Erectile Dysfunction

About the Procedure

Surgical procedures for Erectile Dysfunction are intended to help patients manage their inability to get and/or sustain an erection. Treatments range from taking a pill to penile implant surgery. After a thorough health assessment and lab work, possibly an ultrasound of the penis or an overnight erection test, a diagnosis can be made and one of the following treatment options can be recommended. One non-surgical option is a penis pump, a device that uses a tube that is fitted over the penis; and a pump that then withdraws the air from the tube, causing blood to flow into the penis. A constricting ring is then put around the base, preventing blood from flowing back out, helping to sustain an erection. Two surgical options are the insertion of flexible (semi-rigid) rods on the two sides of the penis or an inflatable penile prosthesis in which two soft plastic tubes are surgically implanted in the penis, with a reservoir of water being implanted in the lower abdomen, and a pump put inside the scrotum.

Regional or general anesthesia is used for the penile implant procedure and a urinary catheter is inserted. An incision is made either in the scrotum or immediately above the penis. The surgeon locates the areas in the penis which become engorged during an erection and places the implant tubes inside. A small pouch is made low in the scrotum and a pump is inserted. Using the same incision, a reservoir is placed in the abdomen and the tubing is connected from one device to the next. The incision is closed with dissolvable stitches.

What to Know Before the Procedure

There can be complications in penile implant surgery but they are infrequent. Choosing a surgeon who performs this surgery often is insurance against errors of judgment or skill. When injuries occur to major vessels inside the penis and scrotum, urination and ejaculation can be affected. A rare, but serious, complication occurs when the device becomes infected and must be removed. Performing a second implant may not be possible if the infection causes severe scarring.

Preparation for this procedure is similar to other operations. A health assessment, blood work, x-rays, adding or changing medications to avoid excess blood loss during the operation, and pre-operative instructions on food and water intake will be provided by the doctor. Advanced planning for a ride at discharge and assistance for the first day is recommended because pain and tiredness are the chief complaints at that time.

What to Know After the Procedure

During the first 24 hours after surgery, pain can be relieved by applying ice packs to the penis and scrotum, placing a towel roll underneath them, and taking pain medication. The catheter inserted during surgery is removed the following morning and, once the patient is able to urinate, he is discharged. Rest is important along with regular walking, but avoid heavy lifting or strenuous physical activities for four to six weeks. Showers may be taken after 24 hours but no baths or swimming are permitted for four to six weeks. Schedule a follow-up visit with the doctor one to two weeks after the procedure. Delay sexual activity until it can be discussed at the first appointment with the doctor. Most men return to work in about two weeks.

If you Need to Travel Outside of your Local Hospital

Choosing a surgeon with excellent credentials and considerable experience is critical in avoiding serious complications and should be a determining factor in choosing where the procedure will be performed. Prior to making a decision about the location for this procedure, consult with the doctor regarding any post-operative travel restrictions which could impact it. When choosing to have this procedure done internationally be sure to discuss the most effective way of receiving follow-up care, and what options are available to you, with your doctor. Consideration should also be given to the level of discomfort felt after this procedure, which may be significant, when deciding on travel plans.