Penile prosthesis rejection can occur due to improper implant sizing, the patient’s health conditions, or not following postoperative recommendations.
Extrusion — when the implant comes out through the penile skin — is one of the complications of a penile prosthesis. Two measures that help minimize this issue are pre- and postoperative evaluation and care. Before the procedure, the urologist should measure the penis, perform a rigidity test with medication-induced erection, and request a penile Doppler exam to assess anatomy. The patient must follow all medical instructions, such as resting, attending follow-up visits, and changing dressings.
Penile prosthesis rejection: what it is and why it can happen
Before explaining how to tell if a penile prosthesis has been rejected, it’s essential to clarify that rejection is different from infection. Rejection occurs when the body does not accept the implant. This can happen even though prostheses contain silicone in their composition, a material approved for medical use. Infection, on the other hand, is related to the patient’s health conditions and habits, factors related to the surgical procedure, and the postoperative period. See below:
| Patient health conditions & habits | Surgical procedure factors | Postoperative |
|
Diabetes and other chronic diseases |
Inadequate surgical technique | Insufficient local hygiene |
| Obesity and smoking | Prolonged surgery |
Hospital-acquired infection |
| Compromised immune system | Failure in instrument sterilization |
Sexual activity before medical clearance |
Regarding infection after a penile prosthesis, diabetes is one of the main causes of complications. This literature review on the role of diabetes in penile prosthesis infection explains that improvements in devices and surgical techniques have reduced infection risk in recent decades. However, the authors emphasize that high blood sugar is still associated with shorter implant survival. Therefore, preoperative testing and strict glycemic control are especially important when implanting a penile prosthesis for diabetic patients.
Symptoms of penile prosthesis rejection
Severe and persistent pain, abnormal swelling, fever and chills, difficulty urinating, or painful urination are possible symptoms of penile prosthesis rejection. Seek medical advice as soon as any of these signs appear.
What to do in case of prosthesis rejection
Many patients wonder what to do if rejection occurs. The first step is to contact your urologist. A physical exam and imaging (ultrasound, CT, or MRI) may be requested to evaluate the implant and penile tissue. According to this review on treatments for penile prosthesis infection, the traditional approach was removal without replacement. Although safe, this strategy could accelerate erectile dysfunction and contribute to length loss. The modern recovery standard is often prosthesis reimplantation. Studies describe this technique as a possibility to preserve penile length and sexual function in selected cases. However, surgeons should explain that removal-and-replacement therapy carries a higher infection risk, especially for men with smoking history, diabetes, weakened immunity, or spinal cord injury. Another salvage option is to use medications to control infection. If there is a favorable response (reduced swelling, redness, and pain), prosthesis replacement surgery may be performed more safely.
Postoperative care to help prevent complications
Postoperative care aims to help prevent infections or rejection. See the main recommendations:
|
Postoperative Care |
Details |
| Medical follow-up | The first postoperative visit is on the same day of surgery and continues for five consecutive days. |
| Dressing changes | Change dressings daily as recommended by your physician. |
| Proper hygiene | Gently wash the area every day with water and mild soap. |
| Rest as advised | Return to work may occur between 5–10 days, depending on activity; sexual activity typically resumes ~30 days after surgery. |
| Monitor symptoms | Watch for redness, swelling, pain, and fever. |
Can penile prosthesis rejection be treated?
Symptoms suggesting penile prosthesis rejection can be evaluated and, in some cases, managed, provided the urologist investigates promptly. Once the underlying cause is identified, the physician may treat the signs of rejection and, when appropriate, consider penile prosthesis reimplantation if the patient’s health status allows.
FAQ
How do I know if my prosthesis is being rejected?
Severe pain, redness, fever, and discharge may indicate penile prosthesis rejection. If any of these signs occur, contact your urologist immediately.
What are the symptoms of an inflamed prosthesis?
Inflammation/infection may present with swelling, warmth, ongoing pain, and increased tenderness. Inform your doctor.
Can pain after a penile prosthesis persist?
Some discomfort in the first weeks is expected while recovering from surgery. Persistent or severe pain should be evaluated.
When does a penile prosthesis need to be removed?
And when should a prosthesis be removed? Removal may be indicated in severe infection, extrusion (implant protruding through tissues), or confirmed rejection. The goal is to protect health; depending on the case, a new implant may or may not be placed.
Questions about penile prosthesis? Talk to Dr. Paulo
Rejection rates have decreased thanks to modern devices and techniques, but events can still occur. If you are not achieving the expected benefits, schedule an appointment or fill out our pre-assessment form. After submitting the form, our team may provide initial guidance by email. Dr. Paulo is a urologist specializing in penile prostheses, with experience accumulated in thousands of procedures throughout his career.
