Surgical Implantation Of Penile Prosthesis

WHAT YOU SHOULD KNOW:

  • Surgical implantation of a penile prosthesis is surgery to treat erectile dysfunction (ED) or impotence. A penile prosthesis is a device that is implanted or placed in the penis. This implant makes it possible for the penis to have and keep an erection. Normally, the penis has spongy tissues that surround a tube through which urine and semen pass. When a man gets sexually stimulated and excited, blood fills his penis, and it becomes erect and firm. An erect penis may make a man able to perform sexual intercourse (sex). More stimulation may lead to an ejaculation where semen is passed out of the penis. Erectile dysfunction or impotence is where the penis fails to become erect enough for sexual intercourse or fails to ejaculate.



  • In surgical implantation of a penile prosthesis, an inflatable or semi-rigid rod implant may be inserted in the penis. An inflatable implant is a fluid-filled device that can easily be hidden and feels the most natural. It has a pump, cylinder (container), and reservoir (storage area). Squeezing the pump allows fluid to flow from the reservoir to the cylinders, which causes the penis to become erect. A release valve or bar allows the penis to deflate. A semi-rigid implant is bendable and may be controlled by bending the penis up or down to give an erection. Your caregiver will make one or more small incisions (cuts) to insert the implants. An incision may be made on the penis, just above the penis where it joins the pelvic area, or just under the penis where it meets the scrotum. An incision may be made on the abdomen (stomach) and the scrotum, depending on the penile implant that is chosen. An implant will help create an erection, but the device will not increase sexual drive or fix other problems related to having sexual intercourse. You and your caregiver will decide on what type of penile implant is right for you. With surgical implantation of a penile prosthesis, your impotence may be treated and your quality of life improved.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your healthcare provider. Do not stop taking your medicine unless directed by your healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Ask your caregiver when you should return to have your wound checked, catheter and drains taken out, and stitches removed.

Bladder care:

  • Urinary catheter: You may need to learn how to insert a urinary catheter by yourself, if you need one after your surgery. A catheter is a soft rubber tube that you put into your urethra to drain your urine. The urethra is the tube through which urine and semen leave the body. Ask your caregiver for more information on self-catheterization and catheter care.

  • Voiding: Do not let your bladder become too full before emptying it. Set regular times each day to urinate. Urinate as soon as you feel the need. Try to urinate often while awake and avoid drinking liquids before going to bed. At bedtime, urinate before lying down. This will keep you from having to get up to urinate after going to bed.

Having sex:

You may need to wait 3 to 6 weeks after the surgery before you may be able to use the penile prosthesis. You may feel awkward or uncomfortable when using the implant for the first time. These problems may not last long and most can be helped. Talk to your caregiver if you are worried, have concerns, or are having problems operating the penile prosthesis. The following may help you get started using your penile implant:

  • Inflatable implant: Squeeze the pump that is located in the scrotum. This transfers the fluid into the cylinders and makes the penis erect. To return the penis to a non-erect position, press the valve or release bar of the pump. The fluid from the cylinders will go back into the reservoir and the implant will be deflated.

  • Semi-rigid implant: A semi-rigid implant is always ready and easier to use. It may be bent down for urination or when not used for sex. When having sex, it may be bent upward or downward.

Rest when you need to while you heal after surgery.

Slowly start to do more each day. Return to your daily activities as directed.

Self-care:

  • Bathing and wound care: When you are allowed to bathe or shower, carefully wash the incisions with soap and water. Afterwards, put on clean, new bandages. Change your bandages any time they get wet or dirty. Always check your drain when changing your bandages. Do not pull it out. Ask your caregivers for more information about wound and drain care.

  • Clothing: Avoid wearing tight-fitting clothes, such as briefs, or tight fitting shorts or pants.

  • Identification (ID) card: Always carry your penile prosthesis ID card in your wallet.

  • Scrotal support: Most men have pain for several weeks after having a penile prosthesis. Aside from taking medicines to ease pain or swelling of your scrotum, you may need to use a scrotal support. You may also need to elevate your scrotum using a towel roll. Ask your caregiver for more information on scrotal support.

CONTACT A CAREGIVER IF:

  • You cannot make it to your next visit with your caregiver.

  • You have a fever.

  • You have blood in your urine or trouble urinating.

  • You have chills, a cough, or feel weak and achy.

  • You have dizziness, nausea (upset stomach), or vomiting (throwing up).

  • You have problems making your implant work, such as problems having an erection, or being unable to deflate the device.

  • You have questions or concerns about your surgery, condition, or care.

SEEK CARE IMMEDIATELY IF:

  • You feel like an implant is stuck to the skin.

  • Your urine has blood in it, becomes very cloudy and foul (bad) smelling, or you cannot urinate.

  • If you have a catheter:

    • You have a problem with your catheter, such as a blocked catheter.

    • You have no urine filling the bag, or there is blood in your urine.

  • You have pain or swelling of the penis or scrotum that does not decrease or go away after taking your pain medicine, or is getting worse.

  • You have swelling, redness, pain, blood, or drainage in or around your incisions, or where the catheter enters the penis.

  • You see tubing or part of an implant poking through the skin.

  • You have sudden chest pain or trouble breathing.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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