What is Penile Prosthesis Implantation

Penile prosthesis implantation is a procedure to put a device that treats erectile dysfunction into the penis. There are two main types of devices that can be put in during the procedure: malleable penile implants and inflatable penile implants.

Malleable penile implant

A malleable penile implant, also called a non-hydraulic or semi-rigid implant, consists of two silicone rubber rods. The rods provide some rigidity. They are also flexible, so the penis can both curve downward in its normal position and become straight for sexual intercourse.

Inflatable penile implant

An inflatable penile implant, also called a hydraulic implant, consists of cylinders, a pump, and a reservoir. The cylinders can be inflated with a fluid that helps to create an erection, and they can be deflated after intercourse. There are several types of inflatable implants.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection in the penis. If this happens, the implant may need to be removed.
• Bleeding.
• Allergic reaction to medicines.
• Damage to other structures or organs, such as the tube that drains urine from the body (urethra).
• Not enough blood reaching the penis. This is rare. If this happens, the implant will need to be removed.

What happens before the procedure?

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
  • You may be given antibiotic medicine.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• A flexible tube (catheter) may be inserted into your urethra and bladder. The catheter drains urine during the procedure and helps your surgeon easily locate your urethra.
• A small incision will be made in your scrotum or in your penis, just below the head of your penis.
• The cylinders of the prosthesis will be put into tissue on each side of your penis.
• If you will have an inflatable penile implant:
  • Incisions will be made in your abdomen and in your scrotum. These incisions will be used to insert the pump and the reservoir.
  • The cylinders, reservoir, and pump will be joined by tubes and tested.
• Your incision(s) will be closed with dissolvable stitches (sutures).
• A bandage (dressing) will be applied to your incision(s).
• You may be fitted with a device similar to a jock strap or underwear with a supportive pouch (scrotal support) to relieve pressure on the incision area.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• If you have a catheter in place, it may stay in place for the day after the procedure.
• You may be given antibiotics or pain medicines as needed.
• You may need to follow a clear liquid diet for the first 24 hours after the procedure.
• You may be encouraged to sit up and walk around.
• A towel roll or an ice pack may be placed under your scrotum to help reduce swelling.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Penile prosthesis implantation is a procedure to put a device that treats erectile dysfunction into the penis.
• There are two main types of devices that can be put in during the procedure: malleable penile implants and inflatable penile implants.
• After the procedure, you may be fitted with a device similar to a jock strap or underwear with a supportive pouch (scrotal support) to relieve pressure on the incision area.

Penile Prosthesis Implantation, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Incision care

• Follow instructions from your health care provider about how to take care of your incision(s). Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during the procedure.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Rest as told by your health care provider.
• Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Managing pain and swelling

• If directed, put ice on the affected area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

General instructions

• Follow instructions from your health care provider about eating or drinking restrictions. For the first 24 hours after the procedure, you may be told to follow a clear liquid diet. This diet is limited to liquids that you can see through, such as clear broth or bouillon, black coffee or tea, clear juice, clear soft drinks or sports drinks, gelatin dessert, and flavored ice.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Wear scrotal support only as told by your health care provider. If your scrotal support irritates your incision area, you may remove the support.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• The implant inflates on its own.
• The implant does not work or it stops working.
• Your penis becomes curved or it changes shape.

Get help right away if:

• You have more redness, swelling, or pain around your incision(s) or in your scrotum.
• You have fluid or blood coming from your incision(s).
• Your incision area feels warm to the touch.
• You have pus or a bad smell coming from your incision area.
• You have pain in your penis that gets worse.
• The skin on your penis becomes dark or discolored.

Summary

• Check your incision area every day for signs of infection, such as more redness or swelling.
• Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Wear scrotal support only as told by your health care provider. If your scrotal support irritates your incision area, you may remove the support.