Revision Surgery
Revision Penile Implant Surgery
Penile implant surgery has high satisfaction rates, but like any mechanical device and any operation, problems can occasionally occur over time. Revision penile implant surgery refers to an operation performed to correct an issue with an existing implant—this may involve repairing, replacing, repositioning, or removing part (or all) of the device.
This page explains why revision might be needed, the different revision operations that can be performed, and what outcomes to expect.
When is revision penile implant surgery needed?
Revision surgery may be recommended if you have:
1) Mechanical failure (device problem)
Implant no longer inflates/deflates properly
Loss of rigidity compared with earlier function
Pump failure, leak, or tubing issue
Autoinflation (unwanted inflation) or inability to deflate
2) Infection
Infection can occur early after surgery or (less commonly) later. Symptoms might include:
Increasing redness, swelling, warmth, worsening pain
Fevers or feeling unwell
Wound breakdown, discharge, or fluid collection
Pump or cylinder becoming visible under the skin (a serious sign)
Infection is one of the most important reasons for urgent review.
3) Erosion or threatened erosion
“Erosion” means the implant is wearing through tissue, such as:
Cylinder eroding into the urethra or through penile skin
Pump eroding through scrotal skin
Reservoir issues (rare, but can cause pain or urinary symptoms)
4) Implant position or sizing issues
Cylinders sitting too far forward/back, causing discomfort or poor function
“Floppy glans” (glans not well supported)
Cross-over (cylinder placed into the opposite side)
Curvature, deformity, or instability during intercourse
5) Persistent pain or dissatisfaction
Ongoing pain beyond the expected recovery period
Difficulty using the pump
Cosmetic concerns or functional concerns despite a working device
(Revision is not always the best solution here—careful assessment is important.)
6) Scar tissue and complex anatomy
Significant corporal fibrosis (scarring), sometimes after infection, priapism, diabetes, or multiple prior operations
Prior pelvic surgery or other urological surgery altering reservoir placement options
What revision operations can be done?
Revision surgery is not “one size fits all.” The operation depends on the problem, your anatomy, and the type of implant you have.
A) Component replacement (partial revision)
If only one part is faulty, it may be possible to replace:
Pump only
Reservoir only
One or both cylinders
Tubing/connectors
This can be suitable for some mechanical failures when there is no infection and tissues are healthy.
B) Complete device exchange
Replacing the entire implant system (pump + cylinders + reservoir) may be recommended when:
The device is older
Multiple components are worn
There is uncertainty about the exact failure point
The revision needs significant repositioning
C) Repositioning surgery (improving function/comfort)
Revision may focus on positioning rather than “device failure,” for example:
Cylinder repositioning or correction of cross-over
Pump relocation within the scrotum to improve access
Reservoir relocation (including “ectopic” placement) if reservoir placement is difficult or causing symptoms
Techniques to improve support of the glans if needed
D) Surgery for curvature, instability, or deformity
If curvature or deformity persists (or develops) after implantation, options may include:
Modeling (gentle straightening manoeuvre in theatre)
Tunical plication (stitch-based straightening)
Plaque incision/excision with grafting (selected cases)
Adjunctive stabilisation procedures in complex deformity
E) Infection management: salvage vs staged approach
If infection is suspected or confirmed, the approach may include:
Immediate “salvage” revision in selected cases
This typically involves removing the device, extensive washout/irrigation, and placing a new device (sometimes a different type) during the same operation.Explant and delayed reimplantation (staged revision)
The implant is removed, infection is treated, tissues recover, then a new device is implanted later.
This may be preferred when infection is severe, tissues are compromised, or there are other risk factors.
F) Explant without reimplantation
Occasionally, removal without replacement is chosen if:
Ongoing infection risk is high
Tissue quality is poor
The patient prefers not to have another implant
What to expect before surgery
Your assessment usually includes:
A careful history of symptoms and how the device is functioning
Physical examination of the penis and scrotum
Review of your original operation details (if available)
Sometimes urine tests, blood tests, or imaging depending on the issue
Discussion of goals: function, comfort, appearance, ease-of-use
If infection is possible, early review matters. Do not wait.
Expectations and outcomes
How successful is revision surgery?
Many men achieve a functioning, comfortable implant after revision, but outcomes depend on:
The reason for revision (mechanical failure vs infection vs scarring)
Number of prior surgeries
Tissue condition and degree of scarring
Diabetes control, smoking status, immune issues, and other health factors
What may be different compared with first-time implant surgery?
Revision surgery is typically more complex because:
There is scar tissue
Anatomy can be altered
Infection risk can be higher (especially after prior infection or multiple operations)
Penile length and shape
Some men notice changes in perceived penile length after implantation. In revision surgery, length can be influenced by:
Scarring and tissue tightness
Need for downsizing/upsizing cylinders
Whether staged surgery is required after infection
Your surgeon will discuss what is realistic for your situation.
Sensation, orgasm and ejaculation
A penile implant generally does not directly change penile skin sensation or orgasm, but:
Recovery and anxiety can affect sexual response temporarily
Some men have erectile dysfunction alongside other causes of sexual dysfunction (hormonal, nerve, psychological, relationship factors)
Satisfaction
Satisfaction is often high when the revision corrects a clear problem (e.g., mechanical failure). Managing expectations is especially important when the goals are primarily pain relief or cosmetic change.
Recovery timeline
This varies by complexity, but commonly:
First 1–2 weeks: swelling and bruising settle, activity limited
2–6 weeks: gradual return to normal daily activity; discomfort improves
4–8 weeks: many patients begin cycling/activation (your surgeon will advise)
6–8+ weeks: intercourse may resume once cleared
If infection treatment or staged surgery is needed, the timeline will be longer.
Risks and complications
All surgery carries risks. Risks can be higher in revision surgery compared with first-time implantation. Possible complications include:
Infection (may require removal or further surgery)
Bleeding/haematoma, wound problems
Pain, altered sensation, scarring
Erosion or tissue injury (including urethral injury in rare cases)
Device malfunction or need for further revision
Cosmetic concerns, glans support issues
Anaesthetic risks (varies with health status)
Your surgeon will talk you through your specific risk profile.
When to seek urgent medical review
Seek urgent advice if you have:
Fever, chills, or feeling unwell after surgery
Increasing redness, heat, swelling, severe pain
Wound discharge, bad smell, or opening of the incision
Difficulty urinating, blood in urine that is worsening
Any part of the device becoming visible through skin
Key takeaways
Revision penile implant surgery can address mechanical failure, infection, erosion, positioning issues, pain, or deformity.
Revision options range from simple component replacement to complete exchange or infection salvage/staged reconstruction.
Outcomes are often good, but revision surgery is more complex and requires careful planning and realistic expectations.
Revision Testicular Prosthesis Surgery
A testicular prosthesis is a medical implant placed in the scrotum to restore the appearance and “feel” of a testicle after testicular loss or absence (for example after orchidectomy, torsion, trauma, cancer surgery, or an undescended/absent testis). Most men do well long-term, but sometimes a revision operation is needed.
This sheet explains why revision may be recommended, the different revision operations that can be performed, and what outcomes to expect.
What is revision testicular prosthesis surgery?
Revision surgery refers to an operation to correct a problem with an existing testicular implant. Depending on the issue, revision may involve:
Repositioning the prosthesis
Replacing it with a different size/type
Removing it temporarily or permanently (in some cases)
Treating complications such as infection, erosion, pain, or scarring
Indications: why might revision be needed?
Common reasons include:
1) Malposition or “high-riding” prosthesis
The implant may sit too high in the scrotum or feel “stuck” in one spot. This can occur due to:
Scar tissue or tethering
A short cord/limited scrotal space
Fixation sutures or capsule formation
Prior scrotal surgery or infection
2) Discomfort or chronic pain
Some discomfort early on is normal, but revision may be considered for:
Persistent ache or sharp pain beyond expected healing
Pain during exercise, cycling, or sexual activity
Pain related to implant edges, scarring, or nerve irritation
(Importantly, not all pain improves with surgery—your surgeon will assess carefully.)
3) Unsatisfactory size, shape, or symmetry
You may feel the implant is:
Too small/large compared to the other testicle
Too firm or unnatural
Not matched to your body habitus or the contralateral testis
Aesthetic outcome not as expected
4) Capsular contracture (scar “capsule” around the implant)
The body forms a thin capsule around any implant. In some cases it tightens, leading to:
Firmness
Change in position
Distortion of shape
Discomfort
5) Infection
Infection can occur early after placement or later (less commonly). Warning signs:
Increasing redness, warmth, swelling, worsening pain
Fever or feeling unwell
Wound breakdown or discharge
Fluid collection
Infection usually requires prompt medical review and often implant removal.
6) Erosion or threatened erosion
Erosion means the implant is wearing through scrotal tissue and may become visible or close to the skin. Risks increase with:
Infection
Poor tissue quality, prior radiotherapy, multiple surgeries
Very thin scrotal skin
This is a serious complication and needs urgent review.
7) Rupture or leak (rare with modern implants)
Modern prostheses are durable, but damage can occur. You might notice:
Change in size/shape
Softening or irregularity
New discomfort
What revision operations can be done?
The best operation depends on the problem, tissue quality, and your goals.
A) Repositioning surgery
Used when the implant sits too high or is rotated/tethered.
Releasing scar bands and creating a better “pocket”
Adjusting fixation (or removing/re-placing fixation sutures)
Re-seating the prosthesis in a more natural dependent position
B) Capsulotomy or capsulectomy (scar capsule surgery)
If capsular contracture is significant:
Capsulotomy: releasing the tight capsule
Capsulectomy: removing part/all of the capsule
This can improve comfort and position and create space for a better fit.
C) Prosthesis exchange
If size/shape/feel is the main issue, or if the implant is damaged:
Replacement with a different size
Replacement with a different model/material profile (depending on availability and surgeon preference)
Combining exchange with pocket revision or capsule surgery
D) Explant ± delayed reimplantation
In some situations removal is recommended:
Infection
Erosion or threatened erosion
Severe pain not improving and implant thought to be contributing
Poor tissue quality where replacement would be unsafe
Options include:
Removal only, if that best matches your preference/risks
Staged approach: remove the prosthesis, allow tissues to heal, then reinsert a new prosthesis later (often preferred after infection/erosion)
E) Drainage of fluid collections
If there is a seroma/haematoma (fluid or blood collection):
Observation can be appropriate if mild and settling
Drainage or surgery may be needed if large, infected, or persistent
What to expect before surgery
Assessment usually includes:
Review of your symptoms and goals (comfort, symmetry, position)
Examination of scrotal skin, implant position, and tenderness
Discussion of prior operations and any infection history
Sometimes ultrasound if there’s concern about collections or unusual findings
Shared decision-making about whether revision is likely to help
Expectations and outcomes
How successful is revision surgery?
Many men achieve a more comfortable and natural position after revision, especially when the issue is clear (e.g., high-riding implant, capsular contracture, sizing mismatch). Outcomes depend on:
Tissue quality and scarring
History of infection or multiple prior operations
Smoking, diabetes control, immune issues, and wound healing factors
Appearance and “feel”
Revision can often improve:
Symmetry (size and position)
Implant mobility
Comfort during daily activity and sport
However:
A prosthesis will always feel somewhat different to a natural testis
Perfect symmetry is not always achievable (the natural testis can change with temperature and time)
Pain outcomes
Pain relief can be good when pain is due to malposition or capsule tightness. If pain is nerve-related or not clearly linked to the implant, improvement is less predictable—this will be discussed during consultation.
Infection and erosion risk
Revision surgery may carry a higher risk of infection than first-time placement due to scar tissue and altered blood supply. Your surgeon will discuss risk reduction strategies.
Recovery timeline
Recovery varies with complexity, but commonly:
First 1–2 weeks: swelling and bruising settle; supportive underwear recommended
2–4 weeks: return to most normal daily activities; discomfort continues to improve
4–6 weeks: gradual return to vigorous exercise/sexual activity (once cleared)
Your surgeon will give personalised guidance.
