SST and The Frozen Pump

Habashy, E, Bonakdar Hashemi, M, Kohler, T

Supersonic Transporter, Glanular hypermobility, Revision surgery, Inflatable penile implant, Frozen pump

An 80-year-old man presented with history of the radical prostatectomy in 2009, followed by concurrent implantation of an inflatable penile prosthesis (IPP) and artificial urethral sphincter in 2012. Within a year of the IPP placement, the patient began experiencing operational difficulties with the pump. Upon examination, we observed glanular hypermobility, manifesting as a supersonic transporter deformity, along with significant IPP inflation challenges.

We initiated the surgical correction through a coronal incision and methodically exposed the anatomical layers. After placing two stay sutures, we meticulously created a pathway for the traction sutures through careful tissue dissection. To ensure safety during suture placement, we fully deflated the device and applied proximal manual compression. Using a large size needle, we positioned two permanent traction sutures in halfway between the incision site and penile tip. Following maximum inflation of the device, we secured two traction sutures to the glans at optimal positions. 1,2

To resolve the pumping mechanism issues, we employed the Frankenstein pump revision technique.3 This involved extracting the pump from its capsule, implementing a replacement pump component, and performing capsular expansion before completing the procedure with thorough irrigation and wound closure. While we used pump components from different manufacturers during the IPP pump revision, our clinical experience demonstrated that this did not affect the device's mechanical functionality.

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1. Ziegelmann MJ, Alom M, Bole R, Kohler T, Trost L. Modified Glanulopexy Technique for Supersonic Transporter Deformity and Glanular Hypermobility in Men With Penile Prostheses. J Sex Med. Jun 2018;15(6):914-919. doi:10.1016/j.jsxm.2018.04.633

2. Köhler, T., Mian, A., Ziegelmann, M. et al. Glans hypermobility scale (GHS): A simple grading scale and description of a modified glanspexy technique. Int J Impot Res 37, 72–75 (2025). https://doi.org/10.1038/s41443-024-00843-4

3. Ungerer, G, Mian, A, Parikh, N, Kohler, T. “Frankenstein & Beyond: IPP Fixes with Pump Exchange and Fluid Addition" The Journal of Sexual Medicine 20.Supplement_1(2023)