Abstract Introduction Inflatable penile prosthesis (IPP) implantation is the gold standard treatment for refractory erectile dysfunction, with excellent functional outcomes. However, complications such as pump malposition may impair usability and reduce patient satisfaction. Pump migration, often caused by tubing redundancy, coiling, or capsular contracture, can require surgical revision to restore proper device function. Objective In this video, we demonstrate a surgical revision technique for pump migration after IPP implantation, involving capsule excision, pump repositioning into a dartos pouch, and secure tubing fixation to prevent recurrence. Methods We report a case of a patient who underwent IPP implantation with a total corporal length of 26 cm (12 cm proximal, 14 cm distal), managed with a 22 (+ 4 extender) cm IPP. Postoperative recovery was uneventful, and initial pump positioning was appropriate. At follow-up, the pump was observed to have migrated proximally toward the penile shaft, resulting in difficulty with deflation and limited accessibility. Surgical scrotal exploration was performed. Intraoperatively, the pump was found displaced by coiled tubing and encased within a fibrous capsule. The capsule was excised, tubing was freed, and the pump was repositioned and placed through an opened dartos pouch. It was then secured in its new position with sutures, and the tubing was fixed with 3-0 PDS to prevent recurrence. Results The revision was completed successfully without intraoperative complications. Postoperatively, the pump was easily palpable, functional, and stable in position. The patient reported restored ease of inflation and deflation, with no recurrence during follow-up. Conclusions Pump migration caused by coiled tubing and capsular formation represents a correctable complication after IPP implantation. Timely revision surgery can restore function, prevent further morbidity, and maintain patient satisfaction. Relocating the pump to the dependent scrotum ensures better accessibility and long-term stability. This case highlights key intraoperative considerations in managing complex pump malposition. Disclosure No
Canguven et al. (Mon,) studied this question.