Penile Prosthesis Insertion
Definition
This surgery places a device into the penis. The device can produce an erection-like state. It allows a man to have sex with his partner. This doesn’t change how the skin feels. It also doesn’t affect the ability to reach an orgasm or ejaculate.
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Reasons for Procedure
This procedure is for men who want to have an erection. It may also be done for those who have:
- Not had success with other methods such as pills, suppositories, vacuum devices, and injections
- Certain conditions that slow blood flow
- Injuries such as those of the spinal cord
- Had surgery that resulted in problems with erections
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:
- Bleeding
- Infection
- Scar tissue
- Tissue breakdown near the implant
- Device doesn't work properly
Your chances of problems are higher for:
- Obesity
- Smoking
- Alcohol use disorder
- Substance use disorder
- Diabetes
- Catheter use for a bladder disease
- Infection
- Bleeding problems
- Paralysis
- Prior pelvic or genital surgery
What to Expect
Prior to Procedure
Your doctor will do:
- A physical exam
- Tests to rule out problems that might be treated with medicines
Leading up to the procedure:
- Talk to your doctor about your medicines. You may need to stop taking some medicines up to 1 week before the procedure.
- Don't eat or drink after midnight the day before your surgery.
Anesthesia
The 2 types used are:
- General anesthesia —blocks pain and keeps you asleep through the surgery
- Spinal anesthesia —numbs the area between your chest and legs
Description of the Procedure
The genital area will be cleaned and shaved. Antibiotics may be given 1 hour beforehand. A thin tube called a catheter will be inserted into the penis. This will keep the bladder drained of urine.
The 2 types are:
- Inflatable—2 cylinders, a pump, tubing, and may have a reservoir
- Malleable—2 semirigid rods are placed into the penis
Inflatable Implant
There are 2 types of inflatable implants. For both types, the doctor will make a small incision at the top of the scrotum. The incision will be made so that stitches that dissolve are placed under the skin.
With the 2-piece implant, the cylinders will be placed into the penis. A pump with fluid will be placed into the scrotum. This type of implant is simpler to insert. It takes up more space in the penis, leaving less room to shrink or expand.
With the 3-piece implant, the cylinder will be placed into the penis. The pump will be placed into the scrotum. Lastly, a reservoir with the fluid that is used for inflation will be placed into the belly.
Malleable Implant
An incision will be made just behind the head or near the base of the penis. An opening will be made into each of the 2 long tubes of spongy tissue inside the penis. One rod will be placed into each tube. Lastly, the incisions will be closed so that no stitches will be needed.
How Long Will It Take?
- Inflatable implant—1-2 hours
- Malleable implant—30-60 minutes
Will It Hurt?
You will be pain free during the procedure. After, medicines are used to ease pain.
Average Hospital Stay
You may need to stay a night in the hospital. If you have problems, it could be longer. Some people are able to go home the same day. Your doctor will let you know before the procedure.
Post-procedure Care
At the Hospital
The healthcare staff will:
- Take out the catheter
- Give you antibiotics and pain medicines
At Home
To help you get healthier faster:
- Don’t have sex for at least 6 weeks.
- Don’t do any heavy lifting or intense activity.
- Follow wound care orders to avoid infection.
Call Your Doctor
Call your doctor if any of these occur:
- Redness, swelling, pain, bleeding, or pus draining from the incision
- Swelling in your scrotum or penis
- Blood in your urine
- Fever, chills, or flu-like symptoms
- Persistent nausea or vomiting
- Pain or other problems when passing urine
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
Men's Health Network
http://www.menshealthnetwork.org
Urology Care Foundation
http://www.urologyhealth.org
CANADIAN RESOURCES:
Diabetes Canada
http://www.diabetes.ca
Men's Health Centre
http://www.menshealthcentre.net
REFERENCES:
Erectile dysfunction. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113875/Erectile-dysfunction. Updated December 15, 2017. Accessed June 14, 2018.
Erectile dysfunction. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/erectile-dysfunction?article=11. Accessed June 14, 2018.
Montorsi F, Rigatti P, Carmignani G, et al. AMS three-piece inflatable implants for erectile dysfunction: a long-term multi-institutional study in 200 consecutive patients. Eur Urol. 2000;37:50-55.
Mulhall JP, Ahmed A, Branch J, Parker M. Serial assessment of efficacy and satisfaction profiles following penile prosthesis insertion. J Urol. 2001;165:1429-1433.
Penile prostheses. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/Pa-St/Penile-Prostheses.html. Accessed June 14, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 6/14/2018