Penile Prosthesis

What are penile prostheses?

Erectile dysfunction (ED) is a common sexual condition. It affects a man’s ability to get or keep an erection. ED is often treated successfully with medicines. When medicines and other treatments fail to help, surgery may be an option. This may include implanting penile prostheses.

A penile prosthesis is a device implanted with surgery. It helps the penis become erect. There are two kinds of prostheses:

• Semi-rigid rods also called malleable implants. The surgeon implants a tube with rods into the penis shaft. You can position the rod however it works best for you. This prosthesis is firm all the time.

• Inflatable cylinders. The surgeon implants 2 inflatable rods into the penis shaft. A saline reservoir is placed in the lower abdomen. A pump is implanted under the skin between the testicles. For an erection, you pump the saline into the rods.

Why might I need a penile prosthesis?

Penile prostheses are most commonly used to treat ED when medicine does not work. They are also used to treat Peyronie disease. This is a condition in which the penis is curved or bent abnormally due to a buildup of scar tissue.

What are the risks of a penile prosthesis?

All surgery has some risk. Possible complications from surgery for ED include:

• Infection

• Bleeding

• Failure or leakage of the prosthesis

• Wearing down of the prosthesis

• Injury to the urethra or bladder

• Impaired sensation

How do I get ready for the procedure?

• Your provider will review your health history and do a physician exam.

• Your surgeon may do a penile duplex ultrasound to assess blood flow in the penis.

• Do not take aspirin or anti-inflammatory medicines for 7 days before the procedure.

• Your healthcare provider will evaluate you for heart and blood vessel disease before you have this procedure. This is because erectile dysfunction is a marker of heart disease. If you have significant heart disease may not be a good candidate for penile implants.

• Your surgeon may want you to take antibiotics before the procedure to prevent infection.

What happens during the procedure?

1. Implantation for a penile prosthesis may be done as an outpatient. You will get general, spinal, or epidural anesthesia. Or it may be done with local anesthesia and sedation.

2. Hair is shaved around the area to be operated on right before surgery.

3. An incision may be made just above the penis in the pubic area or in the area between the penis and scrotum.

4. The implants which have been coated with antibiotic solution are put into place.

What happens after the procedure?

• After the prosthesis pieces are in place. The incision is closed. The penis is wrapped with gauze and a gentle compression dressing.

• Pain medicine may be given as needed,

• Avoid heavy lifting for the first week or two.

• You can shower 24 hours after the surgery.

• You will need to wait 4 to 6 weeks after the procedure before you can use the device. This will allow full healing.

• Penile prostheses will not increase the length of the penis.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure