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Penile implant surgery usually takes 45 minutes to an hour. Your doctor may give you medication to make you unconscious during the surgery (general anesthesia) or may give you medication that blocks pain in the lower part of your body (spinal anesthesia).
Immediately before surgery
- Your doctor will give you IV (intravenous) antibiotics. This will help prevent infection.
- You'll get a general anesthetic to make you unconscious or a local anesthetic to numb the lower part of your body.
- A tube called a urinary catheter may be inserted into your bladder via your penis. 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 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.
- After flushing the area with antibiotic fluid to prevent infection, your surgeon will choose the correct size implant and place the implant cylinders inside the 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.
Recovery
- You'll need to stay in the hospital for at least one night.
- You'll need to take antibiotics to prevent infection. After surgery, take antibiotics exactly as your doctor tells you to. If you miss doses or you don't take the entire course of medication, the antibiotics may not be effective.
- You may need to take medications to ease pain after surgery. Mild pain may persist for several weeks.
- Most men can resume strenuous physical activity about six weeks after surgery. This can vary, so ask your doctor about any limitations on what you can safely do.
- Ask your surgeon when you can resume sexual activity. For most men, this is about six weeks after surgery.
Types of penile implants
There are two types of penile implants: inflatable implants and semirigid rods.
Inflatable implants are the most common type of penile implant used in the United States. Inflatable devices are more natural than semirigid types are 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 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 are 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; 2007. 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 Dec 23, 2010.
- Eid JF. What is new for inflatable penile prostheses? Current Opinion in Urology. 2009;19:582.
- Erectile dysfunction. Cornell University Sexual Medicine Program. http://www.cornellurology.com/sexualmedicine/ed/implant.shtml. Accessed Dec. 23, 2010.
- Wolter CE (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 18, 2010.
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