The inflatable penile prosthesis is a device capable of treating severe erectile dysfunction. It allows the patient to inflate and deflate the penis as desired, restoring erectile function. Check out details about the implant, its functioning and how the surgery is done.
There are many physical and psychological factors that can impact men’s sexual performance. Concern and the search for treatment create doubts about which one is the most effective.
Among so many methods, one of the main ones is the inflatable penile prosthesis. This type of implant is indicated for men with erectile dysfunction who have already undergone other therapies and procedures – a surgical alternative indicated in certain cases of erectile dysfunction, according to individualized medical evaluation.
Today, you will learn more about how the inflatable prosthesis implant works, also called hydraulic penile prosthesis, main types and everything about the operation.
What is an inflatable penile prosthesis?
The inflatable penile prosthesis is a type of device implanted in the penis to restore erectile function in cases of severe erectile dysfunction.
It is composed of three pieces: a saline reservoir, a pump and two cylinders. These pieces make the prosthesis capable of inflating and deflating the penis as the patient wishes.
The penile prosthesis implant works from the moment the patient activates the device that sends the saline present in the reservoir. Housed in the scrotum, the pump sends the saline to the cylinders of the implant, resulting in penile rigidity.
When the patient wants to deflate the penile prosthesis, he only needs to press the deflation valve of the prosthesis so that the penis becomes flaccid.
For whom is the penile prosthesis indicated?
The inflatable or hydraulic implant is indicated for patients with erectile dysfunction who did not obtain satisfactory results, or who had severe side effects, when trying other methods. In addition, the penile prosthesis implant helps men who have penile deformities (Peyronie’s disease).
It is important to keep in mind that age is not a factor that determines whether or not the prosthesis is implanted. Therefore, it is indicated not only for older men, but also for younger men.
Types of inflatable penile prosthesis
First of all, there are variations in shape, material and appearance of the prostheses produced by different manufacturers. All these factors are fundamental when selecting the penile prosthesis.
The greatest specificity is in the volumes of the prostheses, since there are models with two or three volumes. In addition, penile prostheses differ in size and cylinder gauge, and it is important that the size suits the patient’s anatomy.
It is essential that the surgeon evaluates and, together with the patient, makes the best choice, aiming at the adequate adaptation of the prosthesis to the patient’s anatomy. Otherwise, the penis will not have good vertical resistance and, consequently, the dysfunction will not have been properly treated.
Two‑volume prosthesis
The volume of the two‑volume penile prosthesis is composed of the reservoir and the pair of cylinders. To make the penis flaccid, the patient must perform a downward bending movement.
Three‑volume prosthesis
The three‑volume hydraulic prosthesis has the pressurizing pump. Thus, to make the penis flaccid, simply press the pump, without needing to bend the penis.
Standard model
In the standard model, the cylinders are longer and narrower, in addition to having greater vertical resistance. Therefore, this model is usually indicated for patients with longer and thicker penises.
Narrow model
The relationship between cylinder length and gauge needs to be respected, aiming at compatibility between cylinder structure and penile anatomy. In the narrow model, the cylinders are narrower and shorter; therefore, it is indicated for smaller or thinner penises.
Components of the inflatable prosthesis
The hydraulic prosthesis is composed of the following equipment:
Pump
The pump, also known as pump, is positioned in the scrotum. This piece is responsible for transferring fluid from the reservoir to the cylinders and vice versa.
Through it, the patient can choose to keep the penis flaccid or erect.
Cylinders
They are the tubes installed in the penile body and are the receivers of the fluid from the reservoir of the inflatable penile prosthesis, allowing penile rigidity in response to prosthesis activation, according to its mechanics.
It is important that the cylinder is properly chosen to ensure the good functioning of the prosthesis and to avoid the penis bending during penetration.
The cylinder has different sizes and can be implanted with or without extenders.
Reservoir
This piece is positioned in the pelvic region. The reservoir will later be filled with fluid (saline).
Thus, as it is in the lower part of the abdominal region, the reservoir is not palpable or noticeable.
Use of extenders
If a chosen cylinder is smaller than the size of the penis and needs adaptation, the specialist can use extenders, small pieces that fit the cylinder to increase its length.
However, the use of extenders is not recommended because they interfere with the level of penile firmness, since this material does not correspond to the hydraulic part of the inflatable penile prosthesis.
Extenders can interfere with axial resistance, needing case‑by‑case evaluation. This means there is a risk of bending the member during penetration.
Advantages of the inflatable prosthesis
Now that we have addressed the indication and types of inflatable or hydraulic prosthesis, it is essential to know the advantages of its implantation.
Discretion
The inflatable prosthesis is highly recommended for patients seeking a discreet implant that can be handled easily and practically. It is also the best option for patients with blood circulation problems that compromise the penile blood flow.
Malleability
Another advantage is that the prosthesis can be easily accommodated and positioned under underwear while keeping the penis with an always elongated appearance.
Self‑esteem recovery
As it is a definitive surgical procedure, successful inflatable penile prosthesis surgery restores the patient’s self‑esteem, especially because the implant is indicated after the patient did not respond to other treatments.
Thus, the procedure can contribute to aspects of quality of life and confidence in some patients.
Improvement of sexual life
With the implantation of the hydraulic prosthesis, the prosthesis can dispense, in some cases, the use of oral medications or injections, according to medical evaluation. The man will be safer and free to have quality sexual relations.
Disadvantages of the inflatable prosthesis
The main disadvantage of the hydraulic prosthesis is when, previously, there is no Penile Reconstruction Surgery. It is this that guarantees the patient a successful inflatable prosthesis implantation.
Surgical recovery is fundamental.
Therefore, after inflatable prosthesis implantation surgery, the patient will only be able to resume sexual life after 60 days. Thus, discipline and patience are necessary in the postoperative period.
Finally, there is no obligation for health plans to fully cover the hydraulic or inflatable prosthesis.
Plans are only required to provide patients with coverage for the implantation of malleable prosthesis models.
How is the prosthesis implantation surgery?
The surgery to implant the penile prosthesis lasts around one hour and a half. There is sedation or general anesthesia, and the surgeon makes an incision in the region between the penis and the scrotal sac so that the rods are introduced.
To avoid complications and drain fluids, the doctor then inserts a catheter and a drain into the urinary tract. Within one day, the patient is discharged, but the drain is kept in the body for up to two days.
In the recovery period, the man can perform light activities within seven days and more intense ones after 21 days.
For sexual intercourse, the patient needs to rest for 60 days.
Operation of the hydraulic prosthesis
After each component is properly installed and has passed the functional test, it is time to understand how the patient will use the inflatable prosthesis.
To activate the prosthesis and produce erection at the right moment, just activate the pump that will “inflate” the penis, keeping it erect until the man presses the valve and the member becomes flaccid again.
The inflatable penile prosthesis can restore your self‑esteem and sexual life
The inflatable or hydraulic penile prosthesis presents itself as a strategic solution for men who have already undergone other types of treatment.
With varied models, medical follow‑up and surgery, the procedure can collaborate with the resumption of sexual activities, according to clinical indication and individual adaptation.
Dr. Paulo Egydio is a medical specialist in urology, working in the area of penile implants and penile reconstruction.
Still have questions? Contact us on WhatsApp so that we can clarify all issues.
Frequently asked questions
Does the prosthesis make noise when working?
This doubt is quite common and the answer is: no! At the moment when the prosthesis is inflating or even deflating, there is no sound of air or fluid moving in the body.
The device is discreet and silent and it is easily accommodated when it does not need to be used.
How to know if the inflatable implant worked?
As soon as the cylinders are positioned inside the penis, the doctor needs to perform a test during the operation to verify if the prosthesis is working correctly.
For this, after the cylinders are inside the corpora cavernosa, the surgeon will perform a pressurization analysis to observe if the prosthesis works correctly or if it presents any restriction to inflate.
This topic was addressed by Dr Paulo Egydio in a publication in the Journal of Urology in 2017; in the article, the doctor explains that the restriction can be noticed at the point where the penis is bending, that is, if the penis bends during the tests, it means that the prosthesis needs to be readjusted.
What to do when the prosthesis is bending?
When identifying a restriction to the correct pressurization process of the prosthesis, the specialist must make relaxing incisions in the tissue around the implant, allowing the tissue to expand as the prosthesis is inflated.
For this specific procedure, Dr Paulo Egydio uses the Egydio TEP Strategy. This tissue expansion strategy, through geometric incisions, expands the area of the penis that is bending, so it is restructured and the cylinder is completely inflated, without restrictions.
When does the implant need replacement?
As explained earlier, the blockage of fluid passage from the reservoir towards the cylinders is a sign of malfunction of the prosthesis. In some situations, when the doctor does not perform the test during the operation, the patient may later notice that he is suffering from rigidity problems.
This situation is quite unpleasant and can be corrected with the surgical intervention of tissue expansion, as in the Egydio TEP Strategy. However, in some cases the only possible solution will be the replacement of the implant.
What is the warranty of a penile prosthesis?
The prosthesis manufacturer offers material warranty only for cases in which mechanical failure is proven.
Moreover, unlike what many may still imagine, currently penile prosthesis warranties are no longer lifetime. They last on average from 7 to 10 years.
That is, the operation needs to be very careful and precise to prevent the patient from having to operate again.
What is the cost of an inflatable penile prosthesis?
The cost of an inflatable penile prosthesis can vary according to several factors, such as type, brand, quality, warranty, origin, place of surgery, doctor and health plan.
It is important to consult a specialized doctor to know what is the best option for each case and what payment methods are available.
