Rigi10™ Malleable Penile Prosthesis
Also Known As
IPP, Hydraulic Penile Implant, Inflatable Penile Implant, Three-Piece Penile Prosthesis, Pump-Activated Penile Device, Penile Prosthesis, Penis Implant
Definition
A three-piece inflatable penile prosthesis (IPP) is a surgically implanted medical device designed to treat erectile dysfunction (ED) by enabling men to achieve an erection sufficient for sexual intercourse.¹ It is considered a highly effective and permanent solution for ED when other treatments have failed or are unsuitable.²
The device typically consists of three main components: a pair of inflatable cylinders, a pump, and a fluid-filled reservoir. The cylinders are surgically placed within the corpora cavernosa, the erectile chambers of the penis. The pump is usually implanted in the scrotum, and the reservoir, which contains sterile saline solution, is typically placed in the lower abdomen, under the abdominal muscles.¹
To achieve an erection, the patient manually squeezes the pump located in the scrotum. This action transfers the saline solution from the reservoir to the cylinders within the penis, causing them to inflate and become rigid, mimicking a natural erection.¹ The erection can be maintained for as long as desired, even after orgasm.¹ When an erection is no longer needed, the patient activates a deflation valve on the pump, which allows the fluid to return from the cylinders back to the reservoir, causing the penis to become flaccid.¹ This mechanism allows for a controlled and natural-appearing erection and flaccidity. Modern IPPs are designed for durability and aim to replicate the natural function of an erection as closely as possible.²
Clinical Context
A three-piece inflatable penile prosthesis (IPP) is typically considered for patients with erectile dysfunction (ED) who have not responded to, are not candidates for, or are dissatisfied with less invasive treatments. These may include oral medications (such as PDE5 inhibitors like sildenafil), vacuum erection devices, or intracavernosal injections.¹² It represents a definitive and permanent solution for many men seeking to restore sexual function.²
Patient selection is a critical aspect of successful IPP implantation. Ideal candidates are those with realistic expectations regarding the outcomes and who possess the manual dexterity required to operate the device.¹ Preoperative counseling is essential to ensure patients understand the surgical procedure, potential risks, benefits, and the nature of the erection achieved with a prosthesis.¹ Certain conditions may contraindicate the procedure, such as active systemic or local infections, poorly controlled diabetes, or significant psychological conditions that might interfere with the patient’s ability to manage or cope with the implant.¹
The surgical procedure for implanting a three-piece IPP involves placing the cylinders within the corpora cavernosa of the penis, the pump within the scrotum, and the reservoir in the retropubic or ectopic space (e.g., high submuscular).¹ Surgeons may use different incision approaches, commonly penoscrotal or infrapubic, depending on their preference and the patient’s anatomy.¹ Modern surgical techniques and the use of antibiotic-coated or hydrophilic-coated implants have significantly reduced the risk of complications, particularly infections.²
Expected outcomes for IPP surgery are generally very positive, with high satisfaction rates reported by both patients and their partners, often ranging from 85% to 95%.¹ Modern devices also demonstrate excellent mechanical reliability, with rates exceeding 90% at 5 years post-implantation.¹ Recovery typically involves a period of healing for 4-6 weeks before the device is activated and used for intercourse.¹ Most patients can return to normal, non-strenuous activities within a few weeks post-surgery.¹ Potential complications, though infrequent, can include infection (historically 1-3%, but lower with current coated implants), mechanical failure of the device, erosion of device components through the skin, pain, or improper sizing.¹