Three-Piece Inflatable Penile Implant
Complete Guide 2025
What is a Three Piece Inflatable Penile Implant?
The three piece inflatable penile implant represents the gold standard in surgical treatment for erectile dysfunction. This sophisticated medical device is the most advanced and natural-feeling option available for men who have not responded to conservative treatments such as oral medications, injections, or shockwave therapy.
Unlike malleable or semi-rigid prostheses, the three-component inflatable penile prosthesis offers the ability to alternate between flaccid and erect states in a completely natural and discreet manner, providing the closest experience to natural erectile function.
Components of the Three Piece Inflatable Penile Implant
The system consists of three independent elements that work coordinately:
1. Inflatable Cylinders:
Two hollow silicone cylinders implanted in the corpora cavernosa of the penis. These cylinders are responsible for creating rigidity when filled with fluid and allow flaccidity when emptied.
2.Fluid Reservoir:
A silicone bag containing sterile saline solution, placed in the retropubic space (behind the lower abdominal muscle). This reservoir acts as a depot for the fluid that fills and empties the cylinders.
3. Scrotal Pump:
A control mechanism placed in the scrotum that allows the patient to transfer fluid from the reservoir to the cylinders to achieve erection, and release it back to return to the flaccid state.
- Funzionamento Dettagliato
How Does the Three Piece Inflatable Penile Implant Work?
The operation of the hydraulic penile implant is intuitive and completely controlled by the patient:
01.
To Achieve an Erection:
- The patient locates the pump in the scrotum through gentle palpation
- Repeatedly squeezes the pump (typically 10-15 times) to transfer saline solution from the abdominal reservoir to the penile cylinders
- The cylinders progressively fill, expanding in length and diameter
- The penis achieves full rigidity in 30-60 seconds
- The erection is maintained for the desired time without limitations
02.
To Return to Flaccidity:
- The patient locates the deflation button on the pump (usually on the sides or bottom)
- Presses and holds the deflation button for 6-10 seconds
- Simultaneously applies gentle pressure to the shaft of the penis
- The fluid returns from the cylinders to the abdominal reservoir
- The penis returns to its natural flaccid state within 10-30 seconds
This process is completely mechanical and does not require batteries, charging, or any external power source. The system works through simple hydraulic principles and can be activated an unlimited number of times throughout the day.
Advantages of the Three Piece Inflatable Penile Implant
01.
Maximum Natural Appearance
The Three Piece Inflatable Penile Implant provides the most natural appearance in both flaccid and erect states:
- Natural Flaccidity: When deflated, the penis appears and feels completely natural. There is no visible protrusion or abnormal rigidity that could be noticed under clothing or in intimate situations.
- Natural Erection: When inflated, the erection is firm, straight, and visually indistinguishable from a natural erection.
- Glans Engorgement: Some patients experience partial natural engorgement of the glans (head of the penis) during arousal due to preserved blood flow to superficial tissues.
02.
Superior Rigidity and Control
The Three Piece Inflatable Penile Implant offers:
- Optimal Rigidity: The firm erection is sufficient for all types of sexual activity
- Adjustable Firmness: Patients can control the degree of rigidity by varying the number of pump squeezes
- Sustained Erection: The erection maintains consistent firmness throughout sexual activity without loss of rigidity
- Instant Activation: From flaccid to fully erect in less than one minute
03.
Complete Discretion
One of the greatest benefits of the Three Piece Inflatable Penile Implant system is its absolute discretion:
- Components are completely internal and invisible to external observation
- No visible scars on the penis (incisions are made in the scrotum or lower abdomen)
- No one can detect the presence of the implant through observation, palpation, or during intimate activities
- Patients can use public facilities, gyms, pools, and beaches without concerns
04.
Optimal Comfort
The three-piece design prioritizes patient comfort:
- Daily Comfort: In flaccid state, the penis is soft and comfortable, not interfering with daily activities, exercise, or prolonged sitting
- No Restrictions: Patients can engage in all physical activities including running, cycling, swimming, and contact sports
- Comfortable Sleep: No discomfort or awkward positioning during sleep
- Clothing Comfort: No visible protrusion or discomfort wearing tight clothing
05.
High Satisfaction Rate
Medical studies demonstrate that the Three Piece Inflatable Penile Implant has:
- 90-95% patient satisfaction rate
- 85-90% partner satisfaction rate
- High quality of life improvement in validated questionnaires
- Low regret rate (less than 5% of patients regret the surgery)
06.
