Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
BREAKING NEWS A photo exclusively obtained by CNN's Deborah Feyerick shows a bloodied David Sweat moments after his capture. Watch live on CNNgo. News U.S. Video World TV Politics Opinions Tech Health More… Entertainment U.S. Edition Living Travel Money Search CNN Watch Live TV Sports While erectile dysfunction increases, use of penile implants declines By Ben Smart, Special to CNN Updated 5:26 PM ET, Tue June 23, 2015 More Top Stories Shooting near gay pride event Supreme Court a force for change? Jimmy Fallon injury cancels 'Tonight Show' taping Big snake eats porcupine, dies Goalie makes insane double save EU rejects Greek bid to extend bailout This 3-piece inflatable implant can help men with ED achieve an erection after surgical installation. When the smaller bulb is squeezed, saline solution is pumped from the larger reservoir into the two columns on the left, causing them to inflate. Story highlights Erectile dysfunction is the inability to maintain an erection firm enough for intercourse An analysis of 1,763,260 men with ED revealed prostheses declined from 4.6% to 2.3% over a decade Experts say a penile prosthesis is the only ED treatment that works for almost every man (CNN)—Viagra is known for its advertising, but the erectile dysfunction treatment you don't see commercials for are penile prostheses, also known as penile implants. For men with erectile dysfunction, penile prostheses -surgically inserted devices that help achieve an erection - can be life-changing when other treatment don't do the trick. Simply put, a penile implant is a device that that allows a man to have an erection "on demand," when he has trouble doing so naturally. ED is the inability to achieve or maintain an erection firm enough for sexual intercourse. But these implants are waning in popularity, according to new research published in The Journal of Sexual Medicine. More from CNN NYC meter reader teaches cab driver a lesson Mom of pregnant 11-year-old in Paraguay speaks out Nearly 500 injured in Sam Champion on explosion at Taiwan his struggle to come water park out as gay The decline of implant use concerns some doctors, who say penile implants have the highest rate of patient satisfaction among all ED treatments. Middle-aged virgins: That's no rat in "It's like starting a car; you just turn it on when you're ready," said Dr. Darius Paduch, study author and director of Sexual Health and Medicine at Weill Cornell Medical College in New York City. "The guys love it." Why so many Japanese stay chaste KFC's chicken finger Promoted Stories Is your penis size 'normal?' Researchers found that the number of men diagnosed with erectile dysfunction increased 165% over the 10-year study period, while the use of penile implants declined, with 4.6% of men with ED getting a penile implant in 2002 and 2.3% of men opting for an implant in 2010. The study's finding that penile implants are on the downturn resulted from an analysis of 1,763,260 men using Medicare public use files from 2001 to 2010. "When medications like Viagra and Cialis don't work, we then present all the remaining options to the patient as a 'second line,' including penile implants and injections," said Dr. Drogo Montague, director of the Center for Genitourinary Reconstruction in the Glickman Urological & Kidney Institute at the Cleveland Clinic, and professor of surgery at the Cleveland Clinic Lerner College of Medicine. "Penile prosthesis is the only thing that works for almost every man with ED -- unlike injections and pills." Penile implants were most utilized by men from 65 to 74 who had other existing medical conditions, according to the study. Men from the South and West were more likely to get a penile implant than men from other parts of the country. It's believed that this concentration is because of the higher prevalence of obesity, a condition linked to ED, in those areas of the country, according to Paduch. Surgical techniques for inserting penile prostheses have also improved over time. A growing number of operations are now outpatient procedures, which means men can leave the hospital the same day as the surgery. Recommended by More from Health Patient safety evaluated at St. Mary's hospital Patient safety evaluated at St. Mary's hospital The results are in: U.S. still fat, seat belts still save lives and pot treats also trick Healthgrades What skin cancer looks like 5 medical procedures to ease migraines Do you have caregiver stress? 