Penile Prosthesis Insertion

by Jill Buchanan

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.

Penile Implant

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... . Updated December 15, 2017. Accessed June 14, 2018.

Erectile dysfunction. Urology Care Foundation website. Available at:
...(Click grey area to select URL)
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:
...(Click grey area to select URL)
Accessed June 14, 2018.

Last reviewed May 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 06/14/2018

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