Penile Implants
Penile prosthesis implantation is the definitive surgical treatment for erectile dysfunction (ED) refractory to medical management or when other treatments are contraindicated or unacceptable.[1][2] Patient satisfaction was 83% (95% CI 80–86%) in an 83-study meta-analysis; separate series found 53/59 satisfied and 93.1% positive responses among 322 respondents among 542 implanted patients, while another reported a mean EDITS score of 75.14.[12][13][15][17][26] The procedure irreversibly alters corporal tissue and eliminates natural erections, a required informed consent point, but does not remove libido or orgasm.[1][18] The AMS 700 labeling cautions that the prosthetic erection may be shorter, less firm, narrower and less sensitive than the native one, and its pivotal trial (300 men, devices without InhibiZone) recorded impaired urination in 3.7%, decreased penile sensation in 2.3% and abnormal ejaculation in 2.0%.[31]
The Fifth International Consultation on Sexual Medicine published updated penile prosthesis recommendations in 2025, including new and revised consensus statements.[53] For a deeper treatment of specific topics, see the subsection articles:
- Preoperative EvaluationPatient selection, medical optimization and consent before penile implant surgery.
- Intraoperative SetupAnesthesia, positioning, infection prevention and device preparation for penile implant surgery.
- Surgical ApproachesThe incisions used for penile implant surgery, compared step by step.
- Reservoir PlacementWhere to place the implant reservoir, especially after prior pelvic surgery, and how to avoid complications.
- Implant ModelsCurrent penile implant models compared, and how to choose one for each patient.
- Infection — Evolution, Evidence, and Modern ControversiesHow implant infection rates fell, what causes infections today and which prevention measures matter most.
- Revision ScenariosManaging difficult revision cases: corporal scarring, crossover, perforation, persistent curvature and salvage.
- Complications (Non-Infectious)Erosion, glans ischemia, mechanical failure and other non-infectious implant complications, with management.
Indications
Penile implants are indicated for men with moderate-to-severe ED who have failed or cannot use less invasive treatments (PDE5 inhibitors, VED, ICI), or who prefer a permanent solution. Expanded indications include:
- Organic ED refractory to PDE5 inhibitors, VED, and intracavernosal injection therapy
- Peyronie's disease with concurrent ED not responding to pharmacotherapy (EAU 2026 recommends prosthesis implantation, with or without additional straightening by modeling, plication, or incision or excision with or without grafting; strong)[28][35]
- Corporal fibrosis from priapism, infection, or prior surgery
- Post-prostatectomy or radiation-induced ED with failed medical management
- Prior prosthesis explantation requiring replacement
- Neophallus construction (phalloplasty in gender-affirming surgery)
- Acute ischemic priapism that is untreated for >36 hours or refractory to shunting, with or without tunneling; AUA/SMSNA permits considering a prosthesis in these settings [45]
Contraindications and deferral: Do not implant in the setting of active systemic, cutaneous, or urinary tract infection.[30] Address modifiable medical risks, unrealistic expectations, and active untreated psychiatric symptoms through further assessment or treatment before proceeding; psychiatric history alone is not an absolute contraindication.[50]
Preoperative Assessment
Medical Optimization
Risk factors for infection and device failure should be optimized before surgery:
| Factor | Target |
|---|---|
| Diabetes | Optimize glycemic control and discuss higher infection risk with poor control; no validated HbA1c cutoff establishes eligibility for penile implantation.[46] |
