Penile implants – the path to full sexual activity
Modern solutions for treating erectile dysfunction. Learn about the types of implants, their advantages and the treatment process! Discover how technology can change your life.
Vasectomy – an effective method of contraception for men
A simple procedure with lasting effects. Learn how a vasectomy can help you plan your family consciously and give you peace of mind for years to come. Make informed decisions about your future!
Dr Anna Bonder-Nowicka
– Urologist and Sexologist
Male Health Specialist
- prostatitis
- bladder dysfunction
- urinary tract stones
- urinary tract infections
- sexual dysfunction
- ultrasound and Doppler ultrasound of male reproductive organs
- surgical procedures: phimosis, foreskin plasty, frenulum plasty, hydrocele plasty
- biopsies
- treatment of sexually transmitted infections
- pre-exposure prophylaxis (PrEP)
- urological oncology
Precision and experience – penile implants in numbers
Thanks to many years of surgical practice and international internships, Dr Anna Bonder-Nowicka is one of the leading experts in the field of penile implants.
Dr Anna Bonder-Nowicka
I am a urology specialist, a graduate of the Medical Academy in Warsaw, with experience gained as a Senior Assistant in the Urology Department at the Bielański Hospital. I have completed postgraduate studies in Clinical Sexology and Pain Medicine, which allows me to effectively help patients with a wide range of health problems.
In my office, I consult only adults, offering ultrasound diagnostics, biopsies and outpatient procedures such as vasectomy, foreskin plasty and treatment of hydroceles. I also deal with pre-exposure prophylaxis (PreP) for people particularly vulnerable to HIV infection. My priority is to provide effective help based on an individual approach and the latest medical standards.
If you are looking for professional and comprehensive urological or sexological care, I cordially invite you to my office. Please bring your medical records to your first visit – this will allow me to better understand your needs and shorten the diagnosis time.
Facts and myths in urology – find out what is true
Erectile dysfunction is common. Men can experience difficulties in the bedroom for various reasons and at any age. It is worth noting that it occurs more frequently with increasing age (after the age of 60, up to 50% of men experience erectile dysfunction), but this is not a natural, inevitable part of ageing, but the result of accumulating comorbidities and the treatment used to treat them. Sex does not have an “expiry date”; men of all ages can enjoy sexual activity.
And since this is not a unique problem, it is not worth keeping quiet about it. It is not a reason to be ashamed, IT IS NOT YOUR FAULT. It just happened to you right now, and you can do something about it. See your doctor to talk about it. If your problem is ignored, find another doctor. Maybe you just went to the wrong one; not everyone specialises in everything!
Only severe testosterone deficiency leads to erectile dysfunction. The vast majority of men with erectile dysfunction have normal testosterone levels and do not require supplementation. Therefore, if you notice difficulties in achieving and/or maintaining an erection, do not immediately reach for medication, and certainly do not seek access to medication outside of a doctor’s supervision (e.g. at the gym, on the internet, etc.), as this exposes you to great danger, in which erectile dysfunction is only a minor concern.
A man is not a machine or an automaton. He is a multidimensional human being, and sex is only one part of him. Not only may he not feel like having sex because of fatigue, relationship difficulties or a lack of emotional connection, but his body will also resist sex when he is exhausted from overwork, constant and debilitating stress, alcohol and/or other substance abuse, lack of sleep, etc. So do not despair if this happens to you! See your doctor, talk, look for solutions… if someone claims that they always want to and can, they are lying.
Absolutely not! Erectile dysfunction is an early warning system for the cardiovascular system and mental health! Its onset precedes acute coronary events by about 5 years because the vessels supplying the penis are four times narrower than those supplying blood to the heart. The vessels in the penis will show symptoms earlier than those in the heart. In other words, if you get the right diagnosis and treatment when your penis fails, you will be able to avoid life-threatening complications such as heart attack or stroke. A similar correlation applies to mental disorders – erectile dysfunction is often the first symptom that a man is struggling with mood disorders (e.g. depression), severe anxiety, etc. It is important not to overlook this, as the problem will not go away even if you try your hardest to ignore it.
Studies show that almost half of men will stop using these drugs within the first year – they will receive effective treatment for the problem responsible for the onset of the problem, their relationship will improve, or they will use another form of treatment. Phosphodiesterase inhibitors – as these drugs are called – are not addictive. Taking them a few times does not mean that you will have to use them for the rest of your life and will never have an erection without them. Nor will you need increasingly higher doses over time. They work when you take them and only then; for most patients, they are safe and effective.
