Placement of a penile prosthesis is done in men who have failed other conventional treatments for erectile dysfunction such as medication and injection therapy. It is also done at times in men suffering from Peyronie’s disease which causes penile curvature in order to straighten out the penis as well as treating underlying erectile issues. It involves placement of two cylinders along the length of the penis as well as a pump that is placed in the scrotum and a reservoir which is placed in the abdomen. A general or spinal anesthetic is required and one scrotal or lower abdominal incision is typically made. The procedure takes about 90 minutes to perform and patients usually stay one night in the hospital.
What to expect afterwards:
After discharge the patient can expect bruising and swelling of the penis and scrotum. Patients are sent home with antibiotics and pain medication. Patients are also instructed to ice the scrotum and use scrotal support to help with swelling. Your urologist may also recommend that you gently milk the scrotal pump downward 2-3 times a day to keep the pump as low in the scrotum as possible. The device is left inactive for 4-6 weeks after placement. On follow up with the doctor the patient is taught how to use the device. Prior to sexual activity the pump in the scrotum is compressed several times which shunts fluid that is stored in the abdominal reservoir into the penile cylinders creating a rigid and straight erection. Following sexual activity a release button is pressed and the penis is gently squeezed sending the fluid back into the reservoir for storage.
Patients should understand that the erection with the prosthesis might not have the same length or girth that it once had with a normal spontaneous erection. Patients also need to be sure they desire this procedure because once done it is not possible to go back to normal spontaneous erections.