| Obesity | Assess infection risk individually; coded obesity was associated with infection after primary IPP, but BMI 30 is not a validated eligibility cutoff.[47] |
| Active UTI | Treat and clear before proceeding |
| Immunosuppression | Optimize where possible |
| Testosterone | Correct hypogonadism if present |
Psychological Screening — "CURSED" Traits
The CURSED Patient mnemonic is an expert-described list of traits that may signal a need for more preoperative counseling.[50]
| Letter | Trait |
|---|---|
| C | Compulsive personality |
| U | Unrealistic expectations |
| R | Revision — previously operated elsewhere |
| S | Surgeon shopping |
| E | Entitled / demanding |
| D | Denial |
| P | Psychiatric disorder |
Informed Consent Essentials
Patients must understand:
- Natural erections will no longer be possible after implantation
- The procedure is considered permanent and irreversible
- Inflatable-device survival was 76.8% at 10 years and 52.9% at 20 years in a 12-study meta-analysis[25]
- Most patients report satisfaction despite the revision burden[12][15][26]
- Risk of infection, erosion, and device failure requiring explantation
- Postoperative expectations, including differences between inflatable and malleable devices in operation, appearance and concealability; the AUA advises this counseling for every man who chooses implantation, and advises telling men with tunical scarring, corporal fibrosis or loss of cavernous smooth muscle that the prosthesis is unlikely to restore the penile dimensions present before these conditions occurred[30]
- For acute ischemic priapism, discuss the risks and benefits of early versus delayed implantation [45]
Device Types
Three-Piece Inflatable Penile Prosthesis (3-piece IPP)
Described in a narrative review as the gold standard in advanced-economy countries.[3][4][5] Consists of:
- Two intracavernosal cylinders providing rigidity and expansion
- Intrascrotal pump with valve mechanism for inflation and deflation
- Retropubic fluid reservoir (AMS 700 reservoirs are 65 or 100 mL)[31] placed in the space of Retzius or ectopically
Advantages: Best flaccidity and erect rigidity; most natural appearance and function; highest patient satisfaction among device types.
Disadvantages: Most mechanically complex; requires reservoir placement; demands adequate manual dexterity; longer operative time.
Two-Piece Inflatable Penile Prosthesis (2-piece IPP)
The fluid reservoirs are integrated into the proximal ends of the two cylinders, with a separate scrotal pump; no abdominal reservoir is implanted.[51]
Advantages: Avoids reservoir placement (relevant in prior pelvic surgery, transplant recipients); simpler implantation; good option for standard anatomy.
Disadvantages: Less rigidity and less complete flaccidity than 3-piece; limited cylinder expansion.
Malleable / Semi-Rigid Prosthesis
Two firm, bendable rods implanted into the corpora cavernosa. Device is manipulated (bent down to conceal, bent upward to use).
Advantages: Simplest implantation and operation; fewest mechanical failures of the available device types (no fluid components to fail), though 5-year revision/removal rates overall are similar to inflatable devices[36]; suitable for limited dexterity; good length conservation.
Disadvantages: Permanent semi-erect state that can be difficult to conceal; less natural appearance; lower satisfaction scores than inflatable devices.
Device Model Comparison
Three-Piece Inflatable Prostheses
| Model | Manufacturer | Cylinder Type | Key Features |
|---|---|---|---|
| AMS 700 CX | Boston Scientific | Controlled expansion (girth only) | Workhorse 3-piece; available with InhibiZone antibiotic treatment and MS or TENACIO pump; 12–18 mm cylinders[31][32] |
