Abstract
Penile prosthesis surgery represents the end-stage treatment for erectile dysfunction. It is conventionally used only in cases of erectile dysfunction refractory to pharmacological treatments or vacuum constriction devices. Contemporary literature suggests that penile prothesis surgery is associated with a high satisfaction rate and a low complication profile. However, it must be appreciated that the complications of surgery can have devastating consequences on a patient’s quality of life and satisfaction and include infection, prosthesis malfunction, penile corporal perforation and penile length loss. Several factors – such as appropriate patient selection, methodical preoperative assessment and patient optimization, specific intraoperative protocols and postoperative recommendations – can reduce the risk of surgical complications. This narrative review discusses the diagnosis and management of both intraoperative and postoperative complications of penile prosthesis surgery.
Highlights
Penile prosthesis surgery represents the end-stage treatment for erectile dysfunction
Contemporary literature suggests that penile prothesis surgery is associated with a high satisfaction rate and a low complication profile[1]
The complications of surgery can have economic ramifications and negatively impact patient satisfaction and quality of life as there is a risk of penile length loss
Summary
Penile prosthesis surgery represents the end-stage treatment for erectile dysfunction. Penile prosthesis revision surgery is associated with a 10% increased risk of infection compared with primary insertions (0.1%)[13,14], and patients should be counselled . The use of ventral phalloplasty, suprapubic lipectomy, and liposuction and suspensory ligament release are standard techniques for increasing perceived penile length size[99] These procedures can be performed simultaneously with the implant insertion, thereby reducing operating times and additional costs. Other techniques such as relaxing tunica albuginea incisions, lengthening procedures such as the sliding technique or the use of postoperative penile rehabilitation with a vacuum device can increase penile length and improve patient satisfaction[100]. The authors advise that complex procedures should be performed in specialized centres with high-volume surgeons[103]
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