An update on the best approaches to prevent complications in penile prosthesis recipients

Abstract

Placement of inflatable penile prosthesis is a procedure frequently performed for medication-refractory erectile dysfunction. Device implantation is not without risks, and as the frequency of device implantation increases, so do associated complications. The aim of this work is to review the most frequent operative complications associated with implantation of inflatable penile prostheses, and to review the best approaches to prevent these most common complications. Complications can broadly be categorized as infectious, noninfectious tissue-related, device-related, or related to patient and partner satisfaction. With understanding of these complications and ways to avoid them, as well as with appropriate patient selection and counseling, the inflatable penile prosthesis is an excellent option for the treatment of erectile dysfunction.

Treatment of Penile Prosthesis Implant’s Infection

“…Both forms can require removal of the entire device. One of the most problems of the conservative treatments is the presence of the biofilm, which impedes antibiotic penetration and reduces phagocytosis [20, 21]. Once established which is the microorganism involved in the infection, an appropriate antibiotic therapy should be promptly performed (Table 1).…”

“…Although technically harder, delayed re-implant surgery currently remains safer than immediate re-implant surgery. While newer salvage techniques have demonstrated increased success [21], further strong studies are required to identify how to improve techniques and strategies for immediate salvage procedures, enabling a complete exploitation of their benefits relative to delayed re-implantation, cost effectiveness, technically easier, and with a reduced risk of penis shortening.…”

Epididymo-Orchitis and Pelvic Abscess in a Patient With Inflatable Penile Prosthesis

“…Had prosthesis removal been elected, the options would include immediate reimplantation of a new device (termed “concomitant implant after explant”) or revision surgery at a later date. The challenge with delayed reimplantation is fibrosis of the canal and shortening of the penis but is considered safer for the patient [ 12 ].…”

Effect of a three-piece inflatable penile prosthesis combined with a phosphodiesterase-5 inhibitor on erectile dysfunction

“…Because IPP implantation is an invasive treatment for ED patients, it might be associated with various complications, such as urinary retention, mechanical failure, and infection. 26 In this study, we also investigated the clinical outcome after implantation. The results showed that IPP implantation combined with sildenafil could increase the overall IPP survival rate and reduce the complication rate, swelling, and pain duration.…”