Jan. 01, 2009 -- Question: Can I have a penile prosthesis implanted at the time of my prostatectomy, and what is the success rate of penile prosthesis surgery?
Answer: Many men wish to have their prostatectomy and a penile prosthesis implanted at the same time, so they have one operation instead of two. However, most prostatectomies are performed today is a nerve-sparing manner, and most men should recover erectile function. Therefore, to implant a penile prosthesis presuming post-operative impotence would not be reasonable.
If a -- what I call, commando operation is being performed, or a super radical prostatectomy, where both neurovascular bundles are resected and the man is certain not to recover erectile function, then it would be reasonable to consider implanting a penile prosthesis at the time of surgery.
Most urologists prefer to do these as two separate surgeries due to the risk of infection of the penile prosthesis, although that risk is quite low. In my particular practice, I rarely recommend penile prosthesis because we have many other ways of reestablishing erectile function sufficient for intercourse that involve the use of medications, suppositories, vacuum erection devices or injection therapy, which really makes a penile prosthesis rarely necessary in 2008.