Information on Inflatable Penile Prosthetic Device
The inflatable penile prosthesis is an operation used to treat erectile dysfunction (ED). Generally this procedure is used for patients that fail or prefer not to use less invasive treatment (oral medications, urethral suppositories, vacuum devices, or injection therapy). This implant has been in use for decades and has a long track record of safety and efficacy. Patient satisfaction rates are approximately 90%. The prosthesis will allow you to have a rigid erection suitable for sexual activity on demand, and does away with the need for planning for sexual activity as is seen with medical treatments. In the deflated position the penis will have a normal flaccid appearance.
This surgery is generally performed as an outpatient or with an overnight stay, under general or epidural (spinal) anesthesia. The operation usually takes about 45 minutes. It is performed through a small (2 inch) incision just above the penis, or on the scrotum, depending on certain circumstances. Two fluid filled cylinders are placed in the erectile tubes of the penis . A reservoir (balloon) that holds the fluid for the system is placed in the pelvis through the same incision. A control pump that operates the device is placed in the scrotum under the skin next to one of the testicles. You will need to squeeze the pump to transfer fluid from the reservoir into the cylinders to produce an erection. There is a separate button on the control pump used to deflate the cylinders. You will be given detailed instructions on operating the device after the operation. If you feel that you will not be able to use the control pump, you should not have the surgery.
Sometimes a small drain will be placed if there is mild bleeding noted in the operating room; in this case patients are usually kept overnight and the drain is removed the next morning. You will have a dressing around the penis and scrotum for 48 hours. This can be removed 48 hours after surgery. The stitches used to close the incision are absorbable. Postoperative pain is generally mild. You will be sent home with prescriptions for antibiotics, pain medication, and a stool softener. It is common to have some scrotal swelling and discomfort after surgery. It usually resolves within one to two weeks. Patients are instructed to avoid lifting greater than 20 pounds, exercising or performing sexual activity until 4-6 weeks after surgery. You may shower 48 hours after surgery. Tub baths or swimming should be avoided for 2 weeks.
You should notify me immediately if you have any of the following symptoms after surgery: severe pain, fevers, discharge from the incision, blood in the urine or severe swelling. You should schedule a follow up appointment in approximately two weeks after surgery for a wound check. You will be taught how to use the pump and can then use the device about four to six weeks after surgery. You will be given instructions to inflate and deflate the device for 15 minutes twice a day to help stretch the tissues and prevent capsule formation around the device.
Overall patient satisfaction rates are very high and are around 90%, with most men reporting that they are very happy with their decision to receive an implant. There are certain features of the device that are important to consider. Although some of the cylinders expand in and width, some men will report a perceived shortening in their penile length. You should keep in mind that the length of your penis may have decreased by a small amount as a result of long term ED. The maximum size cylinder that your anatomy can accommodate is placed.
Complications for this procedure (and any surgery) include bleeding, infection, and post-operative pain. With any man made medical device, mechanical failure may occur. This is rare with the average device lasting over 10-15 years. Extremely rare is extrusion of the device through the skin or urine channel, perforation of the urethra or erectile body during surgery, damage to adjacent structures. Most patients will have some soreness of the penis post operatively during which time we ask that you do not use the device. Most men are able to inflate and deflate the device themselves within 3 weeks, and are having sex soon thereafter.
If your implant needs to be removed for any reason, you will likely need to have it replaced to have erections in the future. Frequently, in men who require removal of the device for infection or mechanical failure, we are able to replace a new device at the same time to avoid additional surgery.
Please feel free to contact the office with routine questions or concerns and to arrange your follow-up appointment.