What is an Inflatable Penile Prosthesis?

An inflatable penile prosthesis (IPP) is a bionic pump system. During surgery, it is placed inside of a man's penis and surrounding area (scrotum). IPPs give the option of having an erect penis for sexual activity. IPPs are made mostly out of silicone. All inflatable penile prostheses include two cylinders, one on the left and one on the right side of the penis. The surgeon creates a tunnel though the spongy tissue of the penis on each side for a cylinder. The cylinders are connected to a small pump and reservoir chamber, placed inside the scrotal sac. The system is filled with sterile fluid. When fluid is in the reservoir, the penis is soft.  

Good to Know

Surgery to put in an IPP is sometimes done on an outpatient basis, so a patient can go home the same day. Since the penis and scrotum are very sensitive to touch, some may notice a lot of soreness in the first days after the operation. You should always follow your surgeon’s discharge instructions. 

How are Erections Achieved?

An erection with an IPP is very similar in stiffness and thickness to a natural erection. It takes some practice to learn how to find the pump and use it to get an erection and to deflate the erection. To get an erection, a man presses through his skin on the pump, transferring the fluid into the cylinders. To deflate you must push a release valve to transfer the fluid back to the reservoir. An IPP does not change the sensation on the skin of the genital area or the ability to reach an orgasm, ejaculate semen, or urinate. 

When the prosthesis is deflated, the soft penis is a little fuller than normal but does not look unusual. Sometimes the outline of the pump can be seen slightly. The surgical scar is small, and once healed, not easy to spot. It is usually at the base of the penis, on the underside where it meets the scrotal sac. 

Once a man has a penile prosthesis, he is unlikely to be able to get erections if the device is removed. Men rarely can get a usable erection without inflating the implant. Some men who have had to have an IPP removed because of infection or erosion (one cylinder rubs through the erectile tissue and ends up in the urethra) have been able to use a vacuum pump to get an erection, however. On average, an IPP lasts about 20 years.  

What are Common Side Effects? 

Concern about the size of the erection with an IPP, discomfort with the cool temperature of the head of the penis, or lingering soreness during sex in the first few months after surgery are the most common side effects of having an IPP. Many men need some practice to inflate and deflate their IPP completely. 

It is very important to follow your surgeon's instructions on when and how often to inflate and deflate your IPP during the first few weeks after surgery. As healing takes place, a sheath of scar tissue forms around the IPP. If the IPP is not inflated regularly during healing, that scar tissue can get so tight that it cannot be fully inflated. On other hand, inflating the IPP too early, or trying to have sex before it is recommended (usually around six weeks after surgery) could cause pain or even damage. Follow your surgeon’s instructions for the best outcome. 

Are There Health Risks? 

The most serious problem occurs if there is an infection during the first few days after surgery. Because the IPP is a foreign body, it can act as a hiding place for bacteria. Special care is taken to avoid infection when surgery for an IPP is planned. Typically, antibiotics are given just before surgery. The IPP itself is now coated with antibiotics. Most infections happen soon after surgery.  

If infection occurs the IPP may need to be removed and antibiotics would be given, prior to replacement. There is a small chance that an IPP could be infected years after surgery by bacteria in a man's bloodstream, for example, if he got an infection after having another surgery or a dental procedure such as a root canal or tooth extraction. To avoid this chance, many urologists recommend taking an antibiotic pill the day before any procedure. Individuals who have an artificial joint or heart valve get similar instructions. 

Another complication occurs if one of the cylinders wears away the tissue around it over time, ending up in the urethra (urinary tube). This is called erosion and to fix it, the IPP must be removed and replaced.  

What Considerations Should I Make Before an IPP? 

• Most inflatable prosthesis surgeries are successful — implants function well and produce usable erections. 

• In recent studies, patients and partners reported satisfaction post surgery, saying they improved their sexual life. 

• An IPP can result in future procedures to repair or replace the device, as they typically last 20 years.