| AMS 700 LGX | Boston Scientific | Length + girth expansion | Cylinder that expands in length as well as girth; InhibiZone available |
| AMS 700 CXR | Boston Scientific | Narrow-base controlled expansion | Shorter, narrower cylinders for small corpora; useful for re-implantation and fibrosis |
| Titan OTR | Coloplast | Girth expansion | Hydrophilic coating (absorbs antibiotic solution at implant); One-Touch Release deflation |
| Titan Touch | Coloplast | Girth expansion | Tactile ridges on pump for easier identification; hydrophilic coating |
| Infla10 Pulse | Rigicon | See IFU | HydroShield hydrophilic coating (surgeon-selected dip solution); 65, 70 or 110 mL reservoirs; the manufacturer lists Pulse as investigational and unavailable for commercial sale in the United States[54] |
Two-Piece Inflatable Prostheses
| Model | Manufacturer | Notes |
|---|---|---|
| AMS Ambicor | Boston Scientific | Prefilled, preconnected; reservoirs at the proximal end of each cylinder and a scrotal pump, so no separate reservoir; the IFU describes no antibiotic surface treatment; good for prior pelvic surgery or transplant patients |
Malleable / Semi-Rigid Prostheses
| Model | Manufacturer | Notes |
|---|---|---|
| AMS 650 | Boston Scientific | Silver-wound wire core; soft silicone jacket; standard malleable |
| Genesis | Coloplast | Silver wire coil and helix core; hydrophilic coating (surgeon's choice of aqueous solution); 9.5, 11 or 13 mm diameters with trimmable cylinders and tail caps; tactile position indicator; memory-flex core |
| Acu-Form | Coloplast | Malleable silicone prosthesis |
| Tube | Promedon | Malleable: twisted silver wire core with a PTFE cover inside a tapered silicone body of graded hardness; trimmable proximal segment with separate rear tip extenders |
Coating Technologies
| Technology | Manufacturer | Mechanism |
|---|---|---|
| InhibiZone™ | Boston Scientific | Cylinders, pump and reservoir impregnated with rifampin + minocycline at manufacture; comparative laboratory data on the antimicrobial activity of treated devices have been published.[29] The IFU contraindicates it with allergy or sensitivity to rifampin, minocycline or other tetracyclines and in systemic lupus erythematosus; components are not soaked in saline (a brief rinse or dip is allowed) and must not contact alcohols or acetone. A complete device holds at most 33 mg rifampin and 12 mg minocycline, and the label states the coating does not replace the usual antibiotic prophylaxis.[31] A 2026 meta-analysis of 11 observational studies (102,572 patients) found fewer infections with coated devices (HR 0.38) [27] |
| Hydrophilic Coating | Coloplast (Titan) | Absorbs antibiotic solution intraoperatively (e.g., gentamicin + vancomycin); surgeon-customizable antibiotic choice |
| Parylene | Boston Scientific (AMS 700) | Thin polymer coating on cylinder tubes and reservoir interior for wear protection; not an antimicrobial coating |
Device Operation — Inflation and Deflation
The AMS labeling supports first cycling at 3 to 6 weeks and intercourse after a 4 to 6 week check of the wound and device function, with the penis supported upward on the abdomen for 4 to 6 weeks to encourage a straight erection.[31][32] The maneuver differs by manufacturer pump. Adequate manual dexterity and key-pinch strength are prerequisites — assess them preoperatively, because a patient who cannot reliably work the pump is better served by a malleable device.[3]
Inflation (achieving erection; all three-piece devices):
- Locate the scrotal pump by palpation and steady it between thumb and forefinger.
- Squeeze and release the pump bulb repeatedly (typically 6–15 squeezes); each cycle transfers fluid from the reservoir into the cylinders.
- Rigidity builds progressively with each squeeze until the erection is full — stop when it is satisfactory.
