage the patient to do everything that he can do to lower the potential for infection and to raise the potential for a successful, satisfying outcome.

Hemoglobin A1C is a blood test that uses to check sugar control. The level of hemoglobin a1c will tell what sugar control has been like over the past three months.

A lower A1C level is better than a higher A1C, and in my practice, I want the A1C level to be 7.5 or less. If we check a patient’s A1C and it’s greater than 7.5, we don’t schedule their surgery – We send them to their diabetic doctor and tell them about the things to get that A1C level better.

When that level is 7 point 5 or less, we’ll go ahead and schedule the penile implant surgery. We have all of our patients, especially men with diabetes, wash with the surgical scrubs solution, the penis, and the scrotum, and the lower abdomen in the week prior to implant surgery.

What we’re trying to do is kill off skin bacteria that could potentially cause an implant infection. At the time of surgery, we give all of our penile implant patients IV antibiotics, and in the diabetic men, we give them an additional IV medication specifically designed to prevent yeast or fungal infections.

All of our men who have penile implants will be placed on antibiotic tablets after surgery, but in the men who are diabetic, we keep them on the tablets a little bit longer.

In the majority of my patients, I use an in for public incision that’s a very small incision at the base of the penis. The benefit of this incision is that it tends to cause less swelling, less pain, less bleeding, and men with an in for public incision are able to get back to normal activities much sooner.

In my practice, men who have had an in for you big incision after their penile implant surgery come back at about three weeks. Then we teach the patients how to inflate and deflate the implant, and they can begin to use it for sexual activity.

Antibiotic impregnation on the surface of penile implants has been probably the greatest innovation to decrease the potential infection for all patients, especially diabetics. We always use a penile implant with an antibiotic coating.

Lastly, we consistently strive for efficiency and excellence in the operating room. If you’re having a first-time penile implant or even the removal and replacement of a device that’s worn out over time, you can expect a surgery time of 30 minutes or less, but our goal is to be very efficient in the operating room and to have the shortest operative time possible, not by rushing the case but by being efficient and doing the right thing.

Diabetes is a serious disease that can and does cause erectile dysfunction, but the success rates of treating ED and diabetic men are the highest they’ve ever been, and infection rates after penile implant surgery in diabetic men are the lowest they’ve ever been.

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