This is the last resort: when everything else has failed - from Viagra to injections - an "inflatable penile prosthesis", the penile pump, is the only way of restoring erection in case of severe sexual dysfunction. The penile pump is a completely internal mechanism allowing a man to have a full erection at any time, without planning ahead, as in other treatments. The oldest ones are over 25 years, but the technology now in use is both safe and quite effective.
Men with penile pump have full sensation and an orgasm. Men with a removed prostate lose their ability to ejaculate with orgasm, but in case of diabetes, for example, they will have the ability to have an orgasm and ejaculation.
The "inflatable penile prosthesis" is made of three components: cylinders, pump and reservoir. The two cylinders are introduced in the lateral sides of the penis.
The pump is fitted in the scrotum's pouch, on the midline between the two testicles, through an opening of about a centimeter. The pump is very well concealed, yet accessible to the patient. The pump has a ball which, when squeezed, transfers the fluid through a tubing into the cylinders. The release valve is activated by squeezing the sides of the long portion.
The reservoir holds the fluid while the patient is not sexually active. It is located the inguinal ring, and that's the area where men typically get a hernia (which is a hole in the abdominal musculature). In a type of hernia this reservoir is placed. It contains about 60 cc's of fluid. The patient needs about 25 to have an erection.
To get an erection, the patient has to locate the pump behind the two testicles. By gently squeezing the pump, the penis slowly turns rigid. To deflate the pump, one has to squeeze the deactivating device and the penis is getting softer. The cylinders too must be gently squeezed in order to make the penis flaccid.
The first two to three days after the procedure, the patients will experience pain and discomfort. Most of the patients will perceive the pump uncomfortable for the first 10 days. Around three weeks the pump can be put in action.
The advantages of the penile prosthesis are that mechanical failure is rare, the device is unnoticeable even under tight clothing such as swimsuits or jeans, the erection can be maintained as long as necessary, or as long as desired without any of the potentially serious complications of organic priapism and psychological and emotional well-being is greatly enhanced in most men who undergo implant surgery.
There are some disadvantages: the glans does not enlarge and the erection is less firm as a natural erection would be; some models do not deflate easily; men lose between 1-2cm (.25 to .75 in) in length.
Only 80-92% of men report complete satisfaction with the prosthesis. There is a 2-10% complication rate, mainly as a result of infection or device failure.
Some studies indicate a partner satisfaction rate of 70% or less, apparently due to heightened or unreasonable expectations. And remember: this is definitive, as the penis' natural inflating tissues are compromised.