Penile Implant Revision Surgery – Questions answered
I always welcome questions submitted on the behalf of patients or the broader community interested in treatment of ED. I recently received a questions regarding a penile implant revision surgery. As background, this gentleman was 70 years old with a history of prostate cancer in remission, who underwent placement of an infrapubic inflatable penile implant by a well- respected surgeon on the west coast about 3 years ago. The patient had a smooth recovery and has been using the implant for sexual activity, however had two concerns which seemed to be dismissed by the other surgeons he had seen. First, he was worried about a high-riding pump, that had healed in a position close to the junction of the penis and the scrotum. On further discussion in seemed that it did not bother him as much, but did cause discomfort to his partner with certain sexual positions. Second, he was always worried about the slight uneven tips of the implant in the glans. Typically, this can occur given the slight variations in the left and right corpora, but interestingly even within the first year of the implant and even up until now, he reports a slight soreness especially on the right side below the scrotum when inflating the implant and occasionally with prolonged road cycling. It was always in the same spot.
I ultimately recommended the patient obtain an MRI of the pelvis to evaluate the cylinders, and with the implant inflated there was a kinking of the right cylinder right in the location of the patient’s pain. Additionally, this slight kink would explain the uneven cylinders. Although the implant was functional, we discussed in detail a revision surgery to correct these issues. Revision surgery is typically more complicated than a primary penile implant surgery and there are some unique considerations, however in this case, the patient and partner’s concerns would largely be addressed.
He is scheduled for summer over the summer where we will remove and replacement his implant, recreate the space in the right distal corpora to ensure equal tips, resize the implant, and create a new, concealed pocket for the pump in the scrotum that is no longer tethered to the base of the penis.
If you have had a penile implant and are considering revision surgery, please contact me to schedule a consultation. The majority of my practice is devoted to complex penile reconstruction and revision surgeries and I am confident I can help you achieve satisfaction with a penile implant for the treatment of erectile dysfunction.
