Penile implant surgery

Preparation for surgery

In the weeks before

  • Medical optimisation matters: good diabetes control and stopping smoking reduce infection risk. You will be asked to have a urine test (to ensure sterile urine) and a MRSA screen.

  • Tell your surgeon if you’ve had prior pelvic surgery (e.g. prostate surgery) or hernia repair, or if you’ve had Peyronie’s disease/priapism/previous penile surgery, as this can change operative planning

  • Medications: your team will advise what to do with blood thinners/antiplatelets and supplements

The night before/morning of

  • Fasting: follow your fasting instructions (typically nil by mouth for 6 hrs prior to surgery)

  • Avoid shaving the genital area at home

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Day of surgery

  • You will be admitted, meet your anaesthetist and nursing team, and have final checks.

What happens during the surgery

  • Previously selected penile prosthesis (malleable or 3-piece) will be sized and implanted

  • An indwelling urinary catheter is inserted and this is usually removed on postoperative day 1

  • To reduce bruising/haematoma, your surgeon will place a small suction drain and wrap the penis/scrotum in a crepe bandage

Expected inpatient stay

  • Most patients go home 1-2 days after surgery (this varies with surgeon preference, your medical history, and how you recover)

  • The catheter is removed the morning after surgery

  • Before discharge you should be:

    • comfortable on oral pain relief

    • passing urine

    • walking safely

    • clear on wound care and follow-up

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After care

What to expect (first few days)

  • Swelling and bruising of the penis/scrotum is common

  • Pain is common but will resolve in a few weeks

Wound care

  • Keep dressings as advised by your team and keep the wound clean and dry

  • Avoid sitting in bath/pools for 4 weeks

  • Can shower as normal following discharge

Activity

  • Supportive underwear will greatly support your comfort and recovery

  • Avoid heavy lifting/strenuous physical activity for 6 weeks following surgery

  • You are to avoid all forms of sexual activity for 6 weeks after surgery

Using the device

  • A follow up appointment will be scheduled at 3-4 weeks to provide training on device cycling

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When to seek urgent help

Contact your surgeon or go to Emergency if you have:

  • fevers/chills or feel unwell

  • increasing redness, heat, worsening pain, pus or bad-smelling discharge from the wound

  • rapidly increasing swelling/tense scrotum

  • inability to pass urine after catheter removal

  • bleeding or severe pain not controlled with prescribed medication

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Risks and Complications

All surgery has risks. The list below summarises the possible risks and complications of penile implant (penile prosthesis) surgery in a patient-friendly way. Your individual risk depends on your health, prior surgery, and implant type.

Common early (short-term) risks

  • Pain and discomfort - especially in the first days to weeks

  • Swelling and bruising of the penis/scrotum

  • Bleeding / haematoma

  • Wound issues - minor bleeding, delayed healing, scarring

  • Infection - can be serious—may require antibiotics and, in some cases, implant removal

Device-specific risks (implant-related)

  • Mechanical failure over time

  • Fluid leak or cylinder/pump problems

  • Difficulty using the pump

  • Device malposition

  • Erosion or extrusion

  • Injury to surrounding structures

Functional risks

These aren’t dangerous, but they affect satisfaction and should be understood:

  • Perceived change in penis length or girth - some men feel erections look shorter than remembered

  • Changes in sensation - usually minimal, but can vary

  • Orgasm or ejaculation issues - often related to underlying conditions or prior pelvic/prostate surgery rather than the implant itself

  • Persistent curvature or Peyronie’s-related changes

  • Partner concerns - comfort, expectations, adjustment period

Longer-term risks

  • Need for revision surgery - (repair or replacement) due to mechanical issues, erosion, or infection

  • Chronic pain - uncommon, but possible

Factors that can increase risk

  • Diabetes (especially if poorly controlled)

  • Smoking

  • Obesity

  • Immune suppression or chronic steroid use

  • Spinal cord injury or reduced sensation

  • Previous penile implant or revision surgery (revision procedures generally carry higher infection risk)

  • History of pelvic radiation or complex pelvic surgery

When to seek urgent medical advice after penile implant surgery

Contact your surgeon or seek urgent care if you develop:

  • Fever, chills, or feeling unwell

  • Increasing redness, warmth, discharge, or worsening wound pain

  • Rapidly increasing swelling, severe bruising, or uncontrolled bleeding

  • Severe scrotal pain, persistent vomiting, or inability to urinate

  • Sudden device problem after initial recovery (e.g., inability to inflate/deflate)