Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail.
There are two main types of penile implants, semirigid and inflatable. Each type of penile implant works differently and has various pros and cons.
The placement of penile implants requires surgery. Before choosing penile implants, make sure you understand what surgery involves, including possible risks, complications and follow-up care.
For most men, erectile dysfunction can be successfully treated with medications or use of a penis pump (vacuum constriction device). You might consider penile implants if you aren't a candidate for other treatments or you can't get an erection sufficient for sexual activity by using other methods.
Penile implants can also be used to treat severe cases of a condition that causes scarring inside the penis, leading to curved, painful erections (Peyronie's disease).
Penile implants aren't for everyone. Your doctor might caution against penile implants if you have:
Keep in mind that while penile implants allow men to get an erection, they don't increase sexual desire or sensation. Most penile implants also won't make your penis any larger than it naturally is at the time of surgery. In fact, your erect penis might be slightly shorter than it used to be.
Risks of penile implant surgery include:
Infections after penile implant surgery typically occur in the first few weeks or possibly years later. Early infections can cause swelling of the scrotum, pus buildup and fever. Later infections might involve persistent or recurrent long-term pain.
Surgery to remove the implant is likely necessary to treat an infection. Replacing a penile implant can be complicated and can lead to a buildup of scar tissue and a decrease in penis length.
Initially, you'll talk to your doctor or a urologist about penile implants. During your visit, your doctor will likely:
There are two main types of penile implants:
Other special designs can fit a shortened penis, or one that's larger than average. Some inflatable penile implants are also available with antibiotic coatings, which might help reduce the risk of infection.
When choosing which type of penile implant is right for you, consider your personal preference and your medical history. Your doctor might suggest one type of design over another based on your age, risk of infection, and health conditions, injuries or medical treatments you've had in the past.
Type of penile implant
Before penile implant surgery you might also need to:
Penile implant surgery is usually done at a surgery center or hospital. Your doctor might give you medication to make you unconscious during the surgery (general anesthesia) or medication that blocks pain in the lower part of your body (spinal anesthesia).Your doctor will give you IV antibiotics to help prevent infection. The surgery site will also be shaved immediately before surgery to reduce the risk of infection.
A tube (catheter) might be inserted into your bladder via your penis to collect urine at some point during surgery. Your surgeon will make an incision below the head of the penis, at the base of the penis or in the lower abdomen.Next, your surgeon will stretch the spongy tissue in the penis that would normally fill with blood during an erection. This tissue is inside each of the two hollow chambers called the corpora cavernosa.Your surgeon will choose the correct size implant and place the implant cylinders inside your penis. All sizes are customized to your exact body measurements.If your doctor is implanting a two-piece inflatable device, a pump and valve are placed inside the scrotum. For a three-piece device, your doctor will also implant a fluid reservoir under the abdominal wall through an internal incision.Once the device is in place, your surgeon will sew the incisions closed. Penile implant surgery usually takes 45 minutes to an hour.
After penile implant surgery, you'll likely need to take medications to ease pain. Mild pain might persist for several weeks. You might also need to take antibiotics for one week to prevent infection.Your doctor might recommend keeping your penis up on your lower abdomen and pointing toward your bellybutton during the healing process to prevent downward curvature.Your doctor will provide specific instructions about when you can resume normal activities. Most men can resume strenuous physical activity and sexual activity about four to six weeks after surgery. You'll likely need to return to your doctor to have your stitches removed in about two weeks.At this point, your doctor might recommend fully inflating and deflating inflatable penile implants twice a day to give you practice using them and stretch the area surrounding the cylinders.
Although penile implants are the most invasive and least often chosen treatment for erectile dysfunction, most men and their partners report satisfaction with the devices. The 10-year device survival is between 60 and 80 percent.
When a male is born without a testicle or must have one removed due to injury or disease, a testicular prosthesis may be used.
A prosthesis is any artificial device used to replace a body part. When a male is born without a testicle or must have one removed due to injury or disease, a doctor may implant a testicular prosthesis to fill in the empty space in the scrotum (the sac that contains the testicles). The prosthesis is used only to improve appearance and to calm psychological fears. It does not have any functions of a real testicle. More often than not, requests for a testicular prosthesis come from those who are born with and later lose a testicle, rather than from those who have always been missing a testicle.
Testicular prostheses have been in use since the 1940s. In the past they were made of a variety of materials. Now, however, they are mainly made of silicone rubber filled with either silicone gel or saline (salt water). A testicular prosthesis will have the weight, shape, and feel of a normal testicle and will be available in different sizes so that a good match is made to the patient’s body.
Those with the following conditions face a higher risk of complications:
Known complications of testicular prosthesis insertion include:
Two days prior to surgery
Day of surgery