A penile implant, or penile prosthesis, is a treatment for erectile dysfunction (ED).
The surgery involves placing inflatable or flexible rods into the penis. Inflatable rods require a device filled with saline solution and a pump hidden in the scrotum. When you press on the pump, the saline solution travels to the device and inflates it, giving you an erection. Later, you can deflate the device again.
This procedure is usually reserved for men who have tried other ED treatments without success. Most men who have the surgery are satisfied with the results.
Continue reading to learn about different types of penile implants, who is a good candidate, and what you can expect after surgery.
- Penile implants are considered highly effective for treating ED.
- A penile implant might be suitable when oral medication isn’t working for ED.
- It can be a part of gender-affirming surgery.
- A penile implant can be costly.
- There’s a risk of infection.
- It will take several weeks to fully recover.
- Not everyone is a good candidate for an implant.
You may be a good candidate for penile implant surgery if you have:
- persistent ED that impairs your sex life
- already tried medications for ED, such as:
- sildenafil (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra)
- avanafil (Stendra)
- tried a penis pump (vacuum constriction device)
- not had positive results from penile injection medications like TriMix
- a condition, such as Peyronie’s disease, that is unlikely to improve with other treatments
- a history of prostate cancer or have previously undergone a prostatectomy
You may not be a good candidate if:
- there’s a chance ED is reversible
- ED is due to emotional issues
- you lack sexual desire or sensation
- you have a urinary tract infection (UTI)
- you have inflammation, lesions, or other problems with the skin of your penis or scrotum
Your doctor will perform a thorough physical examination and review your medical history. This will help them determine whether a penile implant is right for you.
The physical exam will include a complete urologic exam. This can include examining your genitals and prostrate, and getting a urine sample.
Your doctor will probably advise against penile implant surgery if you have:
- an infection, such as a pulmonary infection or urinary tract infection (UTI)
- diabetes that isn’t well managed
- cardiovascular disease
All other treatment options will be considered before going ahead with a penile implant. Most doctors will only recommend surgery after you’ve tried less invasive treatments for ED, such as oral medications or a penis pump.
Tell your doctor about your expectations and concerns. You’ll have to choose the type of implant, so ask about the pros and cons of each type.
Your doctor will also inform you about the risks of penile implant surgery as well as follow-up care steps.
Your doctor will probably advise you to avoid eating or drinking after a certain time before your surgery. You’ll also need to arrange a ride home after the surgery.
Inflatable devices are the most commonly used type. A three-piece implant involves putting a fluid reservoir under the abdominal wall. The pump and release valve is implanted in the scrotum. Two inflatable cylinders are placed inside the penis.
It’s the most extensive type of penile implant surgery, but it creates the most rigid erection. There are more parts to potentially malfunction, however.
There’s also a two-piece implant in which the reservoir is part of the pump that is placed in the scrotum. This surgery is a little less complicated. Erections are generally a bit less firm than with the three-piece implant. This pump may take more effort to work, but it requires less hand dexterity.
Another type of surgery uses semirigid rods, which aren’t inflatable. Once implanted, these devices stay firm all the time. You can position your penis against your body or bend it away from your body to have sex.
Another type of semirigid implant has a series of segments with a spring on each end. This makes it slightly easier to maintain positioning.
Surgery to implant semirigid rods is simpler than surgery for inflatable implants. They’re easier to use and less likely to malfunction. But semirigid rods put constant pressure on the penis and can be somewhat harder to conceal.
The surgery may be performed using spinal anesthesia or general anesthesia.
Prior to surgery, the area is shaved. A catheter is placed to collect urine, and an intravenous line (IV) for antibiotics or other medications.
The surgeon makes an incision in your lower abdomen, the base of your penis, or just below the head of your penis.
Then the tissue in the penis, which is normally filled with blood during an erection, is stretched. The two inflatable cylinders are then placed inside your penis.
If you’ve chosen a two-piece inflatable device, the saline reservoir, valve, and pump are placed inside your scrotum. With a three-piece device, the pump goes in your scrotum, and the reservoir is inserted under the abdominal wall.
Finally, your surgeon closes the incisions. It’s usually done on an outpatient basis and the procedure generally takes 45 to 90 minutes but those times can vary.
After surgery, you’ll be given instructions on how to take care of the surgical site and how to use the pump.