Durability and Reliability
Modern three-piece systems are highly durable:
- Average lifespan of 15-20 years with proper use
- Mechanical failure rate less than 5% at 10 years
- High-quality medical-grade silicone construction
- Resistance to normal wear and tear of daily use
- Cutting-Edge Technology in Penile Implants
The Three Leading 3-Piece Inflatable Penile Implant Brands:
01.
Coloplast Titan® Touch - The Leader in Durability:
The Titan® Touch represents the latest evolution in inflatable penile prosthesis technology. Its cylinders are equipped with patented Bioflex® technology, a material that is 30% more resistant than traditional silicone. The “Touch” design includes an ergonomic pump with a textured surface for easy location and tactile reference points that facilitate operation even with lubrication.
Exclusive features of the Titan®:
- Automatic lock system that prevents accidental deflation
- Hydrophilic coating that reduces friction during implantation
- Cylinders with “soft tip” design for maximum glans comfort
- Lifetime warranty against manufacturing defects
- Available in standard and “narrow girth” versions for specific anatomies
02.
Boston Scientific AMS 700™ Series - Innovation in Controlled Expansion
The AMS 700™ series has been the gold standard for decades, with millions of successful implants worldwide. The current model, the AMS 700™ LGX, is equipped with “length and girth expansion” cylinders that can increase penis length by up to 20% when inflated, a unique feature among available implants.
Advantages of the AMS 700™:
- InhibiZone® technology with rifampin and minocycline for antibiotic protection
- Momentary Squeeze™ pump with low-profile design
- Pressure relief valve to prevent over-inflation
- Sutureless connections for maximum durability
- Conceal™ low-profile reservoir option for thin patients
03.
Rigicon Infla10® X - La Nuova Generazione:
As the most recent participant in the market, Rigicon has introduced significant innovations. Its Infla10® X system is equipped with a pre-connected pump that reduces surgical time and the risk of leaks in connections. The cylinders use a “dual chamber” design that provides superior axial rigidity while maintaining natural flexibility.
Innovations of the Infla10® X:
- Rapid filling system that reduces the number of pumps needed
- “Shape memory” technology that optimizes fluid distribution
- Pump with tactile indicator of inflated/deflated status
- MRI compatibility up to 7 Tesla
- Competitive price without compromising quality
Three Piece Inflatable Penile Implant vs. Two-Piece : Key Differences
Three-Piece System:
Advantages:
- More natural flaccid appearance (completely soft)
- Greater rigidity for erection
- Larger fluid reservoir allows better expansion
- Preferred for younger, more active patients
- Better cosmetic results
Disadvantages:
- Slightly more complex surgery (additional component)
- Requires adequate abdominal space for reservoir
- Minimally higher cost
Two-Piece System:
Advantages:
- Simpler surgery (one less component)
- Suitable for patients with limited abdominal space
- Adequate option for older patients with less activity
- Slightly lower cost
Disadvantages:
- Less natural flaccid state (semi-rigid)
- Slightly less rigidity for erection
- Smaller reservoir limits expansion
- May be more noticeable under thin clothing
Medical Recommendation: For most patients under 70 years with good general health and normal anatomy, the Three Piece Inflatable Penile Implant system is the preferred choice due to its superior natural appearance and functionality.
The Three-Piece Penile Implant Surgery: Step-by-Step
01.
Pre-Operative Preparation
Medical Evaluation (2-4 weeks before):
- Complete physical examination
- Laboratory tests (CBC, chemistry panel, HbA1c, coagulation studies)
- Urinalysis and urine culture
- Cardiovascular clearance for patients over 50 or with cardiac history
- Medication review and adjustment
Pre-Surgical Instructions:
- Stop anticoagulants/antiplatelets as directed (typically 5-7 days before)
- Antibacterial soap showers for 3 days before surgery
- Complete genital and lower abdomen shaving the night before
- Fasting from midnight before surgery
- Arrangements for post-operative transportation and care
02.
