Chapter 37 · Andrological emergencies
Acute complications after penile injections and implantation
Types of complications
After intracavernosal injections:
- Priapism.
- Hematoma.
- Infection.
- Fibrosis, curvature.
After penile prosthesis implantation:
- Infection (the most serious complication).
- Perforation (erosion) by implant components.
- Mechanical malfunction.
- Hematoma.
- Pain, deformity.
Clinical assessment
- Infection: pain, swelling, redness, fever, discharge.
- Erosion: exposed implant component, pain.
- Priapism: prolonged painful erection.
Emergency management
- Infection: implant removal, antibiotics, drainage.
- Erosion: prosthesis removal and urethral reconstruction if needed.
- Priapism: aspiration, alpha-adrenergic agonists, shunting.
- Hematoma: conservative treatment (cold application, anti-inflammatory medication) or evacuation.
Algorithm
| Step | Action |
|---|---|
| 1 | Assess the complication (infection, erosion, priapism) |
| 2 | Infection → antibiotics + implant removal |
| 3 | Erosion → removal + reconstruction |
| 4 | Priapism → standard protocol |
Cross-references: Chapters 24–26 and 49.