Deflation (returning to flaccidity; differs by pump):
- AMS 700 with MS pump (Boston Scientific): press the deflation button for 2–4 seconds; fluid returns to the reservoir. Squeezing the shaft afterward makes the penis more flaccid. The manufacturer's operating instructions warn against squeezing the deflation button and the pump bulb at the same time.[32][33] If the cylinders will not deflate because both were squeezed together, the current IFU says to squeeze the sides of the valve block and then press the button for 2–4 seconds; the older operating room manual says at least 5 seconds.[32][33]
- AMS 700 with TENACIO pump: press the deflation button fully; the IFU gives no hold time.[31] Its troubleshooting table says to squeeze only the button and not the bulb, and it describes the pump valving as resisting elevated reservoir pressure.[31]
- Coloplast Titan (One-Touch Release, OTR): squeeze the opposing touch-pads on the pump once (one-touch release) to open the valve, then gently compress the cylinders to empty them. In a comparison of 100 OTR recipients with 100 earlier Genesis recipients, the OTR pump needed fewer teaching visits than the earlier Genesis pump (mean 1.19 versus 1.87).[20]
In roughly 7.8% of Coloplast Titan OTR patients in one 550-patient series (5.3% needed a visit; the rest corrected it themselves), the inflate/deflate valve disc sticks in the deflate position: the pump bulb feels hard and will not draw fluid, mimicking device failure. It is corrected at the bedside by applying very firm pressure to the pump bulb to snap the disc back to the inflate position, after which the device functions normally; recognizing this prevents a needless return to the OR.[21]
The AMS 700 has an analogous difficult-inflation state. The MS pump IFU advises pressing the deflation button to reset the lockout valve and then giving a hard, quick first bulb squeeze (a pop is felt), and for a pump bulb that will not compress or fill, applying firm circumferential pressure to the cylinders from the proximal shaft while pressing the deflation button, then reactivating with a hard, quick squeeze. The IFU attributes the latter to a published "stiction syndrome" protocol.[32] That protocol comes from a series of 306 AMS 700 Momentary Squeeze recipients at one institution (2007–2015) plus 4 patients referred from elsewhere: all 10 presented after at least 6 weeks without cycling; the first 4 underwent surgical pump mobilization and replacement, and the next 6 were managed successfully in the office with the forced-deflation maneuver, and none of the patients instructed to cycle daily re-presented with difficult inflation.[40]
Deflation is the harder skill. Patients pick up inflation quickly but commonly struggle with deflation, the more frequent early complaint, and scrotal edema in the first weeks can make the pump hard to locate. Deflation is therefore the focus of teaching and is routinely reinforced at the follow-up visit.
Auto-inflation. The IPP analog of an unwanted change of state is auto-inflation: spontaneous partial filling of the cylinders between uses from reservoir back-pressure. Modern pumps incorporate a lockout valve intended to resist it (in the AMS 700 MS pump the valve sits in the pump, not the reservoir), but the design does not eliminate it: auto-inflation occurred in 5.7% of men in the AMS 700 pivotal trial, which predates the MS pump.[31] The IFU also ties spontaneous inflation or deflation to improper reservoir placement or filling technique, and a patient reporting the device inflating on its own warrants evaluation of reservoir position and valve function rather than reassurance.[23][31][33]
Cycling after activation. Patients inflate and deflate daily; one Titan protocol used daily inflation for 6 months, then maximal inflation 1–2 hours daily; in a 40-patient uncontrolled series, penile measurements were better at 12 months than at 6 months or immediately after surgery.[22] One expert-author postoperative protocol instead recommends maximal daily inflation for 1 to 3 hours throughout the first year to try to improve penile length.[41] For the AMS 700 LGX length-expanding cylinder specifically, physician-reported practice patterns described by the same authors include leaving the device partially inflated for 9 to 12 days and then inflating daily for 1 to 3 hours through the first 3 months, or waiting 4 weeks before starting daily 1- to 3-hour cycling through weeks 5 to 12; no comparative study accompanies either pattern, and a patient unlikely to follow a prolonged cycling schedule may be better served by another model.[42] Note that the IPP has no deactivation lock, unlike the artificial urinary sphincter; it is simply left deflated between uses.
