Penile rehabilitation after surgery

Erectile dysfunction (ED) consist in the impossibility to reach and maintain a sufficiently valid erection for a satisfactory sexual relationship.
Despite improvements in the anatomo-surgical approch and use a different materials biocompatible for penile reconstruction, ED still represents a possible complication.

The aim of rehabilitation treatment of sexual function is two fold.

• Offer a return to adequate erectile function
• Prevent fibrotic involutive processes that could involve the penis

The rehabilitation after surgery consist in:

- Traction with the hand – start first day - 6 times/day
- PDE 5 inhibitor – start 5 to 7 days (Viagra, Cialis, Levitra)
- Stretching device and/or vacuum device – after 3 weeks



Penile stretching
Penile stretching
















Video Vacuum Device

Another possibility is to use intracavernosal vasoactive agents such as alprostadil, phentolamine, papaverine, administred separately or combined. This therapy is indicated when oral treatment is not efficacious or there are contraindication.

Intracavernosal injection
The most common side-effect of intracavernosal therapy is pain. Pain is more likely in men with neuropathy, such as diabetes, alcoholism and those who have undergone a radical prostatectomy. Pain is also more likely in those men with anatomical deformities. Corporal fibrosis may also occur with long-term use and patients should ensure that they inject into the side of corpus cavernosum (as shown in the slide) avoiding the dorsal neurovascular bundle and ventral urethra. There is a high drop-out rate among those who try intracavernosal injection therapy, although patient and partner satisfaction is high among those who successfully persevere. Penile prosthesis implantation are indicated in patients with Peyronie's disease and Erectile Dysfunction that do not response to conservative treatment.




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