Surgical Procedure
Anesthesia:
- General anesthesia (most common) or spinal anesthesia
- Surgery duration: 60-90 minutes for experienced surgeons
Surgical Steps:
- Incision:
- Infrapubic approach (small incision at base of penis) or
- Penoscrotal approach (incision between penis and scrotum)
- Length: 4-6 cm
- Cylinder Placement:
- Dilation of corpora cavernosa
- Measurement of corporal length
- Selection of appropriate cylinder size
- Insertion of inflatable cylinders into both corpora
- Verification of proper positioning and symmetry
- Reservoir Placement:
- Creation of space in retropubic area (Space of Retzius)
- Insertion of fluid reservoir behind abdominal muscles
- Filling reservoir with sterile saline solution (65-100ml)
- Verification of proper placement
- Pump Placement:
- Creation of sub-dartos pouch in scrotum
- Insertion of pump mechanism in dependent portion of scrotum
- Optimal positioning for easy patient access
- Connection and Testing:
- Connection of tubing between all three components
- System testing through multiple inflation/deflation cycles
- Verification of absence of leaks or kinks
- Final positioning adjustments
- Closure:
- Multi-layer closure with absorbable sutures
- Application of sterile dressing
- Placement of scrotal support
03.
Post-Operative Recovery
Hospital Stay:
- Same day discharge or 1-night observation
- Most patients go home within 6-12 hours
Immediate Post-Op (Days 1-3):
- Pain management with oral analgesics
- Swelling and bruising are normal and expected
- Ice packs to reduce swelling (20 minutes every 2 hours)
- Antibiotics for infection prevention (5-7 days)
- Catheter removed before discharge or next morning
- Rest and limited ambulation
First Week:
- Continued swelling and ecchymosis (peaks at days 3-4)
- Pain gradually decreasing (3-5/10 on pain scale)
- Dressing change at 48 hours
- Sponge baths only (no immersion)
- No lifting over 10 pounds
- Avoid driving until off narcotics
Weeks 2-4:
- Swelling significantly reduced
- Minimal pain or discomfort
- Return to light work/activities (desk work at 7-10 days)
- Showering permitted after suture removal
- Gradual increase in physical activity
- No sexual activity or pump activation
Weeks 4-6:
- Pump activation training (typically at 4-6 week mark)
- Surgeon demonstrates inflation/deflation technique
- Patient practices under supervision
- Daily inflation exercises to prevent scar tissue formation
- Gradual return to all normal activities
Weeks 6-8:
- Sexual activity clearance (typically after 6-8 weeks)
- Full healing of surgical sites
- Swelling completely resolved
- Resume all physical activities including sports
- Complete return to normal life
Learning to Use Your Three Piece Inflatable Penile Implant
Pump Activation Training
Your urologist will teach you to operate your implant at the 4-6 week post-operative visit. The learning curve is typically quick:
Inflation Technique:
- Locate the pump in your scrotum (feels like a small lemon or plum)
- Position thumb on one side, fingers on the other
- Squeeze firmly and release in rhythmic motion
- Repeat 10-15 times until fully rigid
- Each squeeze transfers fluid from reservoir to cylinders
Deflation Technique:
- Locate the deflation button (usually on sides or bottom of pump)
- Press and hold button firmly for 6-10 seconds
- Simultaneously bend penis toward abdomen or squeeze shaft gently
- Feel cylinders soften as fluid returns to reservoir
- Release button when penis is completely flaccid
Practice Schedule:
- Daily inflation/deflation cycles for first 2-3 months
- Helps prevent scar tissue and maintains optimal function
- Eventually becomes second nature (like riding a bicycle)
- Most men master technique within 1-2 weeks
Tips for Optimal Use:
- Be patient: It may take a few cycles to become comfortable
- Full inflation: Always pump until firm for best results
- Complete deflation: Ensure full deflation before ending cycle
- Regular use: Daily cycles prevent complications and maintain function
- Communication: Discuss any difficulties with your surgeon immediately
Sexual Function with Three Piece Inflatable Penile Implant
What to Expect:
Positive Outcomes:
- Penetrative intercourse: Fully functional for vaginal, anal, or oral sex
- Duration: Unlimited erection time without loss of rigidity
- Multiple events: Can inflate/deflate multiple times in one session
- Spontaneity: Ready for sex within 60 seconds of activation
- Confidence: Eliminates performance anxiety and fear of failure
Important Understanding:
- Orgasm and ejaculation are separate from erection and are preserved in most patients
- Libido (sex drive) is unchanged – the implant provides mechanical rigidity only
- Sensation is preserved – the implant does not affect penile sensitivity
- Pleasure remains the same or improves due to confidence and lack of anxiety
- No changes to urination or other penile functions
Realistic Expectations:
Length and Girth:
- Most patients maintain their natural erect length
