For most men with erectile dysfunction, first-line treatment usually involves lifestyle changes, medicine (oral or penile injections), and/or a vacuum device. But if underlying health issues prevent you from taking medicine, or if these treatments fail to work, your doctor might recommend penile implants.
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How Penile Implants Work
Penile implants, also known as penile prosthetic devices, are a permanent solution for treating erectile dysfunction. Most devices last 10 to 15 years or longer. Depending on the type of implant, your surgeon will place a device in your penis and, in some cases, in your scrotum or abdomen.
Because implantation is an invasive surgical procedure, your doctor will need to assess your overall health to determine whether or not you’re a good candidate for the surgery.
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Types of Implants
There are two main types of implants: inflatable prostheses — the most common kind — and semirigid rods. Inflatable prostheses, which come in either two or three pieces, have a satisfaction rate of more than 90 percent.
- Three-piece inflatable: Special tubing connects a reservoir filled with salt water inside your abdomen, a pump and release valve in your scrotum, and two inflatable cylinders in your penis. An erection occurs when you squeeze the pump in your scrotum; this pushes fluid from the container into the cylinders. You’ll maintain your erection even after ejaculation. To relax your penis, you squeeze the release valve, which pushes fluid back into the abdominal reservoir. The perks of this device are that you get a natural, rigid erection and that your penis relaxes to normal when deflated. But this implant also has the most moving parts, which increases the risk of malfunction.
- Two-piece inflatable: This functions the same way as the three-piece inflatable, but in this case, the fluid-filled container is part of the scrotum pump. As with the three-piece implant, when you deflate the two-piece implant, your penis loses its erection. However, it doesn’t give you as rigid of an erection as the three-piece inflatable, and it’s more complicated than the semirigid rods.
- Semirigid rods: Your surgeon implants two flexible rods in your penis. While malleable, your penis will always be firm. You can straighten it up to form an erection or bend it down to hide it. One benefit of the rods is that there are fewer parts that can malfunction; rod implants are easier to use and maneuver than inflatables. On the other hand, semirigid implants don’t produce the fullness of the erection that inflatables do. Also, your penis will always be partially erect, which may be uncomfortable or make it difficult to hide under clothing. The constant pressure could hurt your penis.
Your doctor will help you choose an implant that’s right for your needs. Whichever you choose, it will be made to fit your body and penile size.
What to Expect During Implantation
The procedure generally takes one to two hours. While you’re placed under regional or general anesthesia, your surgeon will make a cut on your penis to insert the implant. Depending on the type of implant, they may also make small cuts in your scrotum and lower abdomen.
The surgery doesn’t require a hospital stay, so you should be able to go home the same day. You’ll need to wait six weeks after getting an implant before you can have sex. Your doctor will provide other specific instructions on recovery.
Risks and Side Effects of Implants
Along with the potential drawbacks of each implant mentioned above, as with any surgery, infection is always a risk. The infection rate from implants is less than two percent. To help prevent infection, you’ll receive antibiotics during the surgery. The penile implants are also coated with antibiotics to reduce the risk of infection.
You may feel some pain for several days following the procedure. If pain persists and infection is suspected, the implant will need to be removed.
In some cases, an implant can shorten your penis by one-quarter of an inch. Also, depending on your age, you may need a replacement implant eventually.
Other, less common complications include:
- Tissue injury near the implant
- The implant breaking through the skin
- Implant breakage
- Incorrectly positioned implant
- Defective implant (most commonly caused by leakage from cylinders)
The UPMC Department of Urology treats all manners of conditions involving the urinary tract and male reproductive organs. We treat those disorders both in children and adults. We have a multifaceted team of physicians and researchers working together to provide the best care. We provide cutting-edge treatments, and we continue to lead research into even better methods for diagnosis and treatment. U.S. News & World Report ranks UPMC Presbyterian Shadyside as among the best hospitals in the country for urological care.