Who is not a candidate for a penile prosthesis? Reversible erectile dysfunction, infections, or purely cosmetic reasons make the implant unsuitable—an experienced urologist must assess each case.
Some men who fall into the “not a candidate for penile prosthesis” group include those with reversible erectile dysfunction, active infections or aesthetic motivations. Read on for other contraindications.
What is a penile prosthesis and when is it indicated?
A penile prosthesis is an implant placed inside the penis when conventional impotence therapies fail. Other indications include:
- Men who experienced severe side-effects with medication;
- Patients who responded to injections or oral drugs for erectile dysfunction but no longer wish to rely on them;
- Peyronie’s disease when curvature prevents penetration.
There are two types of prosthesis: inflatable and malleable.
The inflatable model has three cylinders inside the corpora cavernosa, plus a pump and a saline reservoir. When an erection is desired, squeezing the pump fills the cylinders.
A malleable prosthesis consists of two flexible rods that keep the penis constantly firm, allowing it to be positioned upward for intercourse and downward for rest.
Cases where a penile prosthesis should not be recommended
Although effective, the device is not for everyone. Men who should avoid a penile prosthesis include:
- Those expecting penile growth, since the implant does not lengthen the penis;
- Erectile dysfunction due to treatable factors—psychological causes reversible with therapy or hormonal imbalance.
Health conditions that prevent prosthesis surgery
Learn more about penile-prosthesis contraindications:
1. Uncontrolled diabetes
Unmanaged diabetes impairs healing, favours infection and weakens immunity.
2. Heart disease
Severe heart failure, uncontrolled arrhythmias and unstable angina raise cardiac-arrest risk and anaesthesia complications.
3. Advanced kidney failure
Kidney failure elevates potassium and hampers drug clearance, increasing side-effects.
4. Coagulation disorders
Any clotting problem heightens bleeding and postoperative haematomas.
5. Immunosuppression
Immunosuppression—from cancer, HIV, chronic kidney disease, chemotherapy, radiotherapy or transplants—raises systemic-infection risk.
6. Severe psychiatric disorders
Conditions such as bipolar disorder, major depression or schizophrenia may impair adherence to care.
7. Major penile anatomical changes
Late-stage Peyronie’s disease or priapism sequelae (e.g. erectile-tissue necrosis) can make implantation unfeasible.
Medical assessment before indicating a penile prosthesis
Evaluating candidacy ensures safety. The assessment includes:
Urological evaluation
- Physical exam: penile anatomy, testes, prostate;
- Erectile-dysfunction history: onset, duration, severity, prior treatments (oral drugs, injections, vacuum pump);
- Clinical history: urological surgeries, trauma, Peyronie’s disease.
Laboratory evaluation
- Glucose and HbA1c;
- Free and total testosterone;
- Renal function;
- Lipid profile (urea and creatinine);
- Coagulation panel;
- Complete blood count.
Cardiovascular and anaesthetic evaluation
- Electrocardiogram;
- Echocardiogram and stress test.
Why choose a specialised surgeon?
Working with a penile-prosthesis specialist improves clinical outcomes and peri-operative safety. Key advantages include:
- Technical precision and lower risk of infection, bleeding or prosthesis displacement;
- Knowledge to select the right prosthesis type—inflatable or malleable;
- Comprehensive pre- and postoperative guidance;
- Access to hospitals with adequate infrastructure.
When to explore other erectile-dysfunction options
Consider alternatives if:
- There is performance anxiety, depression or chronic stress;
- Erectile issues follow abuse of alcohol, tobacco or illicit drugs;
- Vacuum pumps or intra-urethral therapy have not yet been tried.
Book an appointment and clarify the best treatment for you
If you struggle with erections, schedule a consultation with an erectile-dysfunction specialist. This is the first step to uncover the causes and explore tailored solutions.
Contact Dr Paulo Egydio for more information about penile prosthesis.
Learn more:
- Sexual Health: Egydio Medical Center EMC
- How Not to Fail at the Right Moment? Tips to Avoid Impotence
- When Is a Penile Prosthesis Necessary in Curvature Surgery?
- What Causes Hormonal Disorders in Men? Find Out!
- Penile Prosthesis: Detailed Advantages and Disadvantages
- Penile Prosthesis Rejection: Risks and Cases
- Does prostate removal affect ejaculation? What changes in sexual life
- Penile Prosthesis Maintenance: Do I Need Frequent Replacements?