Surgical Technique
Positioning and Room Setup
The AMS 700 operating room manual describes shaving the abdominal and genital area, a 10-minute povidone-iodine scrub (or the hospital's approved preoperative scrub), sterile draping, and copious antibiotic irrigation of the field throughout the case; it positions the patient according to the surgeon's chosen approach (infrapubic or penoscrotal).[33]
Approaches
Side-by-side trade-offs across the four approaches are reviewed in Otero 2022.[6]
| Approach | Incision | Best For | Notes |
|---|---|---|---|
| Penoscrotal (PS) | Transverse at penoscrotal junction | Primary implants; most common | Direct pump placement; excellent corporal access; slightly longer activation wait[6] |
| Infrapubic (IP) | Lower abdominal above pubic bone | Surgeon preference; earlier activation | Direct reservoir visualization; higher dorsal nerve injury risk; faster operative time[7] |
| Subcoronal (SC) | Circumcising / degloving incision | Complex reconstructive cases | Full corporal access for fibrosis, Peyronie's correction, concurrent work[8] |
Key Operative Steps
The AMS operating room manual has the surgeon place a Foley catheter at the start of the case to help identify the urethra, decompress the bladder, and reduce the risk of bladder injury during reservoir placement.[33]
- Corporotomy. Longitudinal incision into corpora cavernosa bilaterally
- Corporal dilation. Sequential dilation to measured length; cavernotomes for fibrosis
- Sizing. Measure corporal length; select cylinder ± rear-tip extenders to fill space
- Cylinder placement. Cylinders deployed with Keith needle; proximal cap to crus, distal tip to glans
- Reservoir placement (3-piece). Space of Retzius via created defect in transversalis fascia; ectopic subfascial if prior pelvic surgery
- Pump placement. Dependent scrotal position between dartos layers; bilateral testicular placement avoidance
- Connection and cycle test. Tubing connected, device inflated/deflated to confirm function before closure
- Closure. Layered; device left partially inflated in many protocols
No-touch technique: After skin dissection, isolate the operative field with barrier draping and exchange gloves and instruments to minimize device contact with patient skin.[8][9] Wound irrigation with antibiotic/antifungal solution before closure. Many surgeons avoid drains; some high-volume infrapubic surgeons use closed suction.[7] In the observational PHOENIX registry, drain use was not statistically associated with hematoma in the first two postoperative weeks.[11][24]
Operative Time
Approximately 70–95 minutes for primary cases; infrapubic approaches are generally faster than penoscrotal.
Concomitant Continence Procedure — Mini-Jupette Sling
For a man with post-prostatectomy climacturia or minimal stress urinary incontinence alongside ED, a small graft or sling (mini-jupette) can be placed at the time of IPP implantation: it sits at the bulbar urethra, positioned to compress it when the device is inflated, managing both problems in a single operative setting. In the 38-patient pilot, five had postoperative complications and four required IPP explantation at mean 5.1-month follow-up.[37] At mean 59 months, 23/38 original participants were available; among those followed, 91% reported stress-incontinence improvement and 73% climacturia improvement.[58] Comparative outcomes against staged incontinence surgery remain unknown.[37]
Concomitant Ventral Scrotoplasty
Ventral scrotoplasty is commonly added at IPP insertion to improve perceived penile length, but it carries its own wound-complication risk. In a single-surgeon series of 103 scrotoplasties performed with IPP insertion, 15 (14.6%) developed wound dehiscence: 9 mild, 5 moderate (managed with clinic stitches to reinforce the closure), and 1 major (requiring a return to the operating room for washout and exchange to a malleable prosthesis). Diabetes (odds ratio 6.1) and V-Y plasty scrotoplasty technique (odds ratio 4.9) were both independently associated with dehiscence; age, Peyronie's disease, hypertension, intraoperative penile modeling, smoking and device manufacturer were not.[43] Minimizing the transverse incision, placing it at least 2 cm below the perceived penoscrotal junction, closing the vertical wound in layers with interrupted skin sutures, and avoiding concomitant scrotoplasty in diabetic patients with a small scrotum have been suggested to reduce this risk.[43]
Complications
Early postoperative complications
