Penile Implant Sales Rise; Porn King Larry Flynt Has One

3/1/2013 10:44:11 AM

Given his career as the king of porn, it may come as no surprise that publisher Larry Flynt is still sexually active at the age of 70, even after he was paralyzed in an unsolved sniper shooting 35 years ago.
Given his career as the king of porn, it may come as no surprise that publisher Larry Flynt is still sexually active at the age of 70, even after he was paralyzed in an unsolved sniper shooting 35 years ago.

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The publisher of Hustler, who is five-times married and has spoken extensively about his love of women, revealed just this week that he has a penile implant.

"Lots of men have them," Flynt told The Hollywood Reporter.

"There's a little reservoir in the bottom part of your stomach, and you trigger it with a button inside your testicles that doesn't show. Nothing shows."

More men like Flynt are having the implants installed, doctors say.

"He's open about his sexuality and probably didn't want to give up on sex when he was older," said Dr. Andrew C. Kramer, associate professor of surgery and urology at the University of Maryland School of Medicine, who did not treat Flynt.

Kramer performs about 250 penile implant surgeries a year, many of them for older men like Flynt who want to regain their sexual prowess after disease or spinal cord injury.

Experts like Kramer say the penile implant is the "treatment of last resort" for men with erectile dysfunction, but its popularity is increasing due to a dramatic rise -- about 74 percent -- in the number of men undergoing radical surgery for prostate cancer.

"I see young guys in their 40s who wake up impotent," he said. "You have to tell your wife in her 30s, we're just friends and cuddle now."

The most common reason for erectile dysfunction in older men is chronic disease that affects the vessels in the penis -- most often diabetes, hypertension, smoking or high cholesterol. Nerve damage caused by spinal cord injuries, diabetes or prostate cancer surgery is also a culprit.

The penile implant or prosthesis is an inflatable device containing two balloon-like cylinders that is inserted in the penis to work like a hydraulic system. A small pump is placed in the scrotum with a reservoir of about two to three ounces of salt water that connects to the tubing.

The man can activate the pump so the balloons fill up with fluid, creating an erection. After sex, he releases the valve inside the scrotum to drain the fluid back into the reservoir.

"I find it a good treatment," said Kramer, who is part of the third-largest practice in the world for penile implants. "Men come to me and say, 'Doc, my organ stays hard. Psychologically, it [seems] harder than a penis."

Urologists typically start with medications that address blood flow, like Viagra and three other similar drugs -- the least invasive approach. "Pills are great if they work," he said.

When that fails, men have other options, but they are often "cumbersome" and interfere with lovemaking, according to Kramer.

Muse, a suppository about the size of a grain of rice, can be inserted in the urethra and acts to expand the blood vessels. Vacuum erection devices take preparation and "strangulate" the penis by trapping old blood in the organ. Injection therapy requires a needle.

"If a guy feels like having sex, he has to say, 'Hold on, dear,'" said Kramer. "An implant can take 10 seconds and the partner doesn't even know. It's more natural."

Erik, one of Kramer's patients who did not want to share his last name, became impotent in 1997 just before he turned 40 because of hypogonadism, a condition where the body does not produce enough testosterone. "It was awful," he said. "I was way too young."

First he tried Viagra, then injections. "I would take an insulin needle and stick it in my penis," said Erik, now 55. "It was marvelous at the time, but after 10 years, it wore off."

In 2008, he had surgery for a penile implant. "It works fabulously," he said. Erik's wife is especially pleased and doesn't seem to mind the "funny, squeaky noise" it makes as he squeezes the pump about 30 times to achieve firmness.

"It's like being 25 all over again," said Erik. "The implant allows me to do it anytime, anywhere."

Surgery takes less than one hour and most times the man is under anesthesia. Recovery is usually about six to eight weeks before the patient can have sexual intercourse.

"It's relatively noninvasive," said Dr. David Gentile, associate professor of urology at University of Rochester Medical Center, who on average does at least one penile implant surgery a week.

"It sounds very intimidating, but it's not nearly as bad as one would think, especially because when you look at the apparatus, it spooks people."

The cost is daunting, about $18,000, although most insurance plans cover the surgery. The lifespan of the implant, made by several manufacturers, is about 10 to 12 years, but doctors say that with advances in materials, the mechanical failure rate is low and only rarely must parts be replaced.

"By the time I see them, they are begging for the implant," said Gentile. "They have an exponentially high partner satisfaction rate."

Some spouses have told Gentile that their husband is "better than any teenager." A man can have an erection as long as he wants, as he controls the device.

More spontaneous, the penile implant allows the couple to engage in uninterrupted foreplay. "She can inflate the device and it's much more natural," he said.

Don Martin, a North Carolina psychologist, had a retropubic prostatectomy in 1996 at the age of 48, before laparoscopic and nerve-sparing surgery techniques were perfected.

"It sort of went from being everything was wonderful to hardly anything worked," said Martin, who is now 64.

Injections had the opposite effect, giving him an uncomfortable erection lasting for five or six hours. Drugs like Viagra and Cialis caused flushing of his skin that continued hours after intercourse.

The vacuum device was painful. "You slip a rubber ring at the base, so it's like your penis is not attached to your body," he said. "There's not much feeling or sensation."

Martin and his wife, who had been married only seven years, settled for sex without penetration."It caught us both by surprise," he said. "We had been expecting an active and enjoyable sex life."

Just last summer, Martin had surgery for a penile implant. "In some ways it's better than before -- something you can count on," he said.

Both Erik and Martin say their wives are happy customers, but their doctor Kramer said that is not always the case for middle-aged women who have become accustomed to not being sexually active.

"I have done thousands of these surgeries and seen every possible story," said Kramer. "One guy was doing great, but when we asked him about his wife, he said they were divorced. But I've seen men who come in and say my wife is going to leave me if I do not provide her with sex.

"It saves marriages and it ruins them, too."

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