- 28 -
I
mmedIately
p
ostoperatIve
The physician may place a closed system drain in the
abdomen to drain excess fluid from the incision site .
After 24 hours, remove the dressing . Support the penis
on the abdomen for four to six weeks to obtain a straight
erection .
a
fter
the
p
atIent
Is
r
eleased
from
the
h
ospItal
The patient is usually discharged in twelve to
twenty-four hours .
After the patient has returned home and the swelling
from the surgery has subsided, the physician may ask the
patient to pull down on the pump located in the scrotum
to properly position it . Positioning the pump makes it
easier for the patient to locate the pump .
The frequency of positioning the pump is up to the
physician . Some physicians have their patients position
the pump daily .
To position the pump in the scrotum, a patient should be
told to:
•
Locate the pump in the scrotum .
•
Grasp the pump firmly and carefully pull the pump
down in the scrotum . The patient should gently pull
the pump into a position close to the outer scrotal
wall .
After three to six weeks, the physician may instruct the
patient to begin cycling the device for the first time .
To cycle the device, the patient inflates and deflates the
prosthesis several times . It may be painful for the patient
the first few times that he inflates and deflates the device .
However, after the postoperative healing period, the pain
should subside . Instruct the patient to inflate and deflate
the prosthesis several times daily . This will encourage
maximum pseudocapsule development and
reservoir capacity .
Four to six weeks postoperatively, instruct the patient that it is
possible to begin using the prosthesis to have intercourse . To
determine if the patient is ready to use the device:
•
Check the incision site to be sure that it has healed
properly . There should be no redness, swelling, or
drainage . Any of these things may indicate that an
infection is present and the infection should be
treated promptly with antibiotics .
•
Ask the patient about pain when cycling the device
and observe the patient inflating and deflating the
device .
•
If the patient is unable to inflate the device and
you believe the tubing may be kinked, AMS
recommends trying the pull-stretch technique: the
patient’s penis is pulled-stretched out, up, down
and side to side 2-3 times, which may allow the
cylinders to be inflated . This technique may resolve
the issue by slightly modifying tubing placement to
optimize fluid flow .
After determining that the patient knows how to operate
the device and that the device is functioning correctly,
inform the patient that it is possible to have intercourse
If the patient is familiar with injection therapies for
erectile dysfunction, remind the patient that such
therapies can cause damage to the penile prosthesis, and
thus should not be used .
The pump contains a valve that resists elevated reservoir
pressure . However, there is the possibility that the
device will automatically inflate during the immediate
postoperative period and the patient may have to return
to the office for deflation . Autoinflation may occur for
a variety of reasons .
If this occurs, verify that the patient is squeezing the
deflation button for 4 seconds and that the patient does
not squeeze pump bulb after this . Instruct the patient to
inflate and deflate the prosthesis several times daily . This
will encourage maximum pseudocapsule formation and
reservoir capacity .
e
valuatIng
l
ong
-
term
f
unctIon
and
p
lacement
After the postoperative healing period, the physician
should continue to have contact with the patient at
least on an annual basis to evaluate the function of
the device . During the annual evaluation, ask the
patient about how the device is functioning and if he
has noticed any changes in the function, for example,
cylinders losing rigidity . Also check the patient for signs
of infection or erosion .
If the patient is having mechanical difficulty with the
device, or there is infection or erosion present, revision
surgery may be necessary .
Postoperative
Procedures