Inflatable or Hydraulic Penile Prosthesis Implant

The available models of penile prostheses on the market to treat Erectile Dysfunction are varied and, therefore, can cause several doubts about how to properly choose the ideal one for each patient.

After all, which is better: inflatable or hydraulic penile prosthesis implant?

To explain each model of penile prosthesis in the best way possible, we have developed a series of three blogs and videos that will help you understand the difference between the implants — as well as their functionalities.

Inflatable or Hydraulic Penile Prosthesis Implant

Unlike the malleable and articulable prosthesis, the inflatable penile prosthesis provides the patient with the possibility of inflating and deflating the penis at their will. This means that the penis can naturally return to its flaccid state, without the patient having to make an effort to hide it in tight underwear.

With this type of implant, the patient can achieve penile rigidity with the help of a pump filled with saline solution, located in the scrotum, which runs through the cylinders of the implant and inflates the prosthesis.

When the inflated penis is no longer necessary, the patient can press the prosthesis depressurization valve for a few seconds so that the saline returns to the reservoir, and the penis becomes flaccid.

Two-piece or Three-piece Inflatable Prosthesis?

In the inflatable prosthesis category, some specifications may need to be considered, such as the two-piece and three-piece prostheses. But what does this mean?

Two-Piece Inflatable Prosthesis

The two-piece hydraulic prosthesis contains two cylinders, which form one piece, considering that they are always implanted in pairs; plus the saline reservoir, which is the second piece. When the patient pressurizes the cylinder, located in the scrotum, the reservoir where the saline is located is activated, providing the patient with the necessary vertical resistance for penetration. To return the penis to a flaccid state, the patient must depressurize the pump and keep the organ pressed downward, allowing the saline to return to the reservoir, enabling penile flaccidity.

Three-Piece Inflatable Prosthesis

The three-piece inflatable model consists of two cylinders that, as previously mentioned, form one volume, the saline reservoir implanted below the abdomen, and the pressurization pump. Unlike the two-piece inflatable prosthesis, this model does not have a reservoir at the base of the cylinders.

Among the three-piece models, there are characteristics related to the thickness of each prosthesis. The Narrow model is thinner and shorter, and the Standard model is longer and thicker. The choice of the most suitable model for the patient should be made respecting the patient’s body limits; therefore, it is necessary to have the different options available in the operating room.

Caution Regarding the Use of Extenders

Extenders are silicone parts used in the hydraulic prosthesis to give the implant the appropriate size for the patient’s penis. However, these extenders can compromise the axial resistance of the penis, meaning they affect the rigidity that the patient should have during penetration, increasing the risk of the penis bending during intercourse.

To avoid the use of these extenders, it is advisable to carry out the hydraulic prosthesis implant after Penile Reconstruction. Through Reconstruction, carried out through horizontal and vertical incisions that allow for a greater girth and size to the penis (respecting the limits of the patient’s anatomy), the surgeon will be able to choose the ideal hydraulic implant so that their patient is satisfied and recovers their self-esteem and sexual routine.

Below, you will find a video where I explain — in detail — everything you need to know about the inflatable prosthesis, as well as the two and three-piece models. This video will conclude our series on the different types of penile prostheses.

If you still have any doubts about the use of an inflatable or hydraulic penile prosthesis, do not hesitate to contact us. Send a message through the website form or send us a message directly on WhatsApp. My team and I will be pleased to answer your questions and help you, with complete discretion and security.

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Paulo Egydio, M.D.

PhD in Urology from USP, CRM 67482-SP, RQE 19514, Author of Geometric Principles (known as “Egydio Technique”), as well as other articles and scientific books in the area. Guest professor to teach classes and live surgeries at conferences in Brazil and abroad.

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