The inflatable penile prosthesis is a surgical device that enables a man with erectile dysfunction to achieve an erection by transferring fluid from one part of the implant to another. The inflatable prosthesis consists of three components: cylinders, pump, and reservoir. All components are implanted and cannot be seen outside the body.
The prosthesis cylinders are placed one on each side of the penis. Their placement does not require tissue removal. When filled with fluid, they expand and fill the penis, creating a physiological erection. The cylinders do not alter penile sensitivity and allow the patient to continue ejaculating. The glans also continues to fill with blood (in cases where this occurred before surgery). The fluid needed to fill the cylinders and create the erection is stored in the reservoir, which is implanted inside the patient’s abdomen. Fluid transfer is controlled by a pump located in the scrotum.
The penile prosthesis provides the patient with an erection for as long as desired, and it is not interrupted by orgasm. When the patient wishes, the prosthesis can be deflated by pressing a “button” located on the top of the pump, along with compression of the penis. This action causes the fluid to return to the reservoir.
The prosthesis implantation can be performed through a single incision in the scrotal sac. Return to sexual activity typically occurs around 6 weeks post-surgery.

Video of a patient inflating and deflating the penile prosthesis – Watch and understand.

How is the penile prosthesis implanted?

Penile prosthesis implantation is performed through surgery. It is usually done via an incision along the midline at the junction between the penis and the scrotal sac. All prosthesis components are inserted through this incision. Before choosing your penile implant, make sure you fully understand the surgery required, including the risks, complications, and postoperative care.

What are the advantages and disadvantages of the penile prosthesis?

Advantages:

• You can have greater control over your erection, being able to initiate and stop it whenever you want;
• Spontaneity in sexual activity
• High couple satisfaction rate
• Good penile rigidity that lasts as long as you desire.
• Predictable and long-lasting results
• Allows you to have an orgasm
• No need for oral medications or penile injections to achieve an erection
• The prosthesis is discreet and not visible under underwear (in the case of the inflatable prosthesis)
• Easy to use
• Penile prosthesis implantation is a well-established and safe procedure, with high patient satisfaction rates.
• Most men who receive a penile prosthesis implant report significant improvements in sexual quality of life, emotional well-being, and overall satisfaction with the treatment.

Disadvantages:

• Implants are permanent, and spontaneous erections will no longer occur
• Risk of mechanical failure (malfunction of the prosthesis), requiring replacement.
• Risk of infection in the prosthesis, requiring its removal (usually < 1%)
• Difficulty concealing an erect penis with a malleable prosthesis.