Penile Prosthesis Surgery in Italy: Personal Experiences, Complications and Considerations after 552 Cases

Abstract

The Implant of Penile Prostheses (Silicone, Malleable, Inflatable) represents an efficient solution for patients affected by Erectile Dysfunction (ED) and penetrating incapacity who do not respond to the other treatment modalities (PDE5i, PGE1, Vacuum Systems). Patients with penile prostheses regain the spontaneity of intercourses without having to assume drugs, to introduce mechanically medical substances or to activate complex mechanisms. Just like the whole field of prosthetic surgery, introducing into the organism a "foreign body" can lead to complications connected to the patient, the inserted matter, the inserting surgical procedure and the after-care. A "relevant" complication-which almost always leads to the removal of the implant and thus to the failure of the surgeon's treatment and to the extreme disappointment of the patient's expectations-can often be considered as result of an initially "small" complication, which could be faced and solved (with drugs or a minor surgery) without having to resort to removal. The authors present a variety of medical and surgical procedures, derived from their over 34-year experience (1984-2018) in Penile Prosthesis Surgery (PPS), which may be implemented to avoid implant failure. Plenty of other complications are possible and have been registered in Medical Literature. They are often caused by reactions of the penile tissues, by vascular or hemorrhagic phenomena, by modifications in the penile or glans sensibility.

Defining the Incidence and Management of Postoperative Scrotal Hematoma after Primary and Complex Three-piece Inflatable Penile Prosthesis Surgery

“…Hematoma formation is an unfavorable complication with a wide variation in incidence, ranging from 0.2-22.2% in primary implant recipients 6,7,10 - 15 . Prevention of postoperative IPP bleeding complications correlates with shorter recovery time and decreased risk of device infection.…”