Early complications are uncommon in the large prospective PHOENIX registry (30 centers, inflatable and malleable devices), and early hematoma was more frequent in low-volume than in high-volume centers. The authors issued a July 2026 correction to the cohort (1,072 to 1,034 patients), so take exact percentages from the corrected tables. See the complication-page discussion.[11][24]
Late[10][14][16]
| Complication | Rate | Notes |
|---|---|---|
| Infection | 1–3% (primary); 10–13% reported in older revision series[52] | Most feared; often requires complete explantation |
| Mechanical failure | Highly variable; above 15% in about half of studies with 5–11 years of follow-up[10] | Fluid leak, tubing kink, pump/cylinder failure; improved with modern devices |
| Erosion | 0.02–32.5% across studies, with most reporting <5%[10] | Cylinder through urethra or glans; pump/reservoir through skin |
| Urethral injury | 0.1–3% reported occurrence[1] | Repair and defer implantation in most cases, particularly distal or higher-risk injuries; continuation after repair may be feasible for selected penoscrotal injuries.[1] |
| Penile shortening | Variable | Preoperative counseling essential; Peyronie's patients at highest risk |
| Glans ischemia | Incidence not estimated in the cited case series | A newly dusky glans warrants urgent assessment, including whether device removal is needed; in a 21-case series of suspected glans necrosis, all 17 men managed expectantly with implants retained had significant tissue loss, whereas four managed with immediate removal healed without sequelae.[55] |
| Sensory change | Variable | Infrapubic approach carries slightly higher dorsal nerve risk |
Infection Management
Infection typically mandates complete device explantation. Immediate salvage (Mulcahy technique) removes the infected device components, irrigates the wound with antimicrobial solutions, and places a replacement implant in selected patients; erosion or exposed hardware has been included in selected contemporary series. In one 2020 series, 24/26 patients remained infection-free after immediate replacement (22 malleable, 4 inflatable).[48]
Outcomes
Functional Success and Satisfaction
| Metric | Rate | Source |
|---|---|---|
| Follow-up ascertainment and device assessment | Follow-up data were obtained from 43/51 patients (84.3%) at median 26 months in a retrospective series; the 2016 ICSM panel recommends adequate postsurgical follow-up to assess complications, device placement and function | [1][14] |
| Prosthesis functional at ~2 years | 88.4% (38/43 follow-up respondents) overall; 94.4% (34/36) after primary implantation at median 26 months (single-center series) | [14] |
| Patient satisfaction | 83% pooled (95% CI 80–86%); 53/59 satisfied in an SSIPI cohort; 93.1% positive among 322 respondents among 542 implanted patients in another series; mean EDITS 75.14 in a separate cohort | [12][13][15][17][26] |
| Partner satisfaction | Generally somewhat lower than patient satisfaction; higher with inflatable devices | [26] |
Predictors of Satisfaction[15][16]
- In a 142-patient prospective registry at one year, surgeon experience was the only independent predictor of higher satisfaction among the variables tested; an exploratory curve plateaued near 15 implants per year.[15]
- Hydraulic devices report higher satisfaction scores than malleable prostheses[3][15]
- Absence of complications correlates with satisfaction[13]
- Middle-aged men may report lower satisfaction than younger and older patients[16]
- Comprehensive preoperative counseling and realistic expectation-setting improves outcomes
Long-Term Durability
- Device survival (inflatable): about 87% at 5 years, 77% at 10 years, 64% at 15 years and 53% at 20 years in a meta-analysis of 12 studies (20,161 patients; manufacturer-affiliated authors); newer series show better 5-year survival (91% versus 82%)[25]
- Modern coating technologies and device redesign have progressively reduced failure rates[5]
- Median device survival is approximately 20 years in that analysis[25]
Special Populations
Peyronie's disease with ED: IPP implantation straightens most curvatures mechanically; severe residual curvature requires concurrent modeling (gentle manual bending), plication, or grafting at time of implant.
Corporal fibrosis (priapism, prior infection, revision): Specialized dilation tools (cavernotomes, Rossello dilators, corporal excavation) create space in scarred corpora. Malleable implants may be preferred when fibrosis is severe.
