Ectopic Placement of Inflatable Penile Prosthesis Pump into the Mons Fat Pad for Patients with Difficulty Reaching Their Scrotum: A Case Series.

Abstract

Inflatable penile prosthesis (IPP) implantation is a well-established treatment for patients with erectile dysfunction. However, patients with a large body habitus often struggle to manipulate a pump placed in the scrotum. Here, we describe a novel technique for placing the IPP pump in the mons fat pad to improve accessibility. This technique follows the traditional approach for cylinder and reservoir placement, but instead creates a subcutaneous pocket in the mons fat pad overlying the inguinal region, where the IPP pump is secured to the dermis to prevent migration. The tubing was tunneled through the initial incision and connected using the traditional approach. Three patients with a mean BMI of 37.0±5.2 underwent this technique at our institution, including one primary implantation and two revisions due to difficulty accessing a scrotal pump. At follow-up ranging from 4 to 16 months, all devices remained functional, and all patients reported easy pump accessibility. No infections, erosions, or other complications were observed. This novel ectopic placement of the IPP pump in the mons fat pad is safe, technically feasible, and offers an alternative for patients with.