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By Mayo Clinic staff
Penile implant surgery usually takes between one and two hours and is done while you're under general or spinal anesthesia.
To insert the penile implant, your doctor will stretch these tissue-filled chambers inside your penis (corpora cavernosa). With an inflatable implant, your doctor may place a pump inside your scrotum or a fluid-filled reservoir in your lower abdomen.
Immediately before surgery
- Within a couple of hours before the surgery, you may be given antibiotics to reduce your risk of infection.
- You'll get an anesthetic to make you unconscious (general anesthesia) or a spinal anesthetic to block the pain.
- A tube called a catheter may be placed into the bladder through your urethra to drain urine. In most cases, the urinary catheter is removed in the first 24 hours after surgery.
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 stretches the spongy tissues 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.
- After flushing the area with antibiotic fluid to prevent infection, your surgeon will choose the correct size implant and place the cylinders or semirigid rods inside the penis.
- 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 surgeon 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.
Recovery
- Most men go home within 24 hours of surgery.
- You'll need to take antibiotics as directed by your surgeon to prevent infection.
- After surgery, wear loosefitting underwear and clothing. Men with an inflatable device will need to make sure the scrotal pump stays in place during healing.
Most men can resume strenuous physical activity about a month after surgery. You can resume sexual activity four to six weeks after surgery, depending on the type of implant you have and the instructions of your surgeon.
Types of penile implants
There are two types of penile implants: inflatable implants and semirigid rods.
Inflatable implants
In the United States, inflatable devices are the most common type of penile implant. Inflatable devices are more costly than semirigid types are, but they're more natural because they can be inflated to create an erection — and deflated at other times. Inflatable implants also reduce the possibility of damage to the inside of the penis due to constant pressure — which can be a problem for some men with semirigid implants.
There are two- and three-piece inflatable implants.
- The two-piece model currently available in the United States works in a similar way to a three-piece design, but the fluid reservoir is part of the pump implanted in the scrotum.
- Three-piece implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis. Before you have sex, you pump the fluid from the reservoir into the cylinders to cause an erection. After sex, you release the valve inside the scrotum to drain the fluid back into the reservoir.
Semirigid rods
This type of implant is always firm. The penis may be bent away from the body to have sex and toward the body to conceal the device. Although less commonly used than the inflatable type, semirigid implants are less complicated, easier to place and have less risk of failure.
Comparing implant types
The decision about which type of implant you should have is based on both your preference and your medical situation. Your doctor may suggest one type of design over another based on factors including your age, risk of infection, and health conditions, injuries or medical treatments you have had in the past.
| Type of implant | Pros | Cons |
|---|---|---|
| Three-piece inflatable |
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| Two-piece inflatable |
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| Semirigid |
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- Montauge DK. Prosthetic surgery for erectile dysfunction. In: Wein AJ, et al. Walsh: Campbell's Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/119551792-3/801941680/1445/26.html#4-u1.0-B978-0-7216-0798-6..50025-X--cesec13_1966. Accessed Feb. 6, 2009.
- Henry GD. Updates in inflatable penile prostheses. Urology Clinics of North America. 2007;34:335.
- Erectile dysfunction. Cornell University Sexual Medicine Program. http://www.cornellurology.com. Accessed Feb. 6, 2009.
- Carson CC. Penile prosthesis implantation: Surgical implants in the era of oral medication. Urololgy Clinics of North America. 2005;32:503.
