As the penile prostheses become more advanced (associated with more pieces), so do the operations necessary to place them. Unfortunately, the possible complications associated with them increase as well. Each surgeon must have a thorough conversation with their patients informing them of their options including the risks benefits and possible complications associated with each prosthesis type. As with any operation, experience of the surgeon is extremely important. Not all urologists have been trained in the placement of all three kinds of prostheses.
Risks and complications vary with each device. First, because the prosthesis is a foreign body, there is a risk of infection of the prosthesis. This risk increases with the number of pieces. Most patients who have erectile dysfunction also have other medical problems such as diabetes and heart disease that can affect wound healing. The rate of infection can be as high as seven percent. If the prosthesis becomes infected, rarely are antibiotics enough to salvage the device. More commonly, the prosthesis must be entirely removed. The patient must receive a course of antibiotics as well. Often, the prosthetic can be replaced at a later date.
A second complication includes malfunction or device failure. This can occur when a piece breaks or cracks. Obviously, with more pieces, there is a higher chance of malfunction or breakage. The three-piece prostheses are connected with tubing to transport the fluid. These tubes can erode or weaken. The pump can also break not allowing inflation of the device to occur. These problems are rare, and the good news is that they usually can be fixed without removing the prosthesis.
Complications associated with the placement of the device are rare as well and are often dependent on the surgeon’s experience (i.e. the more the surgeon performs the procedure, the less complications he/she may have). A urethral injury can occur when placing the prosthesis. The urethra is the tube in the penis through which men urinate. The urethra is usually not involved during the procedure, but it lies adjacent to the corporeal bodies (the bodies in the penis responsible for erection). If that occurs, usually the operation is stopped and a foley catheter (drainage tube in the penis) is left temporarily in place. Another rare complication is associated with the placement of the abdominal reservoir during a three-piece prosthesis. Several structures exist in the lower abdomen that can be injured including the bladder. Measures are taken to avoid this, but a patient must still be aware of the possibility.