A Modern Approach to Men’s Sexual Health: Understanding Penile Implants

Erectile Dysfunction is common, but many men avoid addressing it because of stigma. For those who haven't responded to medication or other treatments, a penile implant is a permanent surgical option that restores the ability to get an erection without ongoing medication.

There are two types: inflatable implants, which are inflated when needed and deflated afterwards, and semirigid rods, which remain firm and are repositioned manually. Both sit entirely inside the body with no visible difference from the outside. This article covers penile implants and the benefits they offer to men who are struggling to get an erection.

Table of Contents

• What is a Penile Implant?

• Who is the Right Candidate for Penile Implants?

• Are there any risks?

• Penile Implant Surgery

• Conclusion

• FAQs

What is a Penile Implant?

A penile implant is placed surgically inside the penis to produce an erection in men with erectile dysfunction. They are of two types:

1. Inflatable Implants

This is the most common type of implant used for ED. To get an erection, you have to inflate it, and once you are done, you can deflate it. If your doctor recommends a three-piece inflatable implant, the fluid-filled reservoir will be placed just beneath your abdominal wall. Inside the scrotum, a release valve and a pump will be placed. There will be two inflatable cylinders implanted inside the penis.

When you need to get an erection, you will start by pumping the fluid. This salt water is present in the reservoir and is then pumped into the cylinders. Once this is done, you have to release the valve implanted into the scrotum. This drains the fluid back into the reservoir. In the case of two-piece implants, the fluid reservoir and the pump are in the scrotum. Both devices have reservoirs filled with salt water on the day of the surgery. 

These implants also come with antibiotic coatings meant to reduce the risk of infection and reduce friction. 

2. Semirigid Rods

In the case of these implants, the devices remain firm at all times. When you need an erection for sexual activity, you can bend the penis away from the body. When you need to conceal it, you can bend it towards the body. There are special designs for a penis that is larger or shorter than average. 

Who is the right candidate for Penile Implants?

In most cases, erectile dysfunction can be treated using medications or a penis pump. However, if you are not suited for other forms of treatment or those methods haven’t helped you get an erection sufficient enough for sexual activity, you might be a candidate for penile implants.

Penile implants are used for severe cases of ED developed from scarring inside the penis, which can lead to Peyronie’s disease. Men with this condition get curved and painful erections. However, even in this case, you might not be suited for penile implants. If you have an infection like a UTI or a pulmonary infection, or you are dealing with uncontrolled diabetes or heart disease, penile implants are not recommended.

Are there any risks?

Like any surgery, penile implant surgery carries risks:

• Infection: Men with diabetes or spinal cord injury face a higher risk of infection. An infection after surgery usually means the implant has to come out.

• Erosion or adhesion: The implant can sometimes wear through the skin inside the penis or adhere to it. Rarely does it break through the skin surface.

• Implant malfunction: If the device fails, you will need surgery to fix or replace it.

Penile Implant Surgery

Before the Procedure

Before a penile implant, your doctor will walk you through preparation. Here is what it typically involves:

• Your doctor will ask you to pause aspirin and anti-inflammatory drugs ahead of surgery as both raise bleeding risk.

• Arrange for someone to take you home after the procedure. Some patients stay overnight, so check with your doctor in advance.

• Do not eat or drink after midnight before surgery. 

• Your doctor will recommend either general or spinal anaesthesia. 

• You will receive IV antibiotics before the procedure, and the area will be cleaned with an antiseptic solution. 

During the Procedure

The doctor makes an incision at the base of the penis, below the head, or in the lower abdomen. Through this, the corpora cavernosa, the two chambers that fill with blood during an erection, are accessed, and the spongy tissue inside is stretched to fit the implant.

The implants selected for the procedure are customised as per your body measurements. The implant cylinders will be placed inside the penis. If a two-piece inflatable device is used, the doctor will place the valve and pump inside the scrotum. In the case of a three-piece device, the fluid reservoir will be implanted either beneath or above the abdominal wall. 

Once the device has been placed, the incision will be closed. The entire procedure takes somewhere between 45 minutes and an hour. 

After the Procedure

After the surgery, you will need medications to get relief from the pain. In some cases, the doctor will give a long-acting injection into the scrotum that reduces pain for 2-3 days. However, you might still experience mild pain for the next few weeks. You will also have to take oral antibiotics.

Make sure you discuss resuming your regular activities with your doctor. In most cases, you will be allowed to resume sexual activity and physical activity about 4-6 weeks after the procedure. Also, you need to inflate and deflate your penile implants to stretch the area that is surrounding the cylinders. It will also help you practice using them.

Conclusion

Erectile Dysfunction after failed treatment is not a dead end. A penile implant is an established surgical option with high satisfaction rates. The decision about whether it is right for you involves understanding the procedure, the recovery from surgery, and whether the risks are acceptable given your specific health history. If you have been managing ED for a while and other treatments have stopped working, it is worth asking whether an implant is appropriate for you.