You do not need to worry about this. None of the oral medications will cause you to suddenly have an unwanted, reflex erection that will embarrass you. Similarly, you cannot count on them to improve your libido and readiness for sex – they are not magic pills. Their action is to facilitate blood flow to the penis. That’s all. If you are not aroused, if you are not in the mood, if you have causes of erectile dysfunction other than vascular ones – you will not get an erection.
Implants are needed by men who have severe erectile dysfunction. And this can happen at any age. When we want to describe erectile dysfunction, we usually think of an old man, a smoker, obese, with advanced atherosclerosis… However, the reality is that severe erectile dysfunction also occurs in young men – after extensive injuries, traffic accidents, operations, especially in the lower pelvis… Acute neurological events or even priapism will also lead to irreversible disorders.
Young men require even more attention because severe erectile dysfunction will eventually lead to shortening and shrinking of the penis. “Use it or lose it” – if there are no nocturnal physiological erections and a man is sexually inactive for many years, he will lose penis length, even 0.5-1 cm per year. Therefore, it is worth considering seeing a urologist to prevent this.
Not at all. Erectile dysfunction occurs at any age. If you “couldn’t do it” in the bedroom, it doesn’t mean you’re old, that your age has caught up with you. Forget about the offensive word “impotent” too.
Many men remain very sexually active for many years, even in old age. This is clearly demonstrated by the relatively high incidence of sexually transmitted diseases in nursing homes and sanatoriums – seniors, free from the fear of unwanted pregnancy, do not consider the risk of infection.
If erectile dysfunction is more common in older age groups, it is the result of the accumulation of other medical conditions and health events, medications used, etc. With age, we also see more often the consequences of bad choices made in the past – smoking, lack of exercise, mobility limitations, sleep deprivation, untreated sleep apnoea. If you treat your body badly, it will function poorly. Very young men can still compensate for these effects, although this is not always the case. Older men feel the health consequences more acutely. Therefore, the more you take care of your body when you are young, the longer it will remain strong and fit. Age will not prevent you from remaining active in the bedroom. And even if you have something to apologise to your body for, it is never too late to start taking proper care of it – that is why non-surgical interventions and lifestyle changes improve erectile function in up to 40% of men.
This is not entirely true. Sex is an event between two people, and you cannot ignore the feelings of the person you are having sex with. If you get scared and withdraw after a failure, it will affect your partner. And there is nothing to prevent your loved one from thinking that it is her/his fault, that they are no longer attractive or that something terrible has happened in the relationship. They may suspect you of cheating or indifference. When you are focused on catastrophic scenarios in your head, you will not even notice that you are drifting apart. That’s why you should focus on open communication. Ask for support. Dispels doubts about your fidelity and love. Even if you don’t get an erection or it disappears during sex, stay present with the person you share your bed with. Don’t panic, focus on giving pleasure, and maintain intimacy between you.
There is no magic trick that will work immediately, and it is possible that your treatment will take a long time. You will need all the support you can get, so make sure your loved one is by your side.
Not really. Phosphodiesterase inhibitors (PDE5-I such as sildenafil, tadalafil, vardenafil) are safe and effective drugs that improve blood flow to your penis. But for a great erection, you also need other factors – neurological, hormonal, psychological and social. If these are not working properly, you cannot rely on medication. In addition, drugs in this group, although very similar, differ from each other. The biggest differences concern duration, onset of action, conditions of use (a fatty dinner and alcohol exclude the action of sildenafil), and side effects. Therefore, if your first attempt was unsuccessful, do not give up. Talk to your doctor at , as you may have made a mistake along the way. In PDE5-I treatment, we follow the rule of trying a given medication 6-8 times before deciding that it is ineffective. The same applies to side effects – they may not reoccur after changing the medication.
If your erectile dysfunction is caused by factors other than vascular problems, consult your doctor. Pills are not a universal solution to everything.
This is only part of the truth. When you are scared, stressed, distressed, angry, etc., your erection will not appear or will quickly subside. This is a self-preservation instinct. If you encountered a bear in the wilderness, your entire nervous system would instantly mobilise to ensure your survival – there is no room for an erection in such a reaction. And even if you do not go near even the smallest girl, you cannot avoid stressful situations – modern men must constantly endure enormous pressure that their ancestors experienced only occasionally or not at all. It is hardly surprising that this affects their health and sexual performance. However, “nerves” – although important – are not solely responsible for erectile dysfunction. Therefore, talk to your doctor, even if you suspect that your demanding lifestyle is the source of the problem – make sure you do not have any untreated health problems and that you are receiving the best possible care.
No way! You can do a lot yourself by changing your lifestyle and risk factors. The medicines we use can make a big difference. Effective treatment of comorbidities can ensure that this never happens to you again. And even if you do not respond to any treatment options, have undergone radical treatment, or your nerves have been irreversibly damaged, you always have the option of a penile implant. Do not despair! Stay positive! Talk to your doctor.