- Some patients may experience 0.5-1 inch decrease due to corporal fibrosis
- Girth typically similar to natural erection
- Cylinders expand to fill available space in corpora
Appearance:
- Erection appears natural and straight
- No visible hardware or artificial appearance
- Glans may appear slightly less engorged than with natural erections
- Scars are minimal and well-hidden in natural skin folds
Sensation:
- Penile shaft sensation is preserved
- Touch, temperature, and pleasure sensations are intact
- Some patients report slightly decreased sensitivity immediately post-op
- Sensation typically normalizes within 3-6 months
Partner Satisfaction:
- 85-90% of partners report satisfaction with the implant
- Partners often prefer the reliable firmness and duration
- Many couples report improved sexual satisfaction compared to failed ED treatments
- Open communication with partner is key to optimal outcomes
Life with a Three Piece Inflatable Penile Implant
Daily Life:
Normal Activities:
- All regular physical activities without restriction
- Exercise, sports, swimming, cycling, running – all permitted
- No special precautions or limitations
- Travel freely (implant does not trigger metal detectors)
- Clothing choice unrestricted
Discretion:
- Completely undetectable by external observation
- Medical examinations (except specific genital exam) won’t reveal implant
- Can use public facilities, locker rooms, beaches without concern
- Partners often cannot tell the difference from natural erection
Maintenance:
- No maintenance required
- No medications needed
- No charging or batteries
- No expiration date
- Lifelong function (with possible eventual revision)
Long-Term Satisfaction:
Quality of Life Improvements:
- Restoration of sexual intimacy and confidence
- Elimination of performance anxiety
- Improved relationships and mental health
- Return to spontaneous sexuality
- High partner satisfaction
Psychological Benefits:
- Restored masculinity and self-esteem
- Reduced depression and anxiety
- Improved overall life satisfaction
- Enhanced intimate relationships
- Freedom from failed treatment cycles
Real Patient Perspective: Most patients report that after the initial adjustment period (2-3 months), they rarely think about their implant except when using it. It becomes a natural part of their body that simply works reliably when needed.
- FAQ
Frequently Asked Questions
You're likely a good candidate if you have severe erectile dysfunction that hasn't responded to conservative treatments. Specifically, ideal candidates have tried and failed with oral medications (Viagra, Cialis, Levitra), penile injections (Trimix, Caverject), vacuum erection devices, or other therapies like shockwave treatment without achieving satisfactory results for penetrative intercourse.
The best candidates are men in good overall health who can tolerate surgery under anesthesia. You should have realistic expectations about the outcomes and understand that while the implant provides mechanical rigidity for intercourse, it doesn't change libido, sensation, or orgasmic function. Manual dexterity is important since you'll need to operate the pump mechanism independently.
Common underlying conditions that lead to implant candidacy include diabetes with vascular damage, post-prostatectomy erectile dysfunction (after prostate cancer surgery), Peyronie's disease with severe curvature and ED, pelvic trauma, or cardiovascular disease affecting penile blood flow. Age is not a barrier—both younger men (30s-40s) and older men (70s-80s) can be excellent candidates if they're medically cleared for surgery.
You should NOT proceed if you have active urinary tract infections, uncontrolled diabetes (HbA1c over 8.5%), severe immunosuppression, untreated psychiatric conditions, or unrealistic expectations. A thorough consultation with a urologist specializing in prosthetic surgery will help determine your candidacy through physical examination, medical history review, and discussion of your treatment goals.
Yes. During intercourse, the implant provides natural firmness and temperature. Partners typically cannot distinguish between the implant and a natural erection. The movement, warmth, and friction are all natural.
Yes. The implant only provides mechanical rigidity. Orgasm, ejaculation, and sexual pleasure are controlled by separate nerves and systems that remain intact. Most patients maintain their pre-surgical orgasmic and ejaculatory function.
Most patients maintain their natural erect length. Some may experience 0.5-1 inch reduction if significant scarring existed before surgery. The implant does not increase natural penis size beyond your optimal natural erection.
Modern three-piece implants last an average of 15-20 years. Many patients never require revision. When mechanical failure occurs, only the malfunctioning component typically needs replacement.
No. The implant contains no metal and will not trigger metal detectors or show on airport scanners. TSA screening is not affected.