Risks and complications
Possible risks include:
Infection (may require removal)
Bleeding/haematoma or seroma
Wound problems, scarring
Persistent discomfort or altered sensation
Recurrent malposition or contracture
Erosion through the skin (rare but important)
Anaesthetic risks (depend on health)
When to seek urgent review
Seek urgent medical advice if you develop:
Fever, chills, or feel unwell
Increasing redness, warmth, swelling, severe pain
Discharge, bad smell, wound opening
Implant becoming visible under the skin or breaking through the skin
Key takeaways
Revision testicular prosthesis surgery can address positioning, pain, capsule/scar tightening, cosmetic concerns, infection, or erosion.
Options include repositioning, capsule surgery, prosthesis exchange, or removal with/without delayed replacement.
Most patients do well, but outcomes depend on tissue quality and the underlying problem.
Revision Circumcision Surgery
Revision circumcision surgery is an operation performed to correct a problem after a previous circumcision. Most circumcisions heal well, but sometimes issues such as persistent tightness, excess residual foreskin, cosmetic concerns, scar problems, or discomfort can occur. Revision surgery aims to improve comfort, function, hygiene, and/or appearance.
This sheet explains why revision may be recommended, the different revision operations that can be performed, and what outcomes to expect.
What is revision circumcision?
A revision circumcision may involve:
Removing additional foreskin (if too much remains)
Releasing scar bands or tightening
Correcting uneven skin edges or asymmetry
Treating adhesions or skin bridges
Correcting issues around the frenulum (the band under the penis)
Addressing complications such as buried penis/tethering or (rarely) skin deficiency
Revision circumcision is usually performed as a day procedure.
Indications: why might revision be needed?
Common reasons include:
1) Residual foreskin
The foreskin still covers the glans (fully or partially)
Persistent hygiene problems, recurrent inflammation
Patient preference for a more complete circumcision look
2) Persistent tightness
A tight scar ring remains
Difficulty retracting the remaining foreskin
Pain with erections or sexual activity
3) Cosmetic concerns and asymmetry
Uneven skin line or “lopsided” appearance
Excess inner foreskin (“mucosal collar”) or excess outer skin
Prominent scarring or irregular healing
4) Scar problems
Thickened scar, raised scar, or tender scar
Skin contracture causing discomfort or pulling during erection
5) Adhesions or skin bridges
The penile shaft skin becomes stuck to the glans (adhesions)
A band of skin heals abnormally connecting shaft skin to the glans (skin bridge)
This can cause discomfort, pulling, or cosmetic concerns.
6) Frenulum-related symptoms
Persistent pain or tearing under the glans
Tight frenulum contributing to discomfort with intercourse
May be treated with a frenuloplasty or frenulectomy, sometimes combined with revision circumcision.
7) Buried penis, tethering, or penoscrotal webbing
Sometimes the issue is not just “extra skin” but skin tethering at the base of the penis, a prominent web, or concealment of the penile shaft. This may require additional reconstructive steps beyond a standard revision.
8) Complications (uncommon but important)
Wound healing problems
Persistent infection/inflammation (rare)
Sensitivity issues or pain (assessment is important because pain is not always improved by surgery)
What operations can be done?
The best approach depends on the problem, your anatomy, and what outcome you want.
A) Standard circumcision revision
Most revision procedures involve:
Removing extra remaining foreskin
Re-creating a smoother circumcision line
Improving symmetry and scar appearance
B) Scar revision / release of tight band
If the main issue is a tight scar ring or contracture:
Excision of scar tissue and re-closure
Sometimes a tailored incision pattern to prevent re-tightening
C) Lysis of adhesions / division of skin bridges
Adhesions can often be released carefully
Skin bridges usually require division and tidy closure to prevent recurrence
D) Frenuloplasty or frenulectomy (if needed)
If the frenulum is tight or painful:
Frenuloplasty: lengthens and reshapes the frenulum
Frenulectomy: removes part/all of the frenulum
This can be done alone or with circumcision revision.
E) Correction of penoscrotal webbing or tethering
If the penis is “pulled down” by a web of skin between penis and scrotum:
Release of the web with reconstructive closure (technique depends on anatomy)
This is more than a simple revision and may have a different recovery.
