The Three Piece Inflatable Penile Prosthesis – An Accurate Description for Patients Considering The Perito Implant™.
An inflatable penile implant is a surgical device that allows an impotent male to have an erection by transferring fluid from one part of the implant to another. The three-piece penile implant comprises three components: cylinders, pump and a reservoir. Generally, all components are concealed within the body and cannot be seen from the outside.
The penile implant cylinders reside in the penis on either side of the penis. No tissue is removed to place the cylinders; the cylinders simply fill spaces that previously filled with blood, when one was potent, with saline (sterile salt water) providing a physiologic erection. The cylinders do not disrupt the flow of urine or ejaculate. The cylinders do not alter the sensation of the penis. The cylinders also do not affect tumescence of the glans (i.e. head) of the penis.
Saline needed to fill the cylinders resides in a reservoir situated behind the abdominal wall muscles. Unless one has had previous pelvic surgery the reservoir cannot be detected. If the patient has had previous pelvic surgery the reservoir might be palpable and even visually detectable if the patient is slim, like a small pacemaker.
In order to transfer fluid from the reservoir to the cylinders and create an erect penis the patient must compress a pump located in the scrotum. The pump will be positioned in the middle of the scrotum and in the most dependent part of the scrotum allowing for easy manipulation. The number of pumps required to provide a full erection varies and is dependent on the size of the penis. Like all pump devices (e.g. bicycle pump), the penile implant pump will become harder to pump at capacity. This is good and patients are encouraged to use two thumbs to provide the maximum erection.
A penile implant will provide a patient with an erection for as long as the patient desires. The patient can orgasm and continue with sexual intercourse if so desired. The patient determines when he wants the penis to be flaccid. The penile implant, once inflated, can only be deflated electively. This can be accomplished by compressing a deflate bar located above the pump while at the same time compressing the penis, thus transferring saline from the penis back to the reservoir.
Using the minimally invasive penile implant technique (The Perito ImplantÔ), we are able to implant all the aforementioned components through a one-inch incision above the penis where the pubic hair resides similar to the smallest hernia repair. There will be no incision on the penis or the scrotum. The procedure can be performed safely under general, spinal or local anesthesia in less than 15 minutes. The procedure can be outpatient or overnight depending upon what is both safest and most convenient for the patient.
Normally, patients can resume sexual activity between 4 and 6 weeks.