Penile Implant for Erectile Dysfunction

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Overview
Treatment

What Are Penile Implants?

Doctors sometimes suggest penile implant surgery to men who have erection problems.

A penile implant (also called a penile prosthesis) is a surgically placed device. It allows a man with erectile dysfunction (ED) to have an erection.

ED affects up to 30 million men. While almost all men have occasional ED, chronic ED isn't a normal part of aging.

If you have frequent ED, you should see a doctor for treatment.

UPMC doctors may prescribe a penile implant if other treatments for ED don't work, such as:

Oral drugs
Vacuum pumps
Shots

Is Penile Implant Surgery Right for Me?

If other, less invasive treatments haven't worked for your ED, your doctor may suggest a penile implant.

Men who receive implants often have erection problems caused by:

Blood vessel disease
Diabetes
Injury to the pelvis, genitals, or spinal cord
Pelvic surgery
Peyronie's disease, when scar tissue causes a curve or bend in the erection

After a penile implant, a natural erection is unlikely.

So, it's not the right treatment if your ED is short-term or has psychological roots like stress or relationship problems.

Types of Penile Implants

There are two types of penile implants for ED: non-inflatable and inflatable. Your doctor can discuss which is the best choice for you.

Non-inflatable implants:

Are always firm.
Consist of two easy-to-bend silicone rods that you bend outward to have sex and back toward the body at other times.
Are often a good choice for men with spinal cord injuries.

Inflatable implants:

More closely mimic the look and feel of a natural erection.
Consist of a cylinder in the penis and a reservoir or tank that holds salt water. The cylinder replaces the spongy tissue that fills with blood during an erection.
Create an erection by pumping water out of the tank and into the cylinders. After sex, the release valve allows water to drain back into the reservoir.

There are two kinds of inflatable penile implants:

The two-piece implant has the tank at the start of the cylinders at the base of the penis. The pump and release valve are in the scrotum.
The three-chamber implant also has cylinders in the penis and the pump and release valve in the scrotum. But the tank is larger and in the belly, separate from the cylinders.

The three-chamber implant is usually more reliable, but it's a slightly more complicated surgery.

What Are the Pros and Cons of Having a Penile Implant?

As with any surgery, a penile implant has pros and cons.

Pros

Most men who have penile implant surgery can have sex again.
Treatment usually doesn't affect orgasm.
Sex is more spontaneous. Once your implant heals, you don't have to wait an hour to have sex as with oral drugs for ED.
Having penile implant surgery is usually a one-time procedure.
Penile implants often work when other ED treatments don't.

Cons

The implant site can get infected.
The cylinders can leak.
The implant may break.
The surgery can injure tissue near the implant.
The surgery may shorten your penis by about a quarter of an inch.
Depending on your age, doctors may need to replace the implant.

Learn More About Penile Implants

In our Health Library: Penile Implants
From UPMC HealthBeat: Penile Implant Surgery

How to Get Ready for Your Penile Implant Surgery

As with any surgery, you shouldn't eat or drink anything — including water — after midnight the night before.

Your doctor will tell you if you should keep taking your regular medications.

Wear loose-fitting clothes to put on after your implant. Also, bring someone with you to drive you home after surgery.

What to Expect Before, During, and After Penile Implant Surgery

Penile implant surgery takes about an hour or two, often in an outpatient center. But your doctor may want you to stay overnight at the hospital.

Your doctor will place you under anesthesia for the surgery — either regional (you'll be awake) or general (you'll be asleep).

During your penile implant:

A nurse will run a catheter through your urethra and into your bladder to drain urine.
Your surgeon will make a small cut in the penis, lower abdomen, or scrotum to insert the implant.

After the surgery, you may need to stay in the hospital overnight. Your catheter will stay in for about a day.

Recovery from Penile Implant Surgery

Your doctor will prescribe pain medicine and antibiotics to ward off infection. After about two weeks, you can take over-the-counter pain drugs — such as ibuprofen or acetaminophen.

Swelling and bruising may last a few weeks.

Avoid tight clothing, especially underwear, until you heal fully. Too-tight clothing can inadvertently push the saline reservoir out of position.

You should limit physical activity for about a month. Most men feel well enough to have sex about four to six weeks after the surgery.