Can a penile implant stay partly inflated?
Neither the European nor the American guideline describes keeping an inflatable implant partly inflated. An inflatable implant is filled from a pump to make the penis firm and emptied with a release mechanism, while a semi-rigid implant stays firm and cannot be deflated. Mechanical failure affects fewer than 5% of the most commonly used three-piece devices at five years.
How is an inflatable implant filled and emptied?
An inflatable implant moves fluid between a reservoir and two cylinders inside the penis. Pressing the pump in the scrotum fills the cylinders and makes the shaft firm, and a release mechanism sends the fluid back so the penis becomes soft. Before surgery, the steps of operating the pump are demonstrated so that the man and his partner are confident using it.
Two-piece models work the same way without a separate reservoir and are easier to operate than three-piece models, which may suit a man with poor manual dexterity.
What happens if an implant will not inflate or deflate properly?
An implant that will not fill or empty as expected points to mechanical failure, one of the two main complications of implant surgery. Mechanical failure is most common with inflatable models and usually happens when a component, most often the connecting tubing, ruptures and fluid leaks out.
In a database of 7,666 men with a first implant, 11% needed a further operation, and about half of these operations were for mechanical failure. More than half of the mechanical repairs involved the pump, followed by the cylinders and the reservoir. The most commonly used three-piece devices show mechanical failure rates below 5% after five years.
Is a semi-rigid implant an alternative?
A semi-rigid implant has no fluid, so it cannot be partly or fully inflated. The penis stays firm at all times and is bent upward for intercourse and downward to lie against the groin otherwise. The operation is simpler and the device is easy to use, but the penis is harder to conceal.
Inflatable devices generally bring higher satisfaction, although a semi-rigid implant can suit men with limited hand dexterity or when cost is a concern. In one review, erosion was more common with malleable implants, at a mean of 4.1%, than with inflatable models, at 2.5%.
Are inflation routines used after surgery?
Some surgeons have reported daily inflation of the cylinders after surgery, with full inflation for one to two hours a day between six and 24 months, as a way to improve length and girth. Other strategies before, during and after surgery have also been examined for the same purpose.
"The Panel notes that currently there are insufficient data on specific approaches and techniques to constitute a reliable evidence base from which to provide clinical guidance regarding these approaches." Source 2, p. 31
The time before the device can first be used after surgery is part of the counselling before the operation. Instructions on using the device after surgery therefore come from the surgical team rather than from a guideline schedule.