Name of the Procedure:

Insertion of penile prosthesis; inflatable (self-contained) Common name(s): Inflatable penile implant surgery, IPP surgery

Summary

Inflatable penile prosthesis (IPP) surgery involves placing a self-contained, inflatable device inside the penis, enabling men with erectile dysfunction (ED) to achieve and maintain an erection suitable for sexual intercourse.

Purpose

The procedure addresses erectile dysfunction (ED) that has not responded to other treatments. The main goal is to restore the ability to have an erection, thereby improving sexual function and quality of life.

Indications

• Severe erectile dysfunction from various causes, including diabetes, vascular disease, or spinal cord injury.
• Patients who have not responded to or cannot tolerate PDE5 inhibitors (e.g., Viagra), penile injections, or vacuum erection devices.
• Psychological distress or relationship issues due to ED.

Preparation

• Fasting for at least 8 hours before surgery.
• Adjustments to current medications (e.g., blood thinners) as instructed by the surgeon.
• Pre-operative physical examination and blood tests.
• Discussing any allergies, previous surgeries, and current health conditions with the healthcare team.

Procedure Description

1. Anesthesia is administered—either general or spinal.
2. The surgeon makes a small incision in the lower abdomen or at the base of the penis.
3. Specialized instruments are used to insert the inflatable cylinders into the penis.
4. A separate pump device is implanted in the scrotum.
5. Tubes connect the cylinders to a saline reservoir placed in the lower abdomen.

6. The incision is closed with sutures, and sterile dressing is applied.

   Duration

   Approximately 1 to 2 hours.

Setting

Typically performed in a hospital or specialized surgical center.

Personnel

• Urologist or surgeon specializing in penile implants
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection at the surgical site
• Mechanical failure of the implant
• Post-operative bleeding or hematoma
• Erosion of the implant through the skin
• Pain or discomfort
• Scarring

Benefits

• Restoration of erectile function and ability to engage in sexual intercourse.
• High satisfaction rates for both patients and partners.
• Can provide long-term solution for erectile dysfunction.

Recovery

• Rest and avoid strenuous activities for several weeks.
• Pain management with prescribed medications.
• Follow-up appointments to monitor healing and implant function.
• Most men can resume sexual activity 4-6 weeks post-surgery.

Alternatives

• Oral PDE5 inhibitors (e.g., Sildenafil)
• Penile injections (e.g., Alprostadil)
• Vacuum erection devices
• Counseling and sex therapy
• Semi-rigid or malleable penile implants

Patient Experience

• Patients may feel groggy from anesthesia immediately after surgery.
• Some pain and swelling at the incision site, manageable with pain medication.
• Gradual improvement in comfort over a few weeks.
• Instruction on how to use the inflatable device before resuming sexual activity.