What is an Inflatable Penile Implant

The inflatable penile implant is a surgical treatment option for severe erectile dysfunction. To better understand the procedure, let’s first review some information about the male body and this medical condition. 

In the male body, the bladder is on top of the prostate.  The prostate helps to make semen. The urethra is a long tube that connects the bladder to the penis, it carries both urine and semen.

The corpora cavernosa are two long spongy structures in the top of the penis.  An erection happens when the corpora, fill with blood to become straight and hard. Below the penis is a skin sac called the scrotum. 

Erectile dysfunction, ED, is a problem when a penis cannot become firm or hard enough for sex. Many parts of the mind and body must work together for an erection to happen correctly.

Many health problems can damage nerves and blood vessels needed for an erection. Some causes of ED are heart disease, high blood pressure, diabetes, smoking, sleep problems, prostate surgery, and spinal cord or back injury. 

Talking about ED is difficult for most people but waiting to get help can worsen the problem. Treating ED and its cause is important for health and well-being.  Confidence and self-esteem can improve and couples may have a more natural interaction.

Implant surgery is used if medication, exercise, and other therapies have failed or are not an option.

There are 2 types of implants, solid and inflatable.  

The solid device has hard, bendable rods that make the penis have an erection all of the time. This implant is easier to use for some patients.  However, it is more obvious to the partner and has a higher risk of erosion, which is the implant breaking thru the skin.

The Inflatable implant is designed to be hidden, private, and not noticeable or obvious to the partner.  The man or his partner press a pump to make an erection when needed. The pump also deflates or collapses the erection. The parts are softer and have less risk of erosion.

The three-piece inflatable implant has a container or reservoir to hold liquid called saline.  Two cylinders fit in the corpora cavernosa of the penis and fill with saline to make an erection.  The pump is used to control the implant and is hidden in the scrotum.

Surgeons are careful to choose the largest implant for each patient that will fit safely.

Implants are not intended for penis enlargement, because the erections can be smaller than they were naturally.   Be sure you and your partner understand the possible changes to erection size.

The inflatable penile implant is not for men with normal erections.  This surgery is permanent.  After implant surgery, it is impossible to have an erection without using the implant.  ED medications will not work.  Sensation or feeling, ejaculation, and orgasm are usually about the same, not better because of this surgery.  Some patients have less feeling.

Now let’s talk about what happens during surgery to place an inflatable penile implant.

To start, you are given anesthesia to keep you free of pain during the procedure.  You are positioned carefully.

An incision is made.  This can be above the penis, on or under the scrotum depending on your body and your surgeon.

The corpora cavernosa are gently dilated and measured using a probe. Your surgeon selects an implant size to fit your penis.  

The implant cylinders are then placed in the corpora of the penis.

Your surgeon now puts the reservoir in your belly, behind the muscles of your abdomen. Sometimes to get to this part of the body a second small incision is needed.

The pump is placed in your scrotum.  

Your implant is tested during surgery to be sure that it is working properly.  To make an erection, the pump is gently squeezed, to relax the erection the pump is squeezed again. Your urologist and his staff will teach you how to use the pump after surgery.

Finally, the surgical area is carefully checked for bleeding and the incision is closed.

After surgery, “speak up” and tell your care team if you have unexpected pain or problems.

You may be able to go home the same day, but some patients need to stay overnight. You will have a soft tube called a Foley to drain urine, and a large fluffy bandage to decrease bruising and swelling.  Both are removed the day after surgery.

You may have a drain, a tube near your incision.

This is taken out after 1 to 2 days.

You should expect that you may have to take antibiotics for the first week. 

There will be bruising and swelling for a few weeks and you will have some pain and soreness.  

Use ice packs to help with your pain and swelling, especially the first 2 days. Wrap ice packs in a towel before putting them against your skin. Rest as much as possible.  Use Tylenol, Motrin, Aleve, or other pain medication only as recommended by your physician.

Inflatable implants were invented over 30 years ago. They are considered sturdy and reliable.  About 75% or 3 out of 4 men will find their implants still work after 10 years of use.  

However, some men will have problems with their implant.  A risk of this procedure is bleeding which can be seen as bruising and why a drain may be placed.  Infection is a serious risk and is most common during the first few weeks until 3 months after surgery but can happen years later.  Scar tissue often from infection can cause the penis to be shorter.  Some patients complain of numbness or no feeling in parts or rarely the whole penis.

To treat some problems an implant must be replaced, another surgery is done to take out your implant and put in a new one.  Your surgeon may need to do this if you have an infection, which can cause erosion, where the implant breaks thru the skin. Replacement surgery is also done if the implant is broken or not working. 

You can help prevent these problems by following your doctor’s instructions.  During the first week rest as much as possible. Support your scrotum and keep your penis lifted with snug underwear or an athletic supporter,  and keep the area dry for 2 days.

The first 6 weeks you must not have sex. You will start to “cycle” and work with the implant at 4 weeks.  Continue to wear support for your penis and take it easy.  

Showering to stay clean is important but don’t swim or use a hot tub. You should not exercise or do any heavy lifting.

To help your body heal eat healthy foods. Avoid junk food and sugary drinks and snacks. If you are a smoker, don’t smoke.  And if you have diabetes, keep your blood sugar under control.  Both smoking and high blood sugar slow healing. 

Call your doctor if you cannot urinate, have a fever, or pain that is getting worse even with ice, rest and medication. And call for bright red bleeding that doesn’t stop. Hospital admission, medication or surgery may be needed to fix some problems. 

To avoid cancellation or complications from anesthesia or your procedure, your Job as the Patient is to not eat or drink anything after midnight, the night before surgery, not even a stick of gum, take only medications you were told to on the morning of surgery with a sip of water, stop your aspirin or blood thinners before surgery as you are instructed and arrive on time

You should be ready to verify or confirm your list of medical problems and surgeries, all of your  medications, including vitamins and supplements, your current smoking, alcohol, and drug use, and all allergies, especially to medications, latex, and tape 

All surgery and anesthesia have a small but possible risk of serious injury, even some problems very rarely leading to death. It is your job to speak up and ask your surgeon if you still have questions about why this surgery is being recommended for you, the risks, and alternatives.

This video is intended as a tool to help you to better understand the procedure that you are scheduled to have or are considering. It is not intended to replace any discussion, decision making or advice of your physician.