Division of Urology

New Minimally Invasive Implant Procedure for Erectile Dysfunction

Summary: The University of Maryland Medical Center is now offering a minimally invasive approach to penile implant surgery for sexual dysfunction. Dr. Andrew Kramer, a urologic surgeon and director of Reproductive and Sexual Medicine at the University of Maryland Medical Center, discusses the new minimally invasive procedure known as an infrapubic penile implant.

Briefly, what is a penile implant and when would a patient consider having one?

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As with any medical condition, we always try to treat patients with the simplest and least invasive treatments possible, and the same goes for erectile dysfunction. So, before considering any surgical procedure, we do a comprehensive evaluation of the patient to rule out systemic problems or other diseases that can cause impotence. There is a range of treatment options, from oral medications like Viagra, to injections, vacuum devices, and suppositories. If these are found to be ineffective, a patient may consider having penile implant surgery.

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A penile implant is a device that is placed surgically, typically through one incision in the scrotum. The device is either inflatable or noninflatable. Typically the device is filled with salt water (saline), and the patient has a pump, which is hidden in the scrotum. By gently pressing on that pump, the salt water travels through a reservoir that is placed next to the bladder and travels into the device itself, which is in the penis. The device in the penis has two chambers, which go into the erectile chambers of the penis. When these are inflated, and the water inflates the device, then the patient achieves an erection. When they are finished, then they can deflate the device.

What is an infrapubic penile implant and how does it differ from traditional implant surgery?

At the University of Maryland, we offer two approaches to penile implant, also known as sexual restorative surgery. One is the traditional method in which the device is placed through an incision in the scrotum. The infrapubic penile implant is a minimally invasive alternative for doing penile implant surgery. Instead of placing the device through an incision in the scrotum, the implant and reservoir are placed through an incision in the lower abdomen, right above the penis.

Is the penile implant visible or detectable from the outside of the man's body once it has been implanted?

No. The device is completely internal and is hidden from view once it's implanted. The patient inflates and deflates the prosthesis by squeezing a small pump hidden inside the scrotum.

What are the advantages of the infrapubic approach?

It’s a minimally invasive way of doing the implant surgery. This means there is less pain, less swelling, and a faster recovery for the patient. One major advantage is that there is no cutting to the scrotum, which many men are hesitant about.

Also, the infrapubic incision makes it easier for the surgeon to position the reservoir inside the body. This is especially helpful in men who have had a radical prostatectomy since they often have scarring in the pelvic region that makes placing the traditional type of implant more difficult to position.

What can a patient expect in having the minimally invasive implant procedure?

The infrapublic method is outpatient surgery. The actual procedure takes less than an hour. The patient can go home the same day or the next day, whichever is more convenient.

What is the recovery process following penile implant surgery?

Recovery usually takes about 2-3 weeks. Patients are usually able to go back to work in 2-3 days. Most patients can resume sexual activity within one month.

For more information or to schedule a consultation, please call Dr. Kramer at 410-328-6087.

For more information, call the University Physicians Consultation and Referral Service at 1-800-492-5538 (patients) or 1-800-373-4111 (physicians).