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How do penile implants work?

Penile implant surgery is a procedure that helps men with erectile dysfunction that has not responded to other types of treatments.

Penile implant surgery involves placing a prosthetic device inside the penis and scrotum. This device helps the man achieve an erection and regain sexual function.

In this article, we examine the types of penile implants available and how they work. We also take a look at what a man can expect from having penile implant surgery.

Who is a candidate for penile implants?

Men with erectile dysfunction ED caused by a specific medical problem are the best candidates for this type of procedure.

However, in most cases, doctors try simpler and less invasive treatments first. If these treatments are not successful, men with ED may consider penile implant surgery.

Types of implants

Surgeons in an operating theatre working on a penile implant
There are three main types of penile implants that may be offered to men with erectile dysfunction.

There are several different types of penile implants available. The type that is used will depend on the needs and preferences of the man.

There are several factors that the man and his doctor will need to consider before deciding which implant will be the most suitable, including:

  • body size and type
  • the ages of the man and his partner
  • size of the penis, glans, and scrotum
  • any history of previous abdominal or pelvic surgery
  • the presence of colostomy
  • a history of kidney transplant
  • whether or not the penis is circumcised
  • overall health and well-being
  • life expectancy

There are three main types of penile implants.

Three-piece inflatable pump

The three-piece inflatable pump involves placing two cylinders in the penis, an inflatable pump in the scrotum, and a fluid-filled container in the abdomen. All of these components are connected by special tubing.

Squeezing the pump in the scrotum causes fluid to moves from the container into the cylinders, creating an erection. When the release valve is squeezed, fluid moves out of the cylinder and back into the container, making the penis flaccid.

When inflated, a three-piece inflatable pump implant acts and feels like a natural erection. The implant also feels natural and comfortable when flaccid.

Two-piece inflatable

This type of implant is similar to the three-piece inflatable device and works in the same way. However, instead of a separate fluid-filled container, the fluid is kept within the pump in the scrotum.

However, the two-piece inflatable device is not as rigid as the three-piece implant.

Semi-rigid or malleable rods

This type of penile implant involves a surgeon implanting two flexible rods into the penis. The implants never change in size or stiffness and maintain a semi-rigid state. They can, however, be set in different positions easily.

The implants are usually bent downward but can be straightened into an upward position when needed for sexual intercourse.

Even though they are very easy to use, many men find their constant rigid state to be uncomfortable.

What is sex using an implant like?

When the implant is inflated or moved into position, it has a similar feel to a man s regular erection, both in girth and stiffness.

Some men report that the implant does not make their erection last as long as usual, although some newer implants have addressed this issue.

Another difference is that implants do not affect the head of the penis, meaning that it does not become hard.

Penile implants do not affect the way that sexual intercourse feels neither do they affect a man s ability to have an orgasm or ejaculate.

What to expect from surgery

young male doctor speaking with young male patient about a penile implant
A man may have to undergo some tests before surgery is scheduled.

Understandably, most men are somewhat nervous about having surgery on their penis. Knowing what to expect before, during, and after the procedure can be really helpful in reducing that anxiety.

Before scheduling surgery, the doctor should have a full discussion with the man about the:

  • risks
  • benefits
  • alternatives
  • types of implants
  • the recommended procedure
  • what to expect after surgery

Once the man has decided which type of implant he wants, the doctor should provide him with detailed instructions about how he should prepare for the surgery.

Sometimes a man will have to undergo some tests before the procedure to ensure that he is healthy enough to have surgery.

Instructions before surgery may include:

  • not eating or drinking anything for a set amount of time before surgery
  • leaving valuables at home
  • shaving or cleaning the area
  • having someone available to drive home

The procedure itself usually lasts for 1–2 hours and takes place at a hospital or outpatient surgery center. It takes place under anesthesia to prevent the man from feeling what is happening.

During the procedure, the surgeon will make a cut in the penis below the head, and place the implant inside. It is important to customize the size of the implant based on both body and penis size.

For inflatable implants, the surgeon makes small cuts in the scrotum to place the pump and valve. If the surgeon is implanting a three-piece system, they will also make incisions in the abdomen to put the fluid container in place.

Recovering from implant surgery

Men having this procedure should be able to go home the same day. They will need to take pain medication to help with discomfort and antibiotics to prevent infection.

The doctor will provide additional instructions, which may include:

  • waiting for 4–6 weeks after surgery before resuming sexual activity
  • keeping the penis pointing towards the belly button to prevent it from being curved downward
  • when and if stitches will need to be removed
  • when to resume physical activity, work, and exercise
  • instructions for using the implant

The doctor should also provide information on practice exercises involving inflating and deflating the implant each day. These exercises will help stretch the surrounding tissue.

It is worth noting that penile implants do not increase the natural length of the penis. In many cases, an erect penis with penile implants will often be slightly shorter than it was before surgery.

Outlook

Penile implant surgery is quite invasive.

Although an implant can be an effective treatment for ED, it can also reduce the natural reflex for getting an erection. For some men, this means that they will never have a natural erection without the use of the implant ever again.

Despite all of this, most men and their partners are quite happy with their implant and find it to be very effective.

The life expectancy of the implant will depend on the specific device used. Around 60–80 percent of devices will continue to work for 10 years.