Mayo Clinic: Men’s Health Center

Overview

This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable.

Penile implants are usually not recommended until other methods such as lifestyle change and pills have been tried first. Implants have a high degree of satisfaction among men who have tried and failed more-conservative therapies. As with any surgery, there's a risk of complications, such as infection.

























Complications and Risks


Risks and complications

When you have a penile prosthesis, usually you are not able to have a natural erection. Instead, you use the prosthetic implant.

Rarely, problems may happen.

Your prosthesis may need to be removed if:
• The prosthesis doesn’t work.
• You get an infection. (See “When to Contact Your Surgeon.” )
• There is injury to surrounding organs, such as the urethra, bladder or bowels. This is rare but when it happens, another surgery may be needed to repair the organ.
• The tissue next to the prosthesis wears away. This is called tissue erosion. If this happens, the device would pop through the skin or you would see a new bulge in the area. This typically would take many years to happen.
• You often or always have pain in your penis.

Also, fluid from the prosthesis could leak into the body. However, the fluid is salt water, commonly called saline. Your body can absorb it with no bad side effects.

Problems related to anesthesia include heart attack, stroke or death. These are very rare risks. Before surgery, your health care provider may ask you to see an anesthesiologist, cardiologist or other provider. 

How this therapy works


Why Consider a Penile Prosthesis?

Having a penile prosthesis may be a difficult decision for you. Knowing what is involved may help you make your decision. This information is about how you may benefit from a prosthesis, and it describes the kinds of prosthetic implants available. It explains the surgery, how you prepare for it, and how you care for yourself afterward. If you have questions after reading this information, contact your health care provider.

The penis has two erection chambers. They become firm when you have a natural erection. If you cannot have a natural erection, it is called erectile dysfunction.

One way to treat erectile dysfunction is to put a device into your penis that can help you get an erection.

This device is called an inflatable penile prosthesis, or IPP. The device is placed, or “implanted,” completely within your body. What could a penile prosthesis do? A penile prosthesis is meant to help you have a firmer erection for a longer time. It may also increase the width of your penis somewhat. And for some men, it may slightly lengthen the penis. What does a prosthesis not do? The prosthesis and its surgery should not affect the feeling you have in your penis, your orgasms or your ejaculations. A penile prosthesis does not change how you urinate. 

What could a penile prosthesis do?

A penile prosthesis is meant to help you have a firmer erection for a longer time. It may also increase the width of your penis somewhat. And for some men, it may slightly lengthen the penis. 

What does a prosthesis not do?

The prosthesis and its surgery should not affect the feeling you have in your penis, your orgasms or your ejaculations. A penile prosthesis does not change how you urinate. 

How does a penile prosthesis work?

Several types of penile prosthesis are available. The decision about which prosthesis to use depends on your medical condition and needs at this time.

The three types of prosthesis are:

• Flexible implant: A flexible prosthesis has one or two cylinders placed inside, or implanted, in the penis. This type of prosthesis does not have a pump or reservoir. It may be bent by hand into an erect or non-erect position. This is also called a “malleable” implant.

• Two-piece implant: A two-piece prosthesis has a pair of cylinders and a one-piece unit that holds both a pump and a reservoir of fluid. The pump-and-reservoir unit is placed in your scrotum. (See Figure 1.)



 Three-piece implant: A three-piece prosthesis has two cylinders, a scrotal pump and a reservoir. (See Figure 2.)
– Each cylinder is placed in one of your erection chambers. The cylinders are made from medical-grade material. They are not made of latex.
– The pump is implanted inside your scrotum. Pressing on the pump inflates the cylinders with fluid. This gives you an erection. When you don’t need an erection any longer, you press a release button near the pump. This returns the penis to its normal state.
– The reservoir is placed in the lower abdomen, under the muscle. It is filled with saline.





Proper use



Care After Surgery - Also please watch the above common postoperative IPP questions video

• During your surgery, the surgeon may partially inflate the cylinders in your penis with saline. This inflation helps reduce scarring and bruising. The inflation will lead to a mild erection, but it will not be visible to other people. The cylinders stay inflated until your prosthesis is activated or you are given different instructions by your surgeon. Wearing an athletic supporter is advised.

• Your health care provider may take the catheter out of your bladder after surgery or on the next day.

• Your health care provider may take off the dressing 24 to 48 hours after surgery.

• After surgery, you may have ice packs on your scrotal area. These help reduce swelling. Swelling, bruising and pain are common after this procedure.

• Your body needs a few weeks to heal before you use the prosthesis.

For more directions about how to take care of yourself, read the information given to you before you leave.

Activity

During your recovery, take short walks often. Slowly increase your activity as you feel able.

Activity limits

Read the information given to you before you leave.

• Do not take a bath or use a swimming pool, sauna or hot tub for one week after surgery.

• Do not drive any time you are taking narcotic pain medication.

• Ask your surgeon when you may return to work.

For 3 to 6 weeks after surgery:

• Do not lift anything heavier than 8 to 10 pounds. A gallon of milk weighs about 8 pounds.

• Do not engage in sexual activity.

• Avoid heavy exercise and activity, such as football, baseball, biking, golfing, and pushing heavy objects.

Pain

Your scrotum and penis may be swollen, tender and bruised for several weeks after surgery. Wear the athletic supporter for at least the first 24 hours after your surgery. Continue to wear the supporter when you are active. Some men are helped by wearing 2 pair of underwear. This may help you feel more comfortable.

Using an ice pack over the scrotum may help reduce pain and any swelling and bruising. Always keep gauze or a thin towel between the ice pack and your skin.

For some men sitting is very painful, using a "donut" to sit on (often used after hemorrhoid surgery) is effective.

Some men have chaffing issues for which lubricants such as those used by distance runners to prevent abrasions can be effective.