F) More complex reconstruction
If there is significant skin deficiency, scarring, or concealment/buried penis, reconstruction may occasionally be needed. Your surgeon will discuss options if relevant.
What to expect before surgery
Your consultation usually includes:
Discussion of symptoms (pain, tightness, recurrent inflammation, hygiene, sexual function)
Examination of the penis (skin quality, scar pattern, bridges/adhesions, frenulum, webbing)
Review of any medical factors affecting healing (smoking, diabetes, blood thinners)
Clear discussion of your goals (appearance vs function) and what is realistically achievable
Anaesthetic and setting
Revision circumcision is commonly a day procedure.
Can be performed under local anaesthetic with sedation or general anaesthetic, depending on complexity and preference.
You go home the same day with instructions and pain relief.
Expectations and outcomes
What improvements can revision achieve?
Revision surgery may improve:
Comfort (especially if scar tightness or bridges are the cause)
Hygiene and ease of cleaning
Sexual function if pain/tightness has been limiting
Cosmetic appearance (smoother, more symmetrical scar line)
What outcomes are realistic?
Mild swelling and bruising are normal
The scar line typically improves over weeks to months
“Perfect symmetry” is not always possible—natural differences and healing variation can remain
If the primary issue is chronic pain without a clear structural cause, improvement may be less predictable
Sensitivity and sexual function
Many men have normal sensitivity and sexual function after healing
Some temporary sensitivity changes can occur during healing
Rarely, altered sensation or persistent sensitivity issues may occur
Recovery timeline
This varies by extent of revision, but commonly:
First 48 hours: swelling, tenderness; keep dressings as advised
1–2 weeks: skin healing; avoid friction and strenuous activity
2–4 weeks: gradual improvement; most daily activities resume
4–6 weeks: many patients are cleared for intercourse/masturbation (follow your surgeon’s advice)
Up to 3 months: scar softens and appearance continues to improve
Supportive underwear and careful wound care help.
Risks and complications
All surgery has risks. Potential complications include:
Bleeding or haematoma
Infection
Wound separation or delayed healing
Prominent scarring or pigmentation changes
Persistent asymmetry or dissatisfaction with appearance
Changes in sensitivity (usually temporary; persistent changes are uncommon)
Ongoing pain (uncommon, but possible)
Meatal irritation/rare narrowing in susceptible individuals
Your surgeon will discuss your individual risk factors.
When to seek urgent medical review
Seek help urgently if you have:
Significant bleeding that doesn’t stop with firm pressure
Increasing redness, heat, swelling, worsening pain, or pus-like discharge
Fever or feeling unwell
Inability to urinate (rare)
Key takeaways
Revision circumcision can address residual foreskin, tight scarring, asymmetry, adhesions/skin bridges, frenulum problems, or tethering/webbing.
The operation is tailored to the underlying issue and your goals.
Most men recover well and are pleased with improved comfort and/or appearance, but healing and cosmetic outcomes vary.
Glanspexy for Hypermobile Glans
What is a “hypermobile glans”?
The glans is the head of the penis. In some men, the glans can remain too mobile or droop relative to the shaft during an erection-like state, which can cause discomfort, cosmetic concern, and difficulty with penetration. This problem is often called:
Glans hypermobility
“Floppy glans syndrome”
“Concorde deformity” or “SST (supersonic transporter) deformity” in some surgical literature
It is most commonly discussed after penile implant surgery, when the implant cylinders make the shaft firm but the glans still tilts or droops.
What is glanspexy?
Glanspexy (also called glanulopexy or glans fixation) is an operation that stabilises the glans by anchoring it to deeper supportive tissues so it aligns better with the shaft. The goal is to improve:
Stability (less droop)
Comfort
Ability to have penetrative sex
Cosmesis (appearance)
Glanspexy may be performed:
At the time of penile implant placement (if hypermobility is identified), or
As a revision procedure after a penile implant if symptoms persist.
Indications: when might glanspexy be recommended?
