What are the post-operative instructions after penile surgery implant?

Post-Operative Instructions After Penile Implant Surgery

Patients should receive comprehensive infection prevention protocols including antibiotic prophylaxis with an antifungal agent added to antibacterial coverage, along with specific activity restrictions and wound care instructions to minimize the risk of device infection, hematoma, and mechanical complications. 1

Infection Prevention Protocol

Antibiotic Prophylaxis

• Add an antifungal agent (typically fluconazole) to your antibacterial regimen, as this reduces infection risk by 92% compared to antibacterial agents alone 1
• Continue perioperative antibiotics as prescribed, recognizing that infection occurs in 1-6% of patients, with higher rates in diabetics 2
• The use of antibiotic-impregnated/coated devices, antiseptic surgical scrub, no-touch technique, and wound irrigation should be employed during surgery 1, 3

High-Risk Patient Considerations

• Diabetic patients have nearly double the infection risk (HR: 1.9) and require more aggressive prophylaxis 1
• Patients with immunosuppression, prior pelvic radiotherapy, or revision cases need heightened surveillance 2

Activity Restrictions

Immediate Post-Operative Period

• Expect approximately 14 days of time lost from work regardless of surgical setting 4
• Avoid strenuous physical activity, heavy lifting, and sexual activity during the initial healing phase 5
• Minimize activities that could cause trauma to the surgical site 3

Pain Management

• Expect to use approximately 25 analgesic pills during the post-operative period 4
• Pain should progressively decrease; increasing pain may signal infection or hematoma 3

Wound Care and Monitoring

Signs of Complications to Watch For

• Infection warning signs: increasing pain, fever, wound drainage, erythema, or warmth at the surgical site 2, 3
• Hematoma indicators: significant swelling, bruising, or firmness that worsens rather than improves 3
• Device malfunction: inability to inflate/deflate, autoinflation, or unusual mechanical sensations 3

Expected Changes

• Some degree of penile length loss (0.5-2 cm) and girth reduction may occur post-operatively 6
• Penile shortening and potential curvature can develop, particularly if complications arise 7

Follow-Up Care

Timing of Follow-Up

• Early post-operative visit to assess wound healing and device function 5
• Median follow-up typically occurs at 9 months, though patients without complications may be seen at 13 months 2
• Report any concerning symptoms immediately rather than waiting for scheduled appointments 3

Device Activation

• The surgeon will provide specific instructions on when to begin cycling the device 5
• Proper mechanical understanding of the implant is essential for optimal outcomes 5

Common Pitfalls to Avoid

• Do not ignore early signs of infection, as device infection can necessitate explantation, cause sexual dysfunction, and result in additional penile length loss 2
• Inadequate infection prevention by omitting antifungal prophylaxis is a critical error given the 92% risk reduction it provides 1
• Premature return to sexual activity before adequate healing can increase complication risk 5
• Failure to optimize pre-existing medical comorbidities (particularly diabetes) increases infection risk 1, 5

Outpatient vs. Inpatient Setting

• Penile implant surgery can be safely performed in an outpatient setting with 17% cost reduction and no increase in complications 4
• Outpatient surgery is safe even in patients with comorbidities or undergoing secondary procedures 4
• Hospital admission for monitoring, antibiotics, and analgesia administration is not mandatory when proper protocols are followed 4