Our Summary

This research paper is about the use of penile prostheses, commonly used for men who can’t achieve an erection, in patients who have previously had major pelvic surgeries. The placement of the device’s fluid reservoir can be tricky in these patients due to changes in the pelvic anatomy from surgery. The researchers reviewed existing studies on this topic to gather tips and guidance for these difficult cases.

The researchers found that the success rates and reported satisfaction were similar for patients who had undergone pelvic surgery and those who hadn’t, regardless of the reason for the surgery. They also found that if a surgeon was uncomfortable placing the fluid reservoir in the usual place, a two-part penile implant could be used instead. For doctors using a three-part implant, alternative positions for the fluid reservoir have been developed to avoid causing damage to the bowel, bladder, or blood vessels.

The paper concludes that it is possible and safe to fit a penile prosthesis in patients who have had major pelvic surgery, with good results and patient satisfaction. The fluid reservoir can either be placed in a different location, or a two-part device can be used.

FAQs

  1. Is penile implant surgery safe for patients who have previously had major pelvic surgeries?
  2. What alternatives are available if a surgeon is uncomfortable placing the fluid reservoir in the usual place during a penile implant surgery?
  3. Are the success rates and patient satisfaction similar for patients who have and haven’t undergone pelvic surgery prior to penile implant surgery?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about penile implant surgery is to follow post-operative care instructions carefully to ensure proper healing and function of the implant. This may include avoiding strenuous physical activity, keeping the area clean and dry, and taking any prescribed medications as directed. It is also important to attend follow-up appointments with the doctor to monitor the implant and address any concerns or complications that may arise. By following these recommendations, patients can maximize the success of their penile implant surgery and improve their quality of life.

Suitable For

Overall, patients who are typically recommended for penile implant surgery include those with erectile dysfunction that cannot be successfully treated with other methods such as medication or vacuum devices. This may include patients with conditions such as diabetes, cardiovascular disease, or spinal cord injuries. In the case of patients who have had major pelvic surgeries, such as prostatectomy or colorectal surgery, penile implant surgery may be recommended if they are experiencing erectile dysfunction as a result of the surgery.

It is important for patients considering penile implant surgery to consult with a urologist to determine if they are a suitable candidate for the procedure. The decision to undergo penile implant surgery should be made after a thorough discussion of the potential risks and benefits, as well as consideration of the patient’s overall health and medical history. Ultimately, the goal of penile implant surgery is to improve the patient’s quality of life and sexual function.

Timeline

Before penile implant surgery, the patient will typically undergo a series of consultations and evaluations with a urologist to determine if they are a suitable candidate for the procedure. The patient may also undergo tests such as blood work and imaging studies to assess their overall health and anatomy.

During the surgery, the urologist will make an incision in the penis and insert the penile implant device. This can be either a two-part or three-part device, depending on the patient’s anatomy and preferences. The fluid reservoir, which is typically placed in the pelvis, may need to be positioned in a different location for patients who have had major pelvic surgeries.

After the surgery, the patient will need to follow post-operative instructions provided by their healthcare provider, which may include taking antibiotics, managing pain, and avoiding strenuous activities. The patient will also need to attend follow-up appointments to ensure proper healing and functioning of the penile implant.

Overall, the research suggests that penile implant surgery can be a safe and effective option for patients who have had major pelvic surgeries, with similar success rates and patient satisfaction compared to those without a history of pelvic surgery. Alternative placement options for the fluid reservoir can be used to accommodate changes in pelvic anatomy, leading to successful outcomes for these patients.

What to Ask Your Doctor

Here are some questions a patient should consider asking their doctor about penile implant surgery:

  1. What are the potential risks and complications associated with penile implant surgery, especially in patients who have had major pelvic surgeries?

  2. How experienced are you in performing penile implant surgery in patients who have had previous pelvic surgeries?

  3. What type of penile implant device do you recommend for someone who has had major pelvic surgery? Is a two-part implant or alternative reservoir placement necessary in this case?

  4. What is the recovery process like for patients who have had penile implant surgery after major pelvic surgery? Are there any specific precautions or considerations to keep in mind?

  5. What is the expected success rate and satisfaction level for patients who have had penile implant surgery after major pelvic surgery, based on your experience and previous cases?

  6. Are there any specific factors from my previous pelvic surgery that may impact the success of the penile implant surgery, and how will you address these challenges during the procedure?

  7. What post-operative care and follow-up appointments will be necessary for someone who has had penile implant surgery after major pelvic surgery?

  8. How soon after the pelvic surgery can I undergo penile implant surgery, and are there any specific timing considerations to keep in mind?

  9. Can you provide me with any additional resources or information about penile implant surgery in patients who have had major pelvic surgeries, to help me better understand the procedure and potential outcomes?

Reference

Authors: Madiraju SK, Hakky TS, Perito PE, Wallen JJ. Journal: Sex Med Rev. 2019 Jan;7(1):189-197. doi: 10.1016/j.sxmr.2018.10.002. Epub 2018 Nov 30. PMID: 30503795