Current Urology Reports

, 20:18 | Cite as

Inflatable Penile Prosthesis: Considerations in Revision Surgery

  • Anton Wintner
  • Aaron C. LentzEmail author
Surgery (J Simhan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Surgery


Purpose of Review

To provide an evidence based discussion of preoperative, intraoperative, and postoperative factors that lead to successful outcomes in penile prosthesis surgery.

Recent Findings

In the preoperative period, careful patient selection, appropriate counseling, thorough evaluation, and sufficient time for physical and emotional adaptation to an inflatable penile prosthesis are the key. During surgery, the entire device should be explanted whenever possible. A drain and retain strategy for the reservoir is a safe alternative in situation where the reservoir is not easily removable. The mechanical cleansing of lavage is more important than chemical sterilization. Postoperative instructions should be made clear and nursing phone calls may reduce the number of ER visits.


Careful preoperative counseling, attention to intraoperative details, and vigilance in the postoperative period are necessary for a successful outcome with penile prosthesis revision surgery.


Inflatable penile prosthesis Penile prosthesis surgery Urosurgery 


Compliance with Ethical Standards

Conflict of Interest

Anton Wintner declares no potential conflicts of interest.

Aaron C. Lentz reports personal fees (speaker, consultant, and preceptor) from Coloplast Corporation and Boston Scientific.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Scott FB, Bradley WE, Timm GW. Management of erectile impotence. Use of implantable inflatable prosthesis. Urology. 1973;2(1):80–2.CrossRefGoogle Scholar
  2. 2.
    Gregory JG, Purcell MH, Standeven J. The inflatable penile prosthesis: failure of the rear tip extender in reducing the incidence of cylinder leakage. J Urol. 1984;131(4):668–9.CrossRefGoogle Scholar
  3. 3.
    Mulcahy JJ. The development of modern penile implants. Sex Med Rev. 2016;4(2):177–89.CrossRefGoogle Scholar
  4. 4.
    Lee DJ, Najari BB, Davison WL, al Awamlh BAH, Zhao F, Paduch DA, et al. Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States. J Sex Med. 2015;12(7):1638–45.CrossRefGoogle Scholar
  5. 5.
    Montorsi F, Rigatti P, Carmignani G, Corbu C, Campo B, Ordesi G, et al. AMS three–piece inflatable implants for erectile dysfunction: a long–term multi–institutional study in 200 consecutive patients. Eur Urol. 2000;37(1):50–5.CrossRefGoogle Scholar
  6. 6.
    McPhail EF, Nehra A, Bruner BC, Kawashima A, King BF, Kim B. MRI and its role in the evaluation and surgical decision making in patients with challenging IPP presentations: descriptions of MRI findings and algorithm for patient management: challenges with inflatable penile prostheses. BJU Int. 2012;109(12):1848–52.CrossRefGoogle Scholar
  7. 7.
    Outcomes O. AUA update series 2014.Google Scholar
  8. 8.
    Trost LW, Baum N, Hellstrom WJG. Managing the difficult penile prosthesis patient. J Sex Med. 2013;10(4):893–906 quiz 907.CrossRefGoogle Scholar
  9. 9.
    Caire AA, Boonjindasup A, Hellstrom WJG. Does a replacement or revision of an inflatable penile prosthesis lead to decreased patient satisfaction? Int J Impot Res. 2011;23(2):39–42.CrossRefGoogle Scholar
  10. 10.
    Lotan Y, Roehrborn CG, McConnell JD, Hendin BN. Factors influencing the outcomes of penile prosthesis surgery at a teaching institution. Urology. 2003;62(5):918–21.CrossRefGoogle Scholar
  11. 11.
    Rajpurkar A, Dhabuwala CB. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice. J Urol. 2003;170(1):159–63.CrossRefGoogle Scholar
  12. 12.
    Henry GD, Donatucci CF, Conners W, Greenfield JM, Carson CC, Wilson SK, et al. An outcomes analysis of over 200 revision surgeries for penile prosthesis implantation: a multicenter study. J Sex Med. 2012;9(1):309–15.CrossRefGoogle Scholar
  13. 13.
    Hellings PW, Trenité GJN. Long-term patient satisfaction after revision rhinoplasty. Laryngoscope. 2007;117(6):985–9.CrossRefGoogle Scholar
  14. 14.
    Mulhall JP, Ahmed A, Branch J, Parker M. Serial assessment of efficacy and satisfaction profiles following penile prosthesis surgery. J Urol. 2003;169(4):1429–33.CrossRefGoogle Scholar
  15. 15.
    • Sexton SJ, Granieri MA, Lentz AC. Survey on the contemporary management of intraoperative urethral injuries during penile prosthesis implantation. J Sex Med. 2018;15(4):576–81 Management of intraoperative urethral injury during IPP placement by surgeons with specialized training in prosthetic urology. CrossRefGoogle Scholar
  16. 16.
    • Kavoussi NL, Viers BR, VanDyke ME, Pagliara TJ, Morey AF. “Stiction syndrome”: non-operative management of patients with difficult AMS 700 series inflation. J Sex Med. 2017;14(9):1079–83 One of the few causes of IPP mechanical malfunction that can be repaired non-operatively. CrossRefGoogle Scholar
  17. 17.
    Sadeghi-Nejad H, Ilbeigi P, Wilson SK, Delk JR, Siegel A, Seftel AD, et al. Multi-institutional outcome study on the efficacy of closed-suction drainage of the scrotum in three-piece inflatable penile prosthesis surgery. Int J Impot Res. 2005;17(6):535–8.CrossRefGoogle Scholar
  18. 18.
    Henry GD, Wilson SK, Delk JR 2nd, et al. Revision washout decreases penile prosthesis infection in revision surgery: a multicenter study. J Urol. 2005;173(1):89–92.CrossRefGoogle Scholar
  19. 19.
    Mulcahy JJ. Long-term experience with salvage of infected penile implants. J Urol. 2000;163(2):481–2.CrossRefGoogle Scholar
  20. 20.
    Abouassaly R, Angermeier KW, Montague DK. Risk of infection with an antibiotic coated penile prosthesis at device replacement for mechanical failure. J Urol. 2006;176(6 Pt 1):2471–3.CrossRefGoogle Scholar
  21. 21.
    Chung PH, Siegel JA, Tausch TJ, Klein AK, Scott JM, Morey AF. Inflatable penile prosthesis as tissue expander: what is the evidence? Int Braz J Urol. 2017;43(5):911–6.CrossRefGoogle Scholar
  22. 22.
    Scovell JM, Ge L, Barrera EV, Wilson SK, Carrion RE, Hakky TS. Longitudinal and horizontal load testing of inflatable penile implant cylinders of two manufacturers: an ex vivo demonstration of inflated rigidity. J Sex Med. 2016;13(11):1750–7.CrossRefGoogle Scholar
  23. 23.
    Cefalu CA, Deng X, Zhao LC, Scott JF, Mehta S, Morey AF. Safety of the “drain and retain” option for defunctionalized urologic prosthetic balloons and reservoirs during artificial urinary sphincter and inflatable penile prosthesis revision surgery: 5-year experience. Urology. 2013;82(6):1436–9.CrossRefGoogle Scholar
  24. 24.
    Tackitt HM, Eaton SH, Lentz AC. Nurse-initiated telephone follow up after ureteroscopic stone surgery. Urol Nurs. 2016;36(6):283–8.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Duke University Division of Urologic SurgeryRaleighUSA

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