All answers about penile prosthesis or penile implant


An implant should be the last option after trying other types of treatment.

In a first consultation with Dr. Natalio Cruz at the Andromedi Clinic in Seville, all the details of each case are studied and Dr. Cruz himself, together with the patient, decide what would be the best indication for each specific dysfunction.

Some of the patients who are interested in penile prosthesis don’t know that most of the time, erection problems can be solved in previous phases because they are related to psychological issues such as trauma, work or stress, bad habits and/or addictions, etc.

When should we get penile prosthesis implant surgery?

To offer an accurate diagnosis of your erectile dysfunction, the patient must explain in detail to Dr. Natalio Cruz about his lifestyle, of course under the strictest professional confidentiality.

Once a good doctor-patient communication is established, we can find alternative solutions before engaging in penile prosthesis surgery, except for those cases when surgery is the only option, such as patients who have had a radical prostatectomy, or those who have serious physical injuries in the erectile tissue. Patients with diabetes and venous leakage, and patients who don’t have a viable solution through surgery are candidates to solve their erection issues with a penile implant.


Standard protocol that we follow in the Andromedi Andrology and Urology Clinic

1) Initial and thorough exploration of the nature of each case (clinical history, habits, sexuality) to get to know the reason, or reasons behind the patient’s impotence.

In Andromedi we value three fundamental aspects:

  • Physiological aspects
  • Psychological aspects
  • Sexual health

We must have a complete clinical interview with updated tests.

  • Psychological History in relation to sexual life
  • Vascular system data
  • Nervous system data
  • Blood glucose measurements
  • Cholesterol
  • Renal function
  • Morning testosterone levels
  • Intra-cavernous injection test
  • Cavernosography

2) Indication of a combination therapy adapted to the particularities of the case.

These are some of the treatments and therapies that we usually use:

  • Psychotherapy
  • Hormone treatment
  • Intracavernous injection of vasoactive drugs
  • Transurethral introduction of these drugs
  • Vacuum devices
  • Vascular surgery
  • Inhibitors of phosphodiesterase 5 (IPDE5)
  • Medicine based on sildenafil, tadalafil, vardenafil… (better known as Levitra, Quantum, Viagra, Vivirec)

In our Clinic in Seville, we pay attention to the latest techniques and technologies that allow us to offer the best services. For example, we were pioneers in Spain of the implantation of low intensity shock waves as a solution to many cases of impotence. In this video we can see the complete process:

Due to the nature of erectile dysfunction, in some patients, a trial-and-error search process is necessary to find the definitive solution. For example, what seemed like a psychological problem of anxiety at first, was was actually caused by a minute case of an almost imperceptible venous leak that fed back into the psychological part in a vicious circle. There are no instantaneous solutions in many cases, and be wary of those that claim easy solutions. Only through the rigorous medical-scientific study of each patient, with patience and experience, can you be guaranteed healthy and continuous improvement.

3) If the combined therapy (which in some cases can be unitary)  is effective, it’s perfected by finding the appropriate periodicity and intensity. If the initial therapy is not effective, it’s revised and checked.

4) If all the previous attempts aren’t completely effective, we propose the prosthesis due to its great effectiveness returning a full sexual life in special or difficult cases. Right here, the main issue that our patients are most concerned with, the economic issue, is the one that comes to light with more assiduity. Fortunately, we have a very advantageous financing line so that you can use your prosthesis from the first day and it is not necessary to save money for years, nor seek any financial help.

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