A glanspexy may be considered when hypermobile glans causes symptoms such as:
1) Difficulty with penetration or painful intercourse
A drooping glans can make penetration difficult and can create pain or instability during sex.
2) Cosmetic concern
The glans may point downwards (ventral), upwards (dorsal), or to one side (lateral) when the shaft is firm/inflated.
3) Risk of tissue irritation/pressure
In more significant cases, abnormal movement or positioning may contribute to irritation and, rarely, increase risk of tissue problems over time—particularly in complex penile prosthesis cases.
4) “True” hypermobility vs cylinder sizing/position issues
It’s important to confirm the cause. A drooping glans can be due to:
A genuinely hypermobile glans, or
Implant cylinder positioning/sizing issues (for example, inadequate support distally)
Your surgeon will usually examine you with the implant fully inflated (if you have one). Sometimes ultrasound or other imaging is used when the cause is unclear.
What operations can be done?
The exact technique is tailored to the cause and whether you have a penile implant.
A) Glanspexy (glans fixation)
This is the core procedure: sutures are used to secure the glans in a better aligned position relative to the shaft/corpora, reducing tilt and improving stability. Variations include “standard” and “modified” techniques described in the prosthetic urology literature.
B) Distal penoplasty / distal corporoplasty
In some men, additional reshaping/reinforcement of distal penile tissues may be used to improve support and avoid more invasive implant changes when cylinder sizing is otherwise appropriate.
C) Implant-focused solutions (if the main issue is cylinder support)
If the underlying problem is primarily implant cylinder size/position, options may include:
Cylinder repositioning
Cylinder exchange/upsizing (selected cases)
Other revision steps done at the same operation
This decision depends on examination findings and your implant history.
D) Combined procedures (common in complex cases)
Glanspexy may be combined with other penile implant revision steps (or Peyronie’s/curvature correction techniques) when more than one issue contributes to instability.
What to expect before surgery
Your assessment typically includes:
History of symptoms: when it occurs, direction of droop, pain, function
Examination (often with the device fully inflated if you have an implant)
Review of prior operation details and device type (if applicable)
Discussion of goals: stability vs appearance vs comfort
You’ll also discuss anaesthetic options (commonly general anaesthetic or sedation + local, depending on the setting and complexity).
Expectations and outcomes
What glanspexy can improve
Many men experience:
Better alignment of the glans with the shaft
Improved stability during sex
Less discomfort and improved confidence
What glanspexy does not usually do
It does not directly increase penile length
It may not correct significant curvature unless combined with other procedures
It may not fully resolve symptoms if the primary issue is device sizing/position rather than true hypermobility
How durable are results?
Results are often durable, but outcomes depend on:
Tissue quality and scarring
Whether a penile implant is present
Whether the underlying cause was correctly identified and addressed
Recovery timeline
Exact recovery depends on whether glanspexy is done alone or as part of a larger revision.
Commonly:
First 1–2 weeks: swelling/bruising and tenderness settle
2–4 weeks: most day-to-day activities resume; avoid friction/strain
4–6+ weeks: sexual activity and (if applicable) implant cycling/activation based on surgeon guidance
Supportive underwear and careful wound care are usually recommended.
Risks and complications
All surgery has risks. Potential risks include:
Infection (risk is higher if combined with implant surgery)
Bleeding/haematoma, wound healing problems
Persistent pain or tenderness
Palpable sutures or minor contour changes
Altered sensation (usually temporary; persistent changes are less common in published series)
Recurrence of hypermobility or incomplete correction
Rare but serious complications can occur in complex revision surgery; your surgeon will discuss your individual risk profile.
When to seek urgent medical review
Seek urgent advice if you have:
Fever, worsening redness/swelling, discharge, or escalating pain
Any skin breakdown or concern about infection
Inability to urinate (rare)
Key takeaways
Glanspexy is a fixation procedure used to treat hypermobile/floppy glans, most commonly in the setting of penile implant surgery.
The key step is identifying whether the issue is true hypermobility or related to implant cylinder sizing/position, because this changes the best treatment plan.
Many patients improve in stability, comfort, and function after appropriately selected surgery.