Penile Implants

Penile implants do not alter the appearance of the penis or make it larger. The implant has no effect on sensation or the ability to achieve orgasm and does not affect ejaculation.

Penile implants are custom fit to your anatomy. The implant causes the penis to stiffen and thicken, providing a natural feel and look. The device is completely concealed within the body and is undetectable after the area has healed following the procedure. 

The recovery period is usually 4-6 weeks. The implant may require some manipulation before and after intercourse to make the penis erect or flaccid.

New implants on the market have an over 90% satisfaction rate. Inflatable devices are the most often used penile implant, providing men with a natural-looking, simple-to-use, durable option.

Inflatable implants

• Placed inside the penis, with the pump in the scrotum
• When you push the pump, the saline solution shoots up to the rods, inflating them and providing an erection
• Divided into two types:
  • Two-piece inflatable implants
    • Consists of two cylinders inserted into the penis and a single pump bulb inserted into the scrotum
    • To inflate it, press the pump; to deflate it, bend the penis
  • Three-piece inflatable implants
    • Appear more realistic and have more flaccidity than two-piece or malleable (noninflatable) implants
    • Has an abdomen-implanted reservoir, a scrotum-implanted pump, and a pair of penis-implanted cylinders

Flexible implants

• Noninflatable, semi-rigid rods (called malleable implants).
• Straighten the penis to the appropriate position, then bend it back down to make it flaccid.
• The Genesis malleable penile implant is implanted into the shaft of the penis and consists of two adjustable rods.

Inflatable penile implants typically contain the following:

• Two cylinders: Inserted into the penis
• A pump: About the size of a marble and is inserted into the scrotum
• A saline reservoir: Implanted in the abdomen

You squeeze the pump to fill the cylinders with fluid to inflate the penile implant. This simulates blood flow. Then, a release mechanism permits the saline fluid to return to the reservoir. When the penis is not erect, the inflatable penile prosthesis is not noticeable.

Penile implants are advised for men with the following:

• Erectile dysfunction (ED)
• Fit enough to take the stairs
• Cannot take pills for any reason, or medications did not work
• Suffer from certain systemic diseases such as cardiac diseases, diabetes, metabolic diseases, or circulatory illnesses that prevent blood from reaching the blood veins of the penis
• With removed or destroyed nerves responsible for an erection, leading to impotence due to:
  • Prostatectomy (removal of the prostate) after prostate cancer diagnosis
  • Surgery to remove another tumor (such as bladder and bowel cancer)

In the past, a penile implant was considered the last resort of ED treatment. Recent guidelines from the American Urological Association (AUA) for ED, however, suggest that men can begin with any therapy they desire as long as they have a thorough awareness of the advantages, risks, and responsibilities associated. The AUA emphasizes that in certain cases, ED may be so severe that no other treatment option is as effective as penile implant surgery.

The implant process is often performed as an outpatient procedure. 

Procedure

• A small incision (about 1 inch) is made in the scrotum or above the pubic bone, and a surgeon inserts all components through this hole. 
• The procedure is carried out under general anesthesia.

Recovery

• If there are no complications, you can go home the same day, or you may spend one night in the hospital.
• The surgery site may be a little painful and sore. It usually takes a few days to return to normal activities.
• You may be prescribed pain medications and antibiotics to avoid infection.
• Doctors usually advise avoiding intercourse for 4-6 weeks following surgery.
• Avoid pointing your penis upward toward your belly button to keep it from curling downward.
• Inflate and deflate the implant daily so that the tissue inside the penis stretches.

Complications of penile implant surgery are rare, but may include:

• Mechanical failure
  • Occurs when an inflatable prosthesis stops or will not inflate.
  • Not dangerous but requires surgery to fix the problem.
  • Usually occurs years after the treatment and can be corrected by replacing the device.
• Infection
  • Although infections are rare, they may develop within 6 weeks of surgery.
  • Antibiotics alone are usually ineffective for these types of infections. The implant must be removed and replaced. This can restore sexual function in about 75% of the cases.
• Incorrect sizing
  • An implant that is too short may cause drooping of the penile head, whereas an implant that is too long may cause tissue erosion.
  • Sizing errors require revision surgery.
• Reservoir migration
  • In rare cases, the reservoir that stores the saline solution may loosen from its position.
  • The pouch can be moved back to the right place with surgery.