However, the Clinical Guidelines of the American Association of Urology recognize the penile prosthesis may -after being assessed with the patient- be indicated as a first therapy, on the basis of the level of satisfaction provided to the patient & the couple (> 90%).
About the penile implant:
Before considering a penile implant:
As with any surgery, infection is possible. You might be at an increased risk of infection if you have a spinal cord injury or diabetes. However, nowadays with new devices available coated with antibiotics, the risk is really low, less than 2%.
New penile implant designs are reliable, but in rare cases the implants might malfunction. Surgery is necessary to remove, repair or replace a broken implant.
Before the procedure, you will have a full counselling session, with your doctor and specialist nurse, regarding the different types of implant, and you will be shown how they look and work.
Typically, an implant lasts 10 years, after which it will need to be exchanged for a new one.
Penile implant surgery is usually done at a surgery center or hospital. IV antibiotics are given to help prevent infection. The surgery site will also be shaved immediately before surgery to reduce the risk of infection. Never shave the genital skin by yourself at home before going to the hospital.
Surgical technique implantation may be either infrapubic or peno-escrotal.
A tube (catheter) might be inserted into your bladder via your penis to collect urine at some point during surgery. Your surgeon will make an incision at the base of the penis.
Next, your surgeon will stretch the spongy tissue in the penis that would normally fill with blood during an erection. This tissue is inside each of the two hollow chambers called the corpora cavernosa. Your surgeon will choose the correct size implant and place the implant cylinders inside your penis. All sizes are customized to your exact body measurements.
If your doctor is implanting a two-piece inflatable device, a pump and valve are placed inside the scrotum. For a three-piece device, your doctor will also implant a fluid reservoir under the abdominal wall through an internal incision.
Once the device is in place, your surgeon will sew the incisions closed. Penile implant surgery usually takes 45-60 minutes.
After penile implant surgery, you’ll likely need to take medications to ease pain. Mild pain might persist for several weeks. You might also need to take antibiotics for one week to prevent infection.
Your doctor will provide specific instructions during the healing process and about when you can resume normal activities. You’ll likely need to return to your doctor every other two weeks.
At this point, your doctor might recommend fully inflating and deflating inflatable penile implants twice a day to give you practice using them and stretch the area surrounding the cylinders.
Most men can resume sexual activity about four to six weeks after surgery.