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Ask The Expert Archive

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Penile Implant Surgery Archive Questions

Below are Dr. Kramer’s answers to Penile Implant Surgery questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 15 of 26.

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Q : 1

Will an implant interfere with urination?

Absolutely not! It's not in the urethra, but rather the erectile chambers.

Q : 2

Where does the salt water come from?

The fluid in the device stays within the components of it throughout it's (your) lifetime. The same saline cycles between the reservoir and cylinders. The fluid is sterile, does not leak out, and never needs to be replaced. The salt water reservoir is small, and I hide it in the pelvis where you'd never know it's there, no one can see it or tell.

Q : 3

Can you still have children naturally with a penile implant? What is the size range of the implants? Are there any side effects?

Yes, you can have kids with it. In fact, it works like a normal penis. They are available in every possible size. The only major risk with this procedure is infection.

Q : 4

What happens to the corpus spongiosum and the head of the penis after penile implant? I am a radical prostatectomy patient.

The corpus spongiosum and glans are totally preserved and in place after implantation. Men with implants still have swelling in the glans and good blood flow. When implants are done after prostatectomy (40 percent of my patients fit into this category), the implant does a great job for the corpus cavernosum and the glans still gets it's natural flow.

Q : 5

I am a 65 and have Peyronie's disease and ED. Oral medications have not worked and my urologist said that injections won't be effective because of the Peyronie's. Could I be a candidate for IPP?

Having Peyronie's disease is not a contraindication for surgery.

Q : 6

Is there any way to enlarge or to thicken the penis?

Not length, but girth or thickening is possible, but only with a penile prosthesis.

Q : 7

I had surgery 8 weeks ago and my wound is still open and leaking fluid. Today, I noticed the tube on the right is protruding. My surgeon seems unconcerned, should I get another opinion?

Yes, I would get an opinion. If you are seeing the actual tubing itself (not just pushing tissue out with it), and you see the device, then you need to get an opinion ASAP.

Q : 8

How do I make an appointment for penile implant surgery?

You can call to speak to me at (410) 328-6087, or ask for my assistant, Debbie Miller. She can schedule you, either to meet with me, or as many people do, just speak to me first to answer all of your questions. If everything sounds reasonable and you're comfortable that this is the place for you, we'll schedule the surgery.

Q : 9

My penile implant is leaking, causing an erection constantly. The implant was inserted in l986 and is an AMS 165. How can this be corrected? How serious would the operation be to remove the implant?

This is something that is common with older devices; you've done terrific with maintaining this implant for 25 years! It's (relatively) easy to fix. I'd remove/replace everything, it'd take about 20 minutes. It's easier than placing the original device, so a smaller operation than the one you had in 1986 with less pain and a shorter recovery.

Q : 10

What determines the size of the penis when it is inflated? How many inches will the penis be when it's inflated? Does it depend on the size of the implant?

It all depends on your anatomy and the size of your penis. The implant doesn't make the penis larger or smaller, it only fills in the natural size of the penis.

Q : 11

Do penile implant patients have the option of having the suspensory ligaments clipped at the time of the implant surgery?

I do not cut the suspensory ligaments. I think there are high risks involved and it outweighs the benefits.

Q : 12

When you do the surgery using a malleable prosthesis. Where will you make the surgical incision? Will it be on the scrotum or the side of my penis? I hope that I will not be awake during the surgery? Will the catheter be inserted while I'm asleep?

The incision will be in the midline of the scrotum, it won't be seen 2-3 months after surgery. I do not make any incisions on the penis at all. The catheter will be inserted once you're asleep, and I'll take it out in the morning (6am) after surgery. You'll certainly be asleep for the surgery. If you're at all worried about it, I can take the catheter out while you're still asleep.

Q : 13

Does your office accept patients with Medicare who want to have penile implant surgery to correct ED?

Medicare nearly always, more than 99 percent of the time, will cover penile implant surgery entirely. For this reason, despite it being an expensive operation, if you have Medicare it will be covered. Call 410.328.6087 to talk to Debbie Miller to set up an appointment to discuss further if interested.

Q : 14

How long is the hospital stay after a penile implant surgery? Will I be able to drive myself home? Does BCBS federal insurance cover the operation? I also had the nesbit procedure done a couple of years ago and it failed, I still have Peyronie's.

Insurance typically does cover the costs of the surgery, but you can call Debbie (410.328.6087) in my office to verify this information. The hospital policies/rules, which are totally independent of me, will not allow you to drive home the day of surgery because you will have had anesthesia. You could sign out AMA, against medical advice, but I'd recommend staying 23 hours. This way I could give you more antibiotics and you could leave the next day. Otherwise, someone could definitely drive you home the same day if you choose that option. Lastly, the implant will (finally) fix the curvature in your case. I can straighten within 5 degrees of normal anything that starts up to 90 degrees. So the Nesbit doesn't make the operation any more difficult, and will almost surely straighten the penis. Sometimes is takes 3-6 months to be absolutely straight, but it'll get there.

Q : 15

After penile implant can the glans still have erections or is it permanently flaccid?

The glans can still become engorged after a patient has had the implant surgery.

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