This procedure is carried out to correct sexual dysfunction if it is not treatable by other forms of treatment or if you prefer this treatment over others.
Performed under spinal or general anesthesia, in this procedure an incision is made at the junction of the penis and the scrotum, the pubic area (two fingers above the base of the penis), or close to the head of the penis, depending on the type of prosthesis being used. Malleable rods and articulating rods are placed in the penis only.
Two-piece inflatable prostheses have a penile component and pump and reservoir part for placement in the scrotum. Three piece-inflatable prostheses have penile/scrotal (pump) components and pelvic/abdominal (reservoir) components.
This procedure results in loss of 50 cc of blood and does not require blood transfusion. It takes about two hours depending on type of prosthesis being inserted.
Post Operative Care
You will spend two to four hours in recovery. You may/may not be able to eat depending upon your body's reaction to the anesthetic. You will also have a urinary catheter to drain the bladder, which will be removed the next day.
If you have a drain, it will also be removed the next day. The dressing is removed the next day. You may take sponge baths not showers. You may either stay in the hospital overnight or may go home (but will need to come to clinic the following day) and will be able to go back to work in one to two weeks depending on the type of prosthesis.
You will be given pain medications and antibiotics to take at home. You should not engage in sexual intercourse for four weeks and avoid all strenuous activity that might result in contact with the prosthesis or its components. An inflatable prosthesis should be cycled at least once a week and should be deflated at all other times to prevent a constricting fibrous capsule to form around the pump/reservoir component.
Initial success rate is 90 percent. On average, inflatable prostheses function effectively for 10–15 years and semi-rigid a little longer.
- This is an irreversible procedure and results in extensive changes to erectile tissue.
- After this procedure erection is not the same as the erection when you were younger and the penis may become shorter and narrower.
- It might require surgery in the future for its complications, including its removal. Replacement is not guaranteed.
- It does not affect abilities to achieve climax or ejaculation.
- Prophylactic antibiotics may be considered for future surgery on other organs such as dental work.
Possible Side Effects and Complications
- Infection is the most serious complication, and the rate is 1–3 percent. It may manifest early (in 10 days or so) or late (in several months or years). The infection rate is higher if you have scar tissue in the penis from Peyronie's disease or previous implantation.
- Device malfunction is about five percent in five years (much higher after five years). Malfunction includes self-inflation, leakage of fluid, difficult deflation, device failure, and the like.
- Perforation of the prosthesis may occur at the back of the penis behind the scrotum, into the urethra, or at the head of the penis. If perforation of the urethra occurs during surgery, the operation may have to be stopped. If it occurs later, the device will have to be removed or replaced and the site of perforation repaired.
- The tubings of a three-piece prosthesis may be injured in future abdominal or scrotal surgery. Always inform other providers that you have an implant in place!
- Pain may persist for several weeks or even months following surgery.
- Tissue loss (necrosis) may occur in patients with vascular disease (diabetes) or patients undergoing extensive reconstruction of the penis for scarring or Peyronie's disease.
- There may be substantial interference with urination with a semi-rigid prosthesis.
- Other complications include numbness near the incision which may take several months to resolve; swelling and bruising (blue and black), which may take several weeks to resolve; and some scarring near the incision, along with other possible complications.
Pills such as Viagra, a urethral insert such as MUSE, injection treatment into the penis, and vacuum suction device with/without injection treatment are alternatives that you, with your doctor, could consider.