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Penile Prosthesis

Inflatable penile prosthesis for erectile dysfunction


A penile prosthesis can be an option when other treatments for erectile dysfunction have failed. A small proportion of men will not get benefit from oral medications, injections, or a vacuum pump. In the right men a penile prosthesis can be an excellent solution. It works by using a pump placed in the scrotum to inflate 2 cylinders in the penis, giving the ability to have an erection on demand.


There are some downsides however. The device is very expensive, but is usually covered by medical insurance. With any foreign material there is always a risk of infection. This infection risk is higher in men who are overweight, smokers, or diabetic. The other risk with this type of surgery is that there is always a small risk of the device failing. In addition, the glans or head of the penis does not engorge like a normal erection. In men who have not had any luck with other treatments, a penile prosthesis can be an excellent treatment.


The procedure involves an operation done under general anaesthetic. It usually takes 60-90 minutes, and usually you stay the night in hospital.

The device itself is of 3 parts; 2 cylinders which go inside the penis itself, a pump which sits in the scrotum, and a fluid reservoir which sits inside your abdomen. The procedure is done through an incision in the scrotum. Occasionally you need another cut to be made in your groin to place the reservoir. Often you will have a drain and possibly a catheter in place when you wake up. There is a compression dressing wrapped around the penis to reduce bruising and swelling. The drain normally comes out the day after surgery. The device is often inflated overnight, and is deflated before you go home.


What are the risks of penile prosthesis surgery?


Like any procedure there are risks. These include;
1. Bruising and swelling. This occurs in all patients, and is associated with discomfort for 7-14 days. You will go home with a prescription for ample pain relief.
2. Infection of the device–1-2% of patients
3. Mechanical failure of the device–5% of patients
4. Erosion of the device needing more surgery–5% of patients

5. Men do notice a degree of penile shortening. This is usually due to the condition that has caused the erectile dysfunction in the first place, ie it is not directly related to the implant surgery itself. If men do not have erections for an extended period of time this can lead to penile fibrosis and penile shortening. Surgery for prostate cancer will also shorten the penis.


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