You may need pain relievers for a few days or weeks. Your doctor will probably prescribe antibiotics to cut down on the chances of infection.
You may be able to return to work within a few days, but it may take several weeks to fully recover. You should be able to resume sexual activity in about four to six weeks.
Many inflatable penile implant surgeries are considered successful. (That is, they result in erections for intercourse.) Among men who have had the surgery, around
Penile implants mimic a natural erection so you can have intercourse. They don’t help the head of the penis to get hard, nor do they affect sensation or orgasm.
As with any type of surgery, there’s a risk of infection, bleeding, and formation of scar tissue following the procedure. Rarely, complications like mechanical failures, erosion, or adhesion need surgery to repair or remove the implant.
If you have an established medical cause for ED, your insurer may cover the cost in whole or in part. Total costs depend on a variety of factors such as:
- type of implant
- where you live
- whether providers are in-network
- your plan’s copays and deductibles
If you don’t have coverage, your doctor may agree to a self-pay plan. Request a cost estimate and contact your insurer before you schedule surgery. Most providers have an insurance specialist to help you navigate financial matters.
To get an idea of patient satisfaction rates, researchers have sent questionnaires and interviewed people who had undergone the procedure.
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If you frequently find it difficult to maintain an erection, consider booking an appointment with a doctor, even if you’re not sexually active. Although ED might be a temporary issue that goes away on its own, it could also be a sign of an underlying condition.
If an underlying condition is causing your ED, your doctor’s likely first step is to treat that condition before treating the ED.
Before penile implant surgery, your doctor will probably recommend other, less invasive treatments. These can include:
A number of oral medications are available for ED. Nowadays, you can find cheaper generic versions of popular erectile dysfunction medication. Sometimes, insurance might cover it.
ED medication is noninvasive and easy to use. However, it can cause side effects. Your doctor might suggest a different kind of ED medication if one causes side effects.
In some cases, ED medication might not be recommended if you’re taking certain medications (such as alpha-blockers) or if you have certain cardiovascular conditions.
Penis pumps are ideal if you can’t, or don’t want to, use medication to treat your ED. Also called a vacuum pump or a vacuum erection pump, it’s ideal for someone with moderate ED.
To use a penis pump, you place the pump over your penis. Turn on the pump (or use the hand pump) to remove air from the tube. The change in air pressure causes blood to flow to the penis, engorging the blood vessels. This causes an erection.
With penis injections, you’ll have to inject medication into the shaft of the penis before sex. An erection will usually follow within 5 to 15 minutes.
Injectible medication can cost around $5 per dose, according to GoodRx. In some circumstances, it might be covered by insurance.
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Lifestyle changes, such as quitting smoking and managing stress, can help with ED.
These lifestyle changes can be free (or cheap), and they can have the added bonus of improving your overall wellness.
However, if your lifestyle isn’t contributing to your ED, changing your habits might not necessarily help.
In many cases, your doctor might recommend talk therapy before penile implants. This is especially the case if your ED might have an emotional root, such as stress, anxiety, or trauma.
While penile implants typically cost over $10 000, talk therapy is usually $100 to $200 per hour. Most therapists recommend a minimum of six to eight sessions, although it can be longer. Overall, talk therapy might be cheaper and it can benefit your mental health more generally.
But, as with lifestyle changes, it’s not always easy to say whether talk therapy will help with your ED or not. If your ED is not the symptom of a larger emotional problem, talk therapy is unlikely to help.
How long does a penile implant last?
It usually lasts between 15 and 20 years. After this time, you may need to replace the implant.
Is a penile implant noticeable?
Although there will be a small scar on the bottom of your penis, it won’t be very noticeable to other people. However, penile implants that aren’t able to inflate could be seen as a non-flaccid penis.
Does a penile implant increase penis size?
No, penile implants can’t increase penis size.
Do doctors recommend penile implants?
Yes, when they are needed. Doctors recommend penile implants if other ED treatment options are unsuitable or ineffective. Penile implants can also form a part of gender affirming surgery.
What is the recovery time after a penile implant?
It usually takes several weeks to fully recover from a penile implant. Like with any procedure, recovery time depends on your unique situation.
Generally, you can resume sexual activity in 4 to 6 weeks. The recovery period will be longer if you have an infection or other complications.
Penile implants are designed to stay hidden and help you achieve erections for intercourse. It’s a viable option when other treatments are ineffective.