Penile implants to treat erection problems (erectile dysfunction) replace the spongy tissue (corpora cavernosum) inside the penis that fills with blood during an erection with rigid, semirigid, or inflatable cylinders. The implants come in a variety of diameters and lengths.

Rigid and semirigid implants are always firm. The semirigid models can be bent into different positions (outward to have sex; back toward the body to conceal under clothing).

The cylinders in an inflatable implant are hollow. You get an erection by pumping them full of saltwater, or saline, stored in a reservoir in your lower abdomen. A release valve on the pump (in the scrotum ) drains the saline out of the cylinders and back into the reservoir.

Surgery will be done using regional or general anesthesia . The implants are inserted through an incision made in the penis, lower abdomen, or scrotum. A thin, flexible tube is inserted briefly up the urethra and into the bladder to drain urine.

A three-chamber implant (with a cylinder in the penis, a reservoir in the abdomen, and valve in the scrotum) is usually more reliable than a two-chamber implant (with a reservoir and valve in the scrotum). Inserting the three-chamber implant is a slightly more complicated surgery.

What To Expect After Surgery

Generally, you stay 1 or 2 days in the hospital. You will take antibiotics for up to 2 weeks after surgery to prevent infection.

The urinary catheter is used for about 1 day after surgery.

Do not wear tight underwear or clothing until the surgical incision has healed. Men with inflatable implants may need to avoid tight clothing for 6 weeks to avoid pushing the saline reservoir out of position.

You can generally return to strenuous physical activity and sex after about a month. Inflatable implants usually are not inflated for a month.

How Well It Works

The satisfaction rate for most men is high for both noninflatable and inflatable implants. 1 An erection with a properly working implant may seem more natural than one from other, nonsurgical methods, such as a vacuum device. The head (glans) of the penis is not made fully rigid by the devices. Semirigid implants do not increase the size of the penis or produce the fullness of a natural erection.

Implants do not interfere with ejaculation, though ejaculation and orgasm are not ensured. Implants neither increase nor decrease sexual desire.

Noninflatable implants and inflatable devices can last indefinitely.

Risks

The site of the implant may become infected. The risk of infection is higher in men with diabetes, spinal cord injuries, or urinary tract infections. If the infection is severe, the implant must be removed.

Pain may occasionally require removal of the implant.

The most common cause of failure is leakage from the cylinders. Other, less common complications include the following: