An inflatable penile prosthesis is a medical device used to treat erectile dysfunction (ED) in men. It is a surgically implanted device designed to help men achieve and maintain an erection suitable for sexual activity. The prosthesis consists of three main components: a pair of inflatable cylinders placed within the penis, a fluid reservoir implanted in the abdomen, and a pump located in the scrotum.

The cylinders are filled with a sterile fluid, typically saline, and the reservoir is connected to the cylinders by tubing. To initiate an erection, the user manually operates the pump, which transfers the fluid from the reservoir to the cylinders, causing them to inflate. After sexual activity, the fluid is returned to the reservoir to deflate the cylinders, allowing the penis to return to its flaccid state.

Inflatable penile prostheses are considered when other treatments for ED, such as medications or vacuum erection devices, have proven ineffective. While the surgery is irreversible, the device provides a reliable and discreet solution for men with severe erectile dysfunction, enabling them to regain sexual function and improve their quality of life.

In this article, I will give general and up-to-date information about the advantages and disadvantages of inflatable penis prostheses based on my own experiences.

What is inflatable penile prosthesis and how does it work?

An inflatable penile prosthesis (IPP) is a medical device used to treat erectile dysfunction (ED) in men. It is a surgically implanted device that helps individuals achieve and maintain an erection suitable for sexual activity. The prosthesis consists of several components:

• Inflatable Cylinders: These are placed within the erectile chambers of the penis. They can be filled with a sterile fluid, usually saline.
• Fluid Reservoir: This reservoir is implanted in the abdomen and connected to the inflatable cylinders by tubing. It holds the sterile fluid.
• Pump: The pump is usually located in the scrotum. When activated, it transfers the sterile fluid from the reservoir to the inflatable cylinders, causing them to inflate and creating an erection.

The process works as follows:

• Flaccid State: In its flaccid state, the inflatable cylinders remain empty, allowing the penis to remain soft.
• Initiating Erection: To initiate an erection, the user activates the pump, which transfers the sterile fluid from the reservoir to the inflatable cylinders. This causes the cylinders to inflate, producing a rigid erection.
• Sexual Activity: The inflated cylinders provide the necessary rigidity for sexual activity. The erection is maintained until completion of the sexual activity.
• Ending Erection: After sexual activity, the user activates the pump again to return the sterile fluid from the inflatable cylinders to the reservoir. This deflates the cylinders, allowing the penis to return to its flaccid state.

Inflatable penile prostheses are typically recommended when other treatments for ED, such as medications or vacuum erection devices, have failed. While the surgery for implantation is irreversible, the device offers a reliable and discreet solution for men with severe erectile dysfunction, allowing them to regain sexual function and improve their overall quality of life.

Advantages of inflatable penile prosthesis

Inflatable penile prostheses offer several advantages for individuals with severe erectile dysfunction when compared to other treatment options. Some of the key advantages include:

• Efficacy: Inflatable penile prostheses are highly effective in providing a reliable and strong erection suitable for sexual activity. They can be a suitable option for men who have not responded well to other treatments such as oral medications, injections, or vacuum erection devices.
• Natural Feel: The rigidity provided by the inflatable cylinders closely mimics a natural erection, allowing for a more natural and satisfying sexual experience.
• On-Demand Erections: Unlike some other treatments that require anticipation or planning, inflatable penile prostheses allow for on-demand erections. The user can activate the device when desired, providing greater spontaneity in sexual activities.
• Discreetness: Once surgically implanted, the device is not visible, and its presence is not apparent during daily activities. This aspect enhances the discreetness of the treatment.
• Long-Term Solution: Inflatable penile prostheses are designed to be a long-term solution for erectile dysfunction. While the surgery is irreversible, the device has a durable design, and many individuals experience long-lasting benefits.
• High Patient Satisfaction: Studies have shown that many men who undergo inflatable penile prosthesis implantation report high levels of satisfaction with the treatment, particularly in terms of improved sexual function and quality of life.
• Versatility: Inflatable penile prostheses offer the ability to control the duration and rigidity of the erection, allowing users to tailor their sexual experience according to their preferences.

It’s important to note that while inflatable penile prostheses have these advantages, the decision to undergo this type of surgery should be made after careful consideration, consultation with a healthcare professional, and a thorough understanding of the potential risks and benefits associated with the procedure.

Disadvantages of inflatable penile prosthesis

While inflatable penile prostheses can be effective in treating erectile dysfunction, there are also some disadvantages and considerations associated with these devices. It’s crucial for individuals considering this treatment to be aware of potential drawbacks:

• Surgical Procedure: Implanting an inflatable penile prosthesis involves surgery, which carries inherent risks such as infection, bleeding, or adverse reactions to anesthesia. Additionally, the surgery is irreversible.
• Postoperative Pain and Recovery: Following the surgery, patients may experience discomfort, pain, and swelling. Recovery time varies, and individuals may need to refrain from sexual activity and strenuous physical activity during the initial healing period.
• Infection Risk: Infections, while rare, can occur in the area around the implanted device. In some cases, infections may necessitate device removal.
• Mechanical Failure: Although rare, inflatable penile prostheses can experience mechanical failures, such as leaks or malfunctions. If this occurs, additional surgery may be required to repair or replace the device.
• Cost: The cost of the surgery and the device itself can be substantial. Insurance coverage may vary, and individuals should consider the financial implications of the procedure.
• Loss of Natural Erection: The inflatable penile prosthesis provides an artificial erection, and the natural erectile mechanism is permanently replaced. Some men may find the loss of spontaneous, natural erections to be a psychological drawback.
• Partner Considerations: Open communication with one’s partner is essential, as the presence of an implanted device may impact the dynamics of intimacy. Emotional and psychological aspects should be considered.
• Skill Required for Use: Operating the pump to inflate and deflate the cylinders requires manual dexterity, and some individuals may find this challenging.
• Scarring: Like any surgical procedure, there is the potential for scarring, which may be a cosmetic concern for some individuals.
• Not Suitable for Everyone: Inflatable penile prostheses are typically recommended for individuals with severe erectile dysfunction who have not responded to other treatments. They may not be suitable for those with certain medical conditions or anatomical issues.

Before deciding on an inflatable penile prosthesis, individuals should consult with a healthcare professional who can provide personalized advice based on their medical history and individual circumstances. A thorough discussion of potential risks and benefits is crucial for making an informed decision.

Conclusion on the advantages and aisadvantages of inflatable penile prosthesis

Inflatable penile prostheses (IPPs) offer a viable solution for individuals with persistent erectile dysfunction, but the decision to opt for this intervention involves considering both advantages and disadvantages

Advantages:

• Effective Treatment: IPPs are generally effective in restoring erectile function, providing a reliable solution for those who have not responded well to other treatments.
• Patient Satisfaction: Many individuals and their partners report high levels of satisfaction with IPPs, citing improved sexual spontaneity and intimacy.
• Controlled Erections: The ability to control the timing and duration of erections through the inflation and deflation mechanism is a significant advantage.
• Long-Term Solution: Once implanted, IPPs can provide a long-term solution to erectile dysfunction, offering consistent results over time.

Disadvantages:

• Surgical Procedure: The implantation of an IPP involves surgery, which carries inherent risks such as infection, bleeding, or complications related to anesthesia.
• Cost: Inflatable penile prostheses can be expensive, and cost considerations may be a barrier for some individuals, especially if not covered by insurance.
• Device Malfunction: While rare, there is a possibility of device malfunction, which may require additional surgery or intervention to address.
• Naturalness Concerns: Some individuals may express concerns about the naturalness of erections produced by IPPs, affecting body image and psychological well-being.
• Postoperative Recovery: Patients may experience discomfort, swelling, or bruising during the postoperative period, and there is a recovery time before resuming normal activities, including sexual intercourse.

In conclusion, the decision to pursue an inflatable penile prosthesis should be made after careful consideration of the individual’s medical condition, lifestyle, and personal preferences. While the advantages of improved erectile function and satisfaction are significant, the potential disadvantages, including surgical risks and costs, should be weighed to make an informed choice. Consulting with Urologist and considering psychological aspects is crucial to ensure that the benefits outweigh the drawbacks for each patient.

Our patients use inflatable prostheses for a long time without any complications. Both patient and partner satisfaction with the result is 95-98%. There are almost no mechanical problems with the device.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul- TURKEY