Swelling

To help lower your swelling, try using ice packs. (See “Pain.”) Also, rest with your feet raised above your heart.

Medications

• Pain medications: Take the prescribed medication for pain control as you have been told to do. When you no longer need that medication, take a non-aspirin pain reliever, such as acetaminophen (Tylenol™ and generic versions).

• Antibiotics:
– Now: Your health care provider may give you a prescription for antibiotics. Take the antibiotics as directed.
– In the future: Some health care providers may tell you to take antibiotics before you have medical or dental procedures. Most men with penile implants do not need routine antibiotics for these types of procedures. Talk to your health care provider about your prosthesis and about any medical or dental procedures you have planned.

• Stool softener: If you become constipated, ask your health care provider about using a stool softener. General anesthesia and narcotic pain medication may lead to constipation.

Incision care


Do not pull or take out your stitches. They should “melt,” or dissolve, about 6 to 8 weeks after surgery. Keep your incision clean and dry.

Bathing

Follow these directions unless you are given different directions by your surgeon or unless you get different written directions after your procedure.

• For the first week after surgery, take sponge baths and do not scrub the incision area.

• A week after surgery, you may resume showering or bathing.

Diet

• You may return to eating a healthy diet when you feel able.

• Be sure to eat some high-fiber foods. For example, eat whole grain breads and cereals, fresh fruit and vegetables.

• Drink enough fluid daily to help prevent constipation.

Follow-Up

After you are released from the hospital, you will get information about a follow-up appointment. If you need to reschedule that visit, call the phone number listed on that form. During the follow-up appointment, ask your health care provider:

• When you may begin to use your inflatable penile prosthesis.

• How to use your prosthesis.

Follow the directions that came with your prosthesis. If you have questions about the prosthesis after you begin using it, call your health care provider.

Register your prosthesis


You may record, or register, your device with its manufacturer. This information is in the product’s booklet. You will need to know your device number and the date and location where your surgery was done. After you register your implant, the manufacturer will send you a plastic medical identification card. Carry that card with you at all times.

When to Contact Your Surgeon

• If your incision(s) open again.

• If you have any of these signs of infection:

– A temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or greater.
– Chills.
– Drainage, redness or warmth at your incision or on the skin over the pump.
– Drainage from your penis.
– Cloudy or bad-smelling urine.
– Increased pain or tenderness at your incision site

If you have any questions relating to your surgery you can contact your surgeon in the following ways:

  • To contact your surgeon, call the appointment office at (507) 538-5363, where they will create a message to be sent to your surgeon and their care team, a member of the care team will return your call during normal business hours.

  • To contact the nurses, call the Appointment office (507) 538-5363, they will leave a message with the nurses and the nurses will return your call during normal business hours.

  • After hours or with emergency concerns please call (507) 284-2511 and ask to speak with the urology resident on call.

  • If you have the patient portal please feel free to send a message about non-emergency concerns via online messaging. Your message will be responded to by a member of your surgeons care team.


How to prepare for a visit


Before Surgery - Please watch videos above for surgical pre-operative prep 30 days and day prior to surgery

Be sure to read instructions you are given before your surgery. It has directions about what you need to do to get ready for surgery. Also, be sure to talk to your health care provider before surgery day if you have any questions.

Medications

Tell your health care provider about all prescription and over-the-counter medications you take. Follow your health care provider’s directions about taking these medications before and after your surgery.

If you take blood-thinning medications

Before your surgery, your blood-thinning medication routine may need to be changed, it also may not be. Talk with your health care provider who manages these medications as soon as you can. Because blood-thinning medications affect clotting and bleeding, both the health care provider who manages these medications and your surgeon will need to decide if your medications need to change.

If you are not sure if you are on medications that affect blood-thinning, contact your surgeon.

If you have diabetes

Before your surgery, contact the health care provider who manages your insulin or other diabetes medications for specific instructions on taking or adjusting them.

Wash with surgical soap, if you are told to

You may be given special soap to use before surgery. This is called surgical scrub. If you are told to use this scrub, wash with it the night before surgery and the morning of surgery, as you were told by your health care provider.

Other instructions

• You need to have someone drive you home after you are released from the clinic. You will not be allowed to drive for at least 24 hours after surgery. Ask your surgeon whether you are likely to be dismissed on the day of surgery or whether you are more likely to spend one night in the hospital.

• Your surgery may be scheduled for a different time if you have a rash or signs of infection in your groin area. Signs of an infection include:

- Temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or greater.
- Chills.
- Increased swelling, tenderness or redness at the site.
- Increased pain or pain not relieved by pain medications.
- Drainage or oozing, or bad-smelling odor coming from the site.

• If you have questions about your condition, call your health care provider’s office and ask to speak with a nurse.

The Day of Surgery


On the day of surgery, a health care provider places an intravenous (IV) catheter in your arm. You are given antibiotics and pain medication through the catheter. You are also given general anesthesia, which causes you to sleep. You have a different catheter in your bladder to drain urine during surgery.

How is the prosthesis placed?

Your surgeon makes small cuts, called incisions, either above the penis, where the penis meets the abdomen, or under the penis, where the penis joins the scrotum. No tissue is removed. Men usually do not lose a lot of blood during this procedure.

After the prosthesis is placed, your surgeon closes the incision with stitches. The stitches, also called sutures, should melt, or dissolve, in about 6 to 8 weeks. You do not need to return to where you had your procedure to have the stitches taken out.

Right after surgery

After surgery, you have a gauze dressing covering the incision(s). You need to wear an athletic supporter for at least 24 hours after surgery. But you can wear it any time after surgery to reduce pain or discomfort. (See also “Pain.”) An athletic supporter is also called a jock strap, a duke strap and a scrotal supporter.


Did you know?

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