​How should I position the genitals?

• With the penile and testis implants in place, the genitals are heavier and will require support during the healing process. A great way to do this would be to use slightly loose boxer briefs and some gauze or a wash cloth to support but not smash the genitals. It is also important to avoid compression or extra pressure on the skin overlying parts of the implant (i.e. the tip of the penis and front of the scrotum). 

• There is no specific direction to point the penis. Essentially, keep the penis in a comfortable spot for you, and this may vary from day-to-day. Avoid positions that cause the implant underneath to "tent" or put pressure on the overlying skin.

• For patients who get the penile or testis implants, it is important to know where the scrotum is during daily activities like walking, sitting, and so forth. Conscious adjustments are required many times a day to avoid complications like erosion and migration of the implants. After about 4-6 weeks, this becomes second nature and patients rarely need to be as vigilant with genital positioning.

• Straddling activities like bench related workouts and biking may lead to delayed complications like erosion or malposition; take care always with straddling type activities. 

How do I know if the implant is infected?

• If there is the combination of redness, with worsening swelling, pain and fever over 101F, this is a bad infection. If there are 2 or 3 out of 4 symptoms (no fever, for example) this could be a localized or less severe infection.

  • With fever, going to the ER and/or​ calling 911 may be required.

• Notify your surgeon or the office for guidance.

When should I be worried about erosion?

• If the skin overlying part of the implant is pink (usually near tip of penis and/or scrotum), and the skin is not mobile over the implant, this area may be at risk of erosion. 

• When you notice drainage of fluid from somewhere, there is a possibility of implant erosion.

• Notify your surgeon if you see erosion symptoms.

Is it normal to have penis or scrotal swelling?

• Yes, swelling is expected and varies in degree of severity from patient to patient.

• Yes, after intercourse, swelling and some redness is common and usually lasts less than a day. 

• It is not normal if the swelling is combined with worsening pain and spreading skin redness. If this is noted, contact your surgeon.

Is it normal to have pelvic itching?

• Yes, if it's random and there are no overlying skin changes. Some patients report the itching around the top of the scrotum or the base of the phallus, and underneath the skin. 

• If there is overlying skin redness, it could be a fungal infection, in which case topical anti-fungal cream (over the counter) may be used. If concerned, contact your surgeon's office.

Will my urinary symptoms be affected?

• Yes, sometimes the penis tissue will swell in response to the implant. In addition, the implant itself can push on the urethra.

• The stream will usually be weaker for the first few days but should resolve after a few days.

• Blood in the urine is not normal and requires evaluation. Contact your surgeon if you notice blood in the urine after implant surgery.

Will it be ok to go on a plane?

• Yes, many patients with anatomic or flap-based penises have implants and frequently travel. TSA is usually aware.

How do I inflate and deflate the inflatable penile prosthesis (IPP)? 

• Inflation: squeeze on the round "grenade" like portion of the pump with your thumb and fingers. Continue pumping until the rod is at its desired rigidity or you can no long squeeze the grenade portion of the pump. This shunts fluid from the reservoir to the rod component.

• Deflation:

  • OTR: there is a "drum" portion just above the "grenade" portion of the pump that is connected to all the tubing. On one face of the drum is a nipple or button. Using your thumb and finger, locate each face of the drum and compress the button. Then squeeze the phallus to speed up the deflation process. This shunts saline from the rods back into the reservoir. 

  • Classic: this older but well designed pump has two long oval shaped buttons above the grenade portion; compress the oval buttons and squeeze the penis/cylinders to deflate the implant.

• Please click video link "IPP video" for more information.

When can I start using the implant for sexual activity?

• At 8 weeks postop, the implant may be used, assuming everything has healed well. During use, remember to deflate the implant after activity, and remember to use plentiful lubrication.

• Swelling is common after sexual activity and should resolve in 1-2 days; if swelling and redness persists, notify your surgeon.

• Note: only certain positions with your partner will work. This is true for any erect penis (with or without an implant). Experimenting will demonstrate which positions work and which don't.

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Is it ok to get an MRI?

• Yes, but there are certain conditions ("MRI conditional") as described by the manufacturer.

• Conditions:

  • Static field of 3 Tesla or less​

  • Spatial gradient field of 720 gauss/cm or less

  • Maximum whole body averaged specific absorption rate of 3W/kg for 15 minutes of scanning produced a temperature rise of less than 0.5 degrees Celsius.

• MRI image quality ​may be compromised if the area of interest is at or near the implant. Therefore, on occasion, MR imaging parameters may need to be optimized to account for the implant.

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