8 health issues smoking makes worse Blood sugar essentials for diabetics The rise of ED treatment alternatives While the discovery of ED treatments such as Viagra and intracavernosol injection (a shot a man gives himself to induce an erection) is blamed for the falling popularity of penile implants, it's also possible that medical providers are choosing simpler treatments in lieu of complex surgical procedures. A penile prosthesis is surgically installed, often in an outpatient procedure. EXPAND IMAGE "There's a real need for penile prosthesis, but this isn't generally recognized by the public and even some medical professionals," said Montague. "Not being able to have intercourse has been shown in numerous studies to cause low self-esteem depression." According to Montague, it's common for men with ED to give up hope when better-known treatments -- medicines such as Viagra and penile injections -- don't work. He said men should be given all of the options early on in treatment, including penile prosthesis. Dr. Tom Lue, professor and vice chair of Urology at UC San Francisco, emphasized the patient's lifestyle when treating ED. "Number one is education," said Lue. "That's better than any surgery." He said he focuses holistic treatments, then prescribes medication if the problem isn't solved. For instance, Lue said men experiencing daily, chronic stress can experience erectile dysfunction as a result. "Surgery is a last resort," said Lue. "Penile implants are much more invasive and have a higher rate of complication, especially for patients with underlying conditions like obesity and high blood pressure." Penile implants: An 'on demand' erection for men Penile implants, invented in 1973, were once considered the gold standard of ED treatment before the widespread use of Viagra and other treatments. There are two main types of penile implants, each with advantages and disadvantages. The patient and his doctor decide what's best after considering factors such as age, overall penis size and ratio between the visible and internal portions of the penis. An inflatable penile prosthesis is the most common type of implant. When a man is ready for sex, he squeezes a pump implanted in the scrotum, which transfers saline solution from a reservoir behind the groin to cylinders in the shaft, taking the penis from soft to hard. "It takes a couple of minutes, depending on how hard you squeeze the pump," said Montague. "The bigger the penis, the longer it takes." The other type of implant is a semi-rigid penile prosthesis, which is an implanted device composed of two malleable stainless steel wires surrounded by silicone. In essence, the penis is always erect and is manually bent up or down depending on the man's needs. Experts say men with penile implants report higher levels of satisfaction compared to those using medications or injections partly because the implant is part of the body and is not visible from the outside. Penile implants have no impact on pleasure sensation, and ejaculation also functions normally, according to experts. Erectile dysfunction cases are increasing Over the past 10 years, erectile dysfunction has almost doubled, according to Paduch. "This is partly due to the increased prevalence of obesity and diabetes, but also because patients and doctors are more knowledgeable." First-line treatment: Viagra, Levitra, Cialis and Stendra are PED5 inhibitors, the most common treatment of erectile dysfunction EXPAND IMAGE Paduch also notes that ED awareness has benefited from lots of publicity, thanks to television advertising for medications such as Viagra. Broadly, erectile dysfunction can be either organic -meaning physiological -- or psychological, or a combination of both. One study estimates that nearly 20% of all men over the age of 20 in the United States live with erectile dysfunction. The prevalence of erectile dysfunction is highly correlated not only with age, but also with cardiovascular risk factors. "Anything that is bad for your heart is also bad for your penis," said Paduch. That's why lifestyle changes such as smoking cessation, increased exercise and weight loss have shown to help treat erectile dysfunction, especially as men age. But aging alone isn't a sentence for ED, said Montague. "Men who are healthy are not expected to lose erectile function solely on the basis of age. However, with each decade of life there is a higher and higher rate of men with ED because of age-related disorders ... which pile up and can cause erection problems." Paduch said men shouldn't be afraid to discuss any sexual problems with their physician. "We approach the issue in a matter-of-fact way, so most patients are not embarrassed, as you might think they would be." Promoted Stories Recommended by More Promoted Stories More from CNN Female scientists tweet #DistractinglySexy photos 'You'll never see a poor, black family on TV again' $13 billion warship is first of its kind Female prison employees 'can be owned' by an inmate Japan shakes off 67-year ban on dancing after midnight Is Europe Dead? Recommended by New York City, NY Search CNN 72° NEWS VIDEO TV OPINIONS MORE… U.S. CNNGO CNNGO POLITICAL OP-EDS PHOTOS WORLD LATEST NEWS SCHEDULE SOCIAL COMMENTARY LONGFORM POLITICS MUST WATCH VIDEOS CNN FILMS IREPORT INVESTIGATIONS TECH DIGITAL STUDIOS SHOWS A-Z CNN PROFILES A-Z FACES OF CNN CNN LEADERSHIP HEALTH ENTERTAINMENT WORLDWIDE LIVING TRAVEL MONEY SPORTS U.S. Edition © 2015 Cable News Network. Turner Broadcasting System, Inc. All Rights Reserved. Terms of service | Privacy guidelines | AdChoices | Advertise with us | About us | Work for us | Help | Transcripts | License Footage | CNN Newsource