Indeed, we associate arousal in men with an erection, but this is not entirely true. Your most important sexual organ is your brain – this is where arousal and desire originate. Suffice it to say that a dream or a memory is enough to cause an erection. And the erection itself is only part of your sexual response – if your penis is not as hard as a board, it does not mean that you have no reason to engage in sex at all. Therefore, do not shut yourself off if you notice changes in yourself, if you need different/longer stimulation than before. Talk to your partner, ask her often what she likes and talk about what suits you and what you would like to try. See your doctor to find an effective treatment.
This may be true. But it does not have to be.
Women and men differ from each other. And the scale of differences within the sexes is often greater than the presumed difference between women and men. Therefore, there are no uniform rules and patterns – you and your loved one will determine them together. There is no norm for how often you should have sex – you will decide that for yourselves. Be open to communication and cooperation – you will be amazed at how much you will enjoy life outside the established patterns and rigid frameworks imposed by culture and society.
This is what people say for whom contraception means only hormonal contraception – there really is no such thing. Past attempts to invent hormonal contraception for men have been too risky for patients. But contraception means controlling your fertility, and here men have options to choose from – they can control their fertility. They can use widely available condoms or opt for a permanent solution such as a vasectomy. This procedure involves cutting the vas deferens, which interrupts the natural path that sperm take to reach the semen. The procedure itself is short, performed under local anaesthesia, safe and well tolerated. After a vasectomy, a man has the same libido, the same erection, the same level of arousal… his semen looks the same, smells the same, there is the same amount of it… nothing changes except the certainty that an unwanted pregnancy will no longer happen. And for many couples, the absence of this stress acts as a powerful aphrodisiac!
This is a myth perpetuated by a culture that considers sex to be “dirty and forbidden”. Studies on testosterone levels after intercourse are contradictory – they do not provide an answer here. Long ago, it was believed that regular, heavy training lowered testosterone levels, but now we know that this is not true. If you engage in satisfying sex, you will be relaxed and calm afterwards – and no one can deny that rest and regeneration are part of every workout. Being close to your partner will give you a lot of confidence and improve your mood – the better for your performance. It is not without reason that condoms are free, widely available and used in huge quantities in Olympic villages.
The only circumstance in which a correlation has been observed is sex shortly before competitive sport or timed competitions – here, an interval of 12 hours before the start signal is recommended.
I always have it with me, it’s discreet – perfect, right? Well, no. Condoms require specific storage conditions – temperature, humidity, time… A single condom carried around for years, faithfully waiting for an opportunity to be used, is useless. Its durability decreases rapidly when, along with your wallet, it is exposed to frost (when you keep your wallet in your jacket pocket in winter), high temperatures and pressure (when your wallet ends up in your trouser pocket) or sunlight (when you throw your wallet on the passenger seat in summer).
Do not put yourself or your sexual partner at risk. Store condoms at room temperature, away from sources of moisture, mechanical damage and sunlight. And always use them when you are sexually active – unless you are with someone you are “exclusive” with.
There is no such risk. Sexually transmitted microorganisms outside the human body have a very short lifespan and cannot be transmitted in this way. Without the high temperature and humidity of the human body, they quickly disappear. The only way to contract a sexually transmitted disease in a public toilet is through unprotected sexual contact with an infected person in a public toilet.
This is nonsense. Studies clearly show that 85% of men’s partners are satisfied with the size of their partners’ penises, while only 45% of these men were satisfied. The penis is not a magic wand whose job is to reach the “on/off” switch at the bottom of the vagina; that is not where orgasm is triggered. The entire innervated area of the female partner’s vagina is in the first 5 cm of the vagina – that is the only area that needs stimulation – and it is very rare to find a penis that is unable to meet these requirements. What is more, a penis that is too large, especially in positions that favour deep penetration, will cause pain and discomfort to the female partner. Being average is much more advantageous.
There is no need to worry, the implant itself will not shorten the penis. However, the reason for the implant will shorten it – long-term erectile dysfunction will cause the penis to shorten by 0.5-1 cm each year. The size of the penis will remain the same as it was at the time of implantation. At the same time, men must be aware that no implant WILL MAKE THE PENIS BIGGER than it was before the implant was inserted.
Sex will be different after the operation because factors that contributed to the onset of erectile dysfunction have already occurred. You cannot reverse the years, illnesses, operations or accidents that led to severe erectile dysfunction. Sex will not be the same because you yourself are no longer the same. But your physical and mental situation and your relationship will be much better if the implant allows you to remain sexually active for as long as you want.
