Inflatable penile prosthesis surgery involves the insertion of a device entirely underneath the skin through a small incision (either above the penis or on the scrotum) that reliably produces an erection for sexual activity.
The device includes inflatable cylinders within the penis, a reservoir in the pelvis to hold fluid needed to fill the cylinders, and a control pump next to the testicles in the scrotum.
When to Ask a Urologist about Inflatable Penile Prosthesis Surgery
Inflatable penile prosthesis is a reasonable management option for men dissatisfied with other erectile dysfunction (ED) treatments, such as oral medications, and with sufficient dexterity to operate the control pump. In particular, the device is rigid enough to correct most penile curvature and therefore is a very good management option for men with penile curvature (Peyronie’s disease) in addition to ED.
Typically covered by most insurances (although coinsurance and deductibles may apply). Coverage will be verified prior to proceeding. If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.
Men with realistic expectations are typically quite happy with the procedure (over 92% satisfaction rate). This 1 hour procedure allows you to have reliable, hard erections that last for as long as desired with normal penile sensation. The prosthesis however does not increase penile length or girth as much does a natural erection. The stretched penile length, when soft, most closely approximates penile length after implantation. Use of a vacuum erection device without constriction band twice daily in preparation for surgery can help maximize the potential implant size and potentially increase length by a couple of centimeters.
Possible Side Effects
The various risks associated with the procedure include but are not limited to the possibility of a palpable reservoir, infection, device malfunction, and damage to surrounding structures. An additional incision in the lower abdomen may be required to place the reservoir due to changes in the pelvis following prior surgery. The risk of infection is l about 1-3%. Avoiding smoking and good blood sugar control lower infection risk. When infection occurs, it requires surgical removal of the entire device. Occasionally the device can be replaced at that time but there may need to be a delay and additional operation. The risk of mechanical failure is about 5% at 5 years and 30% at 15 years.
Alternatives to IPP placement include observation without treatment, oral medications, use of a vacuum erection device, medicated intraurethral suppositories, penile injections, semi-rigid (not inflatable) penile implants.
What to do to Prepare for Surgery
You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery (when to stop depends on the type of blood thinner). Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.
On the day before surgery, you will receive a phone call alerting you to the time that you should arrive, and you should wash the surgical area with an antibacterial soap.
You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.
What to Expect after Surgery
The procedure typically requires an overnight hospital stay with a catheter and a surgical drain that are both removed the following day. There can be significant tenderness, bruising and swelling that dissipates over 2-3 weeks. Device inflation / deflation at home starts around 2 weeks after surgery, and device use for sexual activity can start around 6 weeks after surgery.