What is a penile implant?
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.
Who’s a good candidate for this procedure?
You may be a candidate for penile implant surgery if:
- You have persistent ED that impairs your sex life.
- You’ve already tried medications such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). These drugs result in erection appropriate for intercourse in as many as 70 percent of men who use them.
- You’ve tried a penis pump (vacuum constriction device).
- You have a condition, such as Peyronie’s disease, that is unlikely to improve with other treatments.
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.
- You have inflammation, lesions, or other problems with the skin of your penis or scrotum.
What do you need to do to prepare?
Your doctor will perform a thorough physical examination and review your medical history. All other treatment options should be considered.
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.
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.
What happens during the procedure?
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. The procedure may take 20 minutes to an hour. It’s usually done on an outpatient basis.
What’s recovery like?
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.
How effective is the surgery?
About 90 to 95 percent of inflatable penile implant surgeries are considered successful. That is, they result in erections suitable for intercourse. Among men who have had the surgery, 80 to 90 percent report satisfaction.
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, mechanical failures, erosion, or adhesion require surgery to repair or remove the implant.
How much does it cost?
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.
What is the outlook?
Penile implants are designed to stay hidden and help you achieve erections for intercourse. It’s a viable option when other treatments are ineffective.
Q&A: Penis implant inflation
How do I inflate and deflate a penis implant? Is there something I need to push or pump? Is it possible to accidentally inflate the implant?
To inflate a penile implant, you repeatedly compress the implant pump concealed in your scrotum with your fingers to move fluid into the implant until a state of erection is achieved. To deflate the implant, you squeeze a release valve positioned close to the pump inside your scrotum to permit the fluid to evacuate the implant and return to the fluid reservoir. Because of the pump’s location and precise action needed to ensure fluid movement, it’s very difficult to accidently inflate the implant.Daniel Murrell, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.