What is a Penile Implant

A penile implant is a medical device that is surgically inserted into the penis to help achieve and maintain an erection in patients with erectile dysfunction (ED). This surgical option is suitable for patients with ED who do not respond to other treatments, such as medications, therapy, or lifestyle modifications. Penile implants come in different types, allowing for a customised approach based on the patient’s needs and preferences.

How a Penile Implant Works

A penile implant works by manually or mechanically creating an erection, depending on the type of implant used. The device focuses on providing the physical ability to have an erection rather than increasing sexual desire or sensation. A penile implant works by physically simulating the process of an erection through either inflatable or malleable devices.

Inflatable implants are composed of cylinders placed inside the penis, a pump in the scrotum, and a fluid-filled reservoir in the abdomen. To activate the pump of an inflatable penile implant, you gently squeeze the pump located in the scrotum. By doing so, the fluid from the reservoir is transferred into the cylinders in the penis, creating an erection. To deflate the implant, you’ll need to press the release valve on the pump. This allows the fluid to return to the reservoir and the penis to return to a flaccid state or relaxed condition.

Malleable implants, on the other hand, consist of bendable rods that are surgically inserted into the shaft of the penis. These rods are flexible yet firm, allowing the patient to manually position the penis for sexual intercourse by bending it upwards into an erect position. After use, the penis can be easily bent back down to a flaccid state. Malleable implants remain semi-rigid at all times and are suitable for patients who may have difficulty using more complex inflatable devices.

How the Procedure is Performed

The procedure to implant a penile device typically takes about 60 to 90 minutes, depending on its complexity. To minimise patient discomfort, it is performed under general or spinal anaesthesia.

During the surgery, the surgeon makes a small incision either at the base of the penis or in the lower abdomen, depending on the type of implant being inserted. If an inflatable implant is used, the cylinders are placed inside the penile shaft. Then, the pump is placed in the scrotum, and the reservoir is placed in the lower abdomen. In the case of a malleable implant, rods are inserted inside the shaft. The incisions are then closed using sutures.

Recovery

The recovery from penile implant surgery varies from patient to patient, depending on the type of implant used and individual healing capacity. In general, full recovery from the procedure can be achieved after several weeks. In the first few days, swelling and discomfort are expected as the surgical incisions heal. Pain and other discomfort can be managed with the prescribed medications. The surgeon will provide specific aftercare instructions to aid with recovery, such as proper wound care, activity restrictions, and when to resume sexual activity.

Risks and Complications

As with any surgical procedure, penile implants carry potential risks and complications. These include the following:

• Anaesthesia risks
• Auto-inflation (for inflatable implants)
• Chronic pain
• Device breakage or malfunction
• Erosion or migration
• Implant malposition
• Infection
• Mechanical failure
• Reduced sensitivity
• Scar tissue formation
• Shortened penis length