Once inserted, the pump is invisible and the penis and scrotal sac look normal both in the flaccid and erect position. The entire IPP can be placed through a very small (two- to three-centimeter) opening in the skin of the scrotum in less than an hour. This is a breakthrough when compared to previous techniques, which made much larger openings that required a longer and more painful healing process. The beauty of this technique is that the skin on the penis itself is never opened so that there are no visible scars and normal sensation is preserved. In my hands, this is a safe procedure with an infection rate of less than 0.3 percent. It can even be done with a local anesthetic and on an outpatient basis. Again, the penis looks and feels normal. The internal pump does not interfere with normal sensation or ejaculation.
Men also report additional benefits from the IPP that include: opportunity for spontaneous sexual activity, restoration of normal penile anatomy (many patients after radical prostate cancer surgery lose penile length and girth), larger looking flaccid penis, and the ability to maintain an erection after orgasm. Use of the Internal Penile Pump has resulted in documented high satisfaction rates for both patient and partner, and doesn’t require additional treatments, such as injection or vacuum.
The Internal Penile Pump is an excellent alternative for men who do not respond to Viagra. For most men, it represents a cure. Excellent candidates are men between the ages of 50 and 90 years old, sexually motivated and active; men who have had prostate, bladder, or colon cancer treatment, and who have penile deformity and/or atrophy (shrinkage). (The Internal Penile Pump is also referred to as penile implant or prosthesis.)
MUSE (Medicated Urethral System for Erection) contains a prostaglandin pellet that can be applied one-and-a-half inches deep into the opening of the urethra just prior to intercourse. The pellet acts by widening the penile blood vessels, causing blood flow to go to the penis. Since its FDA approval in 1996, patient response to MUSE has been very disappointing. This method is less effective and more painful than penile injection therapy. Also since FDA approval of Viagra, MUSE has become much less popular. Finally, Topiglans is a paste of Alprostadil (it is currently under investigation), which is applied to the head of the penis and may cause enlargement of the glans penis. This method, however, also causes penile ache and does not improve the rigidity of the erection.
Prior to the FDA approval of Viagra, injection therapy was the most effective medical treatment available. Injection therapy works by injecting a type of medication through a very small hypodermic needle at the base of the penis five minutes before intercourse. The medication injected dilates the blood vessels to produce an erection. In the 1980s, the injection consisted of a mixture of papaverine and phentolamine. Side effects from the injections of these two drugs have led to scarring (from repeated injections) and sometimes painfully prolonged erections (solved by reducing the drug dosage).
Prostaglandin E-1 (Alprostadil) (Caverject or Edex) has been the drug used for injections since 1995. Alprostadil is a naturally occurring substance in the penile tissue. It can be self-injected safely at home with few side effects. A dull penile ache is experienced by 40 percent of patients using prostaglandin E-1. This is transient and well-tolerated in the majority of patients. Tests show that scarring from prostaglandin E-1 injections are minimal (occurring in only five percent of cases) and the satisfaction rate is high. This is currently the only FDA approved medication for penile injection. Off-label use of Trimix (Papaverine, Phentolamine, and Alprostadil) is very successful and safe, and is currently the preferred penile injection method. The instance of long-term use, however, is poor; more than 50 percent of men stop using the injection method after two months and less than 30 percent use this technique for more than two years.