Subspecialty Areas » Impotence » Figures

Penile Implant Surgical Procedure

Figure 1

Coloplast Titan® inflatable penile implant, with One Touch Release pump. Two inflatable cylinders are placed in the penile erection chambers. These cylinders are available in a wide range of sizes. During the implant procedure, the penis is stretched to its maximum length, and measurements are taken. We then install the largest cylinders that the erection chambers will accommodate. A new One Touch Release pump is placed in the scrotum, in between the testicles. A fluid reservoir with a Lock Out valve (to prevent auto-inflation) is placed in front of the bladder. The patient squeezes the pump bulb to inflate the implant and create an erection. After sexual activity is finished, he gives one firm squeeze to the release pads, allowing the implant to deflate and the penis to become flaccid. This implant has a hydrophilic coating, which decreases the risk of infection. (Courtesy of Coloplast Corporation, Minneapolis, Minnesota, USA, www.us.coloplast.com)

Figure 1A

American Medical Systems (AMS) LGX (length and girth expanding) implant, with Momentary Squeeze pump. Two length and girth expanding inflatable cylinders are placed in the penile erection chambers. A new Momentary Squeeze pump is placed in the scrotum, in between the testicles. A fluid reservoir is placed in front of the bladder. The patient squeezes the pump bulb to inflate the implant and create an erection. After sexual activity is finished, he gives one firm squeeze to the release button, allowing the implant to deflate and the penis to become flaccid. This implant has an Inhibizone (rifampin and gentamicin) coating, which decreases the risk of infection. (Courtesy of American Medical Systems, Inc., Minnetonka, Minnesota, USA, www.americanmedicalsystems.com)

Figure 1B

American Medical Systems (AMS) Ambicor implant. Two inflatable cylinders are placed in the penile erection chambers, and a pump is placed in the scrotum, in between the testicles. No intra-abdominal fluid reservoir is needed. The patient squeezes the pump bulb to inflate the implant and create an erection. After sexual activity is finished, he bends the implant cylinders for approximately 10 seconds, allowing the implant to deflate and the penis to become flaccid. (Courtesy of American Medical Systems, Inc., Minnetonka, Minnesota, USA, www.americanmedicalsystems.com

Figure 2

A roughly one inch incision is marked on the upper scrotum.

Figure 3

The urethra is seen in between the forceps; the left and right erection chambers are on either side of the urethra.

Figure 4

The left erection chamber is opened, dilated, and measured, in preparation for cylinder placement.

Figure 5

The right erection chamber is likewise opened, dilated, and measured.

Figure 6

The optimal-size cylinders and pump are selected and prepared.

Figure 7

The cylinders have been inserted into the left and right erection chambers. The urethra is in the midline and is unharmed.

Figure 8

The reservoir is about to be inserted where it will not be felt or appreciated by the patient.

Figure 9

The reservoir is filled with sterile saline; the connection between the reservoir and pump is about to be created.

Figure 10

The connection has been made, and the cylinders and reservoir have already been installed. The implant has been inflated.

Figure 11

The pump has been installed in between the testicles, and is under the skin at the bottom of the scrotum.

Figure 12

The procedure is complete and the skin is closed. The implant is deflated.

Figure 13

When the implant is inflated, it produces an excellent erection. When the incision heals, it will be nearly invisible. The patient will learn how to inflate and deflate the implant 4-6 weeks post-operatively.