18 March 2019 Author: Bruno Graça The implantation of a penile prosthesis is a surgical treatment for erectile dysfunction. This is an option to consider when less invasive therapies have been unsuccessful and it is the last possible option. Penile prostheses are also used in the treatment of penile curvature associated with erectile dysfunction. This enables both problems to be dealt with simultaneously. What are the different types of penile prosthesis? There are two types of penile prosthesis: Malleable prosthesis; Hydraulic prosthesis. Both prostheses rest completely inside the body without any external components. Malleable prosthesis Malleable prostheses consist of 2 prosthetic cylinders and do not require manipulation to obtain an erection. The penis is always erect , and can be guided to the desired position. Hydraulic prosthesis Hydraulic prostheses consist of 2 parts (cylinders and pump) or 3 parts (cylinders, pump and reservoir). It is associated with a higher rate of satisfaction than the malleable prosthesis, as the penis can be flaccid most of the time and rigid only when is necessary. With the hydraulic prosthesis, it is possible to obtain an erection only for the duration of sexual intercourse, by operating the pump located in the scrotum. Thus, it is necessary for the patient to have normal manual skills. By manipulating this pump, the patient can maintain the desired erection to engage in sexual activity for as long as he needs in order to have satisfactory sexual relations with his partner. When intercourse is over the prosthetic cylinders are emptied, again by operating the pump, and the penis returns to its normal flaccid state. Where is penile prosthesis implantation surgery carried out? Penile prosthesis implantation surgery should be performed at specialised centres. The surgery takes about one hour , and the components for the prosthesis are inserted through a small incision in the scrotum. As a general rule, the post-operative period involves no complications and patients are discharged in less than 24 hours. How can good post-surgical recovery be ensured? For optimum recovery, physical exertion should be avoided for around 1 week after discharge. Other measures that should be taken include: Application of ice to the area; Use of elastic compression dressing; Pharmacological treatment. These measures are determined by the doctor and are adapted to each case as applicable. Two or 3 weeks after the surgery, with the support of a urologist or a dedicated nurse the patient knows how to manipulate the prosthesis, and will be able to use it in the next sexual intercourse. Are there any risks associated with penile prosthesis surgery? The are no significant risks associated with surgery for the implantation of penile prostheses. In fewer than 1% of cases infection may occur, and it may be necessary to remove the prosthesis. There are reports of rare and delayed cases (several months or years after the implantation of the prosthesis) where: Infection of the prosthesis has required its removal; Erosion of the urethra or gland has occurred as a result of the prosthesis (more common with a malleable prosthesis); Mechanical malfunction of the pump has required the replacement of components (hydraulic prosthesis). Are there any limitations associated with penile surgery? Penile prostheses do not interfere with the activities of daily life or call for any special restrictions. Patients can work, travel and play sport normally. In the first few weeks , when the body is adapting to the prosthesis, there may be some discomfort, which is temporary. The penile prosthesis does not have a defined period of duration and the same prosthesis can function normally for the rest of the patient's life. At the hospitals and clinics of the Hospital da Luz network, you can find urology specialists who will carry out the necessary examinations and procedures in this area. More about the urology team at Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
