Penile Prosthesis Complications: Planning, Prevention, and Decision Making

Area of Science:

• Urology
• Surgical Complications
• Erectile Dysfunction Treatment

Background:

• Inflatable penile prosthesis (IPP) is a primary treatment for erectile dysfunction (ED) refractory to other therapies.
• While complication rates are low (<5%), they significantly impact patient morbidity and quality of life.
• Prosthetic urologists must be knowledgeable about potential IPP complications.

Purpose of the Study:

• To comprehensively review penile prosthesis complications.
• To discuss preventative strategies for IPP placement.
• To guide preoperative, intraoperative, and postoperative decision-making to minimize risks.

Main Methods:

• Literature review of IPP complications from 1973 to 2018 using PubMed.
• Analysis of publications detailing preoperative planning and specific complications.
• Inclusion of studies on hematoma, infection, erosion, and other adverse events.

Main Results:

• Preoperative strategies include careful patient/device selection and realistic expectation setting.
• Intraoperative techniques involve lateral dilation to prevent corporal perforation/crossover and urethral injury.
• Postoperative management focuses on monitoring for infection, ischemia, and erosion, with strategies to prevent hematoma.

Conclusions:

• Evidence-based decision-making throughout the perioperative period is crucial for reducing IPP complications.
• Effective management strategies can minimize patient dissatisfaction, even in complex cases.
• Awareness and application of these strategies enhance surgical success rates for ED patients.