Post-radiation: Prior radiation can make primary IPP placement technically more difficult. In a matched 211-versus-211 cohort, intraoperative complications were higher (4.3% versus 0.9%), but postoperative complications and reoperation did not differ significantly through 24 months; longer durability was not assessed.[49]
Neophallus (phalloplasty patients): No native corpora; implant placed in surgically created neocorpora or directly in the neophallus tissue. Technically demanding; both inflatable and malleable devices are used, and narrow-profile cylinders have been reported in neophallus series.[56][57] A nine-study meta-analysis found no significant difference in overall complication or explantation rates between the two device classes.[57] Erosion rates higher than in cis men.
Concurrent penile prosthesis + AUS: Staged or simultaneous implantation safely performed in experienced centers; pump positioning planned to avoid device-on-device conflict in the scrotum. In a small comparative transscrotal series (15 synchronous and 8 staged patients), most patients in both groups reported "great improvement" on the Patient Global Impression of Improvement at 1 year; no major postoperative complications were recorded, and all staged patients said they would have preferred synchronous surgery.[38] A later caution from Steven K.[39] Wilson's own practice advises against placing both devices through one shared incision, since a complication could then threaten both devices, and suggests separate scrotal and perineal incisions to limit that shared exposure.[39]
Postoperative Management
- Immediate: Partial device inflation for 24 hours to 2 weeks to reduce hematoma and promote tissue molding around cylinders. The AMS IFU has the surgeon leave some fluid in the cylinders at closure so the capsules stay large enough to ease later inflation (the MS pump manual does this by pressing the deflation button as the last step; the TENACIO IFU by squeezing the bulb), dressing removal at 24 hours, discharge usually within 12 to 24 hours and a drain, if used, for 12 to 24 hours[31][33]. Daily pulling of the pump into a dependent portion of the scrotum for the first 3 postoperative weeks has been described to limit proximal pump migration.[44]
- Activation visit: at 3–6 weeks for first cycling and 4–6 weeks for readiness for intercourse per the AMS labeling, with wound assessment, pump cycling instruction, patient education on device use; annual device review thereafter[31][32]
- Pain management: Multimodal protocols (nerve block, NSAIDs, non-narcotic analgesics); narcotic-free pathways increasingly adopted[19]
- Sexual activity: Typically cleared at the activation visit (about 4–6 weeks); the AMS labeling says intracavernosal injection therapy can damage the prosthesis and should not be used after implantation[31]
- Device ID card: Patients carry identification for TSA screening and MRI clearance purposes. The AMS 700 is MR Conditional; the older global IFU allows 3 T or less at a spatial gradient of 720 gauss/cm or less, whereas the current MS pump and TENACIO IFUs list 1.5 T or 3 T with gradients up to 40 T/m (4,000 gauss/cm), normal operating mode and image artifact extending about 33 to 36 mm, so check the edition matching the implant[31][32][34]
- VTE: Neither the device IFUs nor the EAU sexual health guideline gives an IPP-specific VTE recommendation. Apply the general incontinence/prosthetic-surgery risk framework (age, obesity, prior VTE, malignancy, prolonged operation or immobility) on the VTE Prophylaxis page
Counseling Summary
| Point | Detail |
|---|---|
| Natural erections after surgery | Not possible — irreversible change |
| Patient satisfaction | 83% pooled patient satisfaction (83 studies; 9,429 participants with satisfaction data)[26] |
| Device survival | ~77% at 10 years and ~53% at 20 years for inflatable prostheses (12-study meta-analysis)[25] |
| Infection risk | 1–3% primary; higher in some revision series |
| Effect on sensation and orgasm | Libido and orgasm preserved; the label cautions the erection may be shorter, narrower and less sensitive (decreased sensation 2.3% in the AMS 700 pivotal trial)[31] |
| Effect on ejaculation | Usually unchanged; abnormal ejaculation 2.0% in the pivotal trial[31] |
| Sexual activity clearance | ~4–6 weeks postoperatively |
See Also
- On WHITWIKI, the sister site for GU oncology: Sexual Function and Fertility.
Podcasts
References
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