Penis Implant

Penis Implant
Are of stable mind and in good physical health
Have chronic erectile dysfunction that detracts from a quality sex life
Have tried using a vacuum constriction device (penis pump) with little success
Have realistic expectations about the risks and possible benefits of the procedure
Have Peyronie’s disease or another medical condition that is not likely to be treated successfully with other treatment options
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Penile implants, or penile prostheses, are a plastic surgery procedure used as a last resort option in men with erectile dysfunction who have failed alternative therapies.
A penile implant is a mechanical device that can be used to achieve an erection in a patient with otherwise untreatable ED (erectile dysfunction). This article is a guide to help you understand the different types of penile implants, some details of penile prosthesis surgery, and the risks and possible side effects. It also reviews who are good candidates for these devices, the pros, and cons of each type of implant, and some before and aftercare instructions that patients typically receive from their doctors.
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To understand how penile implants work, it is important to know the meaning of the term “corpus cavernosum”.
The majority of the penis is formed by two separate corpus cavernosum regions. Together, these sponge-like masses of erectile tissue form the bulk of the penis shaft. In men with normal sexual function, these cavernous bodies are flooded with blood to cause natural erections.
The goal of penile implant surgery is to allow a man with ED to achieve an erection that is sufficient for sexual intercourse. The procedure is usually recommended for men who have had no luck with other ED treatment options like medications or vacuum constriction devices (penis pumps). Penile prosthetics may also be used to treat a condition marked by curved, painful erections called Peyronie’s disease.
Note that penile implants do not increase libido, cause the head of the penis to become erect, improve sexual performance or stamina, increase sensation, or affect orgasm. A penile implant simply mimics a natural erection, allowing the shaft of the penis to become rigid enough to facilitate intercourse.
A penile prosthesis will not make the penis longer or larger than it is naturally. Since the implant does not make the head of the penis hard, many men find that their erections are somewhat shorter than they were naturally. However, most men who have the surgery, and their sexual partners, report high satisfaction rates.
Following are some of the pros and cons associated with each type of penile implant:
Semi-rigid Non-Inflatable Penile Implant
These are the least complex type of implant. Having fewer parts means a simpler surgery and less chance for a mechanical malfunction. They are also the least expensive option and the easiest to operate, even for those with limited physical dexterity due to arthritis or other medical conditions.
On the downside, non-inflatable penile implants are always semirigid, making them difficult to conceal underneath clothing. Further, having a permanent erection can be uncomfortable and otherwise bothersome. Because of this, they are the least popular implant type.
2-Piece Inflatable Penile Implants
The main advantage of this type of implant relative to a semi-rigid implant is that it includes a release valve. When the valve is opened, the saline solution is allowed to return to the fluid reservoir (inside the pump), causing the erection to subside. This allows the patient to achieve an erection when desired, and not have to have it constantly.
The cons of this type of implant include that it appears abnormal to others even when deflated, has a small pump that is difficult for those with limited dexterity to operate, and creates a less firm erection than a 3-piece device does.
3-Piece Inflatable Penile Implant
This type of implant looks and feels more natural than the others. When deflated, the penis appears completely flaccid with no rigidity as with the other two types. Its pump is larger and easier to operate than that of a 2-piece device. It also produces the firmest erections, is the most expensive, and the most popular.
The downside of this type of implant is that it has a higher risk for mechanical failure simply because it contains more components than the other types.
Discuss the best type of device for you with a board-certified plastic surgeon or licensed urologist who specializes in penile implant surgery.
Penile implants are used for ED treatment but not as a first option. Up to 70% of men with erectile dysfunction are able to achieve erections sufficient for sexual intercourse by using PDE5 inhibitor drugs like Viagra® (sildenafil), Cialis® (tadalafil), Levitra (vardenafil), and Stendra (avanafil), and therefore have no need for a penile prosthesis implant.
Good candidates for penile implant surgery:
Penile implant devices are not well-suited for all men equally. Your surgeon or urologist might recommend against this treatment if your ED symptoms are situational or reversible, if you have a pulmonary infection or urinary tract infection (UTI), or if you have diabetes that is not well managed.
Penile implants may also not be recommended for men who lack sexual desire, cannot feel sexual sensations, have skin lesions on the penis or scrotum, and/or have ED caused by emotional/psychological issues.
All surgeries have risks for the formation of scar tissue, bleeding, swelling, pain, and infection. Penile implant surgery also has risks for mechanical malfunction and/or internal erosion or adhesion. Any subsequent surgeries needed to repair or replace defective or broken components could cause increased scar tissue formation and/or decreased penis length.
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Like choosing the surgeon you feel comfortable working with, choosing between the three primary types of penile implants is an important decision that you should take your time making. Your doctor can help you choose the best type for you based on your ED symptoms, medical history, age, and various other personal factors.
Non-Inflatable Penile Implant
This type of semirigid penile implant consists of two malleable rods placed into the corpus cavernosa. There is no pump or liquid reservoir. The implant allows the penis to be used during intercourse but it always remains semirigid, even when not in use.
2 Piece Inflatable Penile Implant
A two-piece penile implant is made up of a pump and two flexible rods that create rigidity. A saline solution is housed either in the pump or the rods, which is forced by pressure to achieve penile rigidity at the owner’s discretion. The pump and expanding rods are surgically placed into the scrotum and the corpus cavernosum shafts, respectively.
3 Piece Inflatable Penile Implant
Instead of reserving the solution in the pump or the inflatable cylinders like a two-piece device, a three-piece penile implant surgery places the liquid reservoir in the patient’s abdominal cavity. The pump is placed inside the scrotum, and two inflatable tubes are placed into the corpus cavernosum shafts of the penis.
The surgical placement of a penile prosthetic implant is an invasive procedure that is performed under general anesthesia or spinal anesthesia. The operation involves making an incision to allow the insertion of the implants at the base of the penis and/or in the lower abdomen.
The surgeon will customize the sizes of the pump, reservoir, tubing, and 2 shaft implants based on the patient’s measurements.
In two-piece inflatable implant surgery, the pump, saline solution reservoir, and release valve are all placed inside the scrotum. During a surgery to insert a 3-piece prosthesis, the pump and the release valve are placed inside the scrotum and a separate fluid reservoir is placed under the lower abdominal wall.
This procedure does not involve the removal of any penile tissue. It is typically performed on an outpatient basis and takes between 30 minutes and an hour for a surgeon to complete.
Arrange transportation home from the surgery center or hospital where you have this procedure, and have someone stay with you for the first night or so. Your surgeon will prescribe pain medications and anti-inflammatory drugs as needed to help you manage post-surgical discomfort and swelling. You will also likely be given antibiotics to help fight off infections.
The doctor's staff will give you instructions about how to care for your incisions sites, change bandaging, and other aftercare protocols. Following these instructions closely will help expedite your recovery.
You will also receive instructions about how to operate your prosthetic device. Your doctor may recommend keeping your penis pointed upward toward your stomach during recovery to prevent an abnormal downward curvature from developing.
You will be encouraged to practice using the device twice daily during recovery, which helps familiarize you with its operation and stretches the areas of tissue that surround the inflatable rods.
You will return to see your surgeon to remove stitches and monitor your progress about 2 weeks after the surgery. Some patients can return to non-strenuous work and other light activities within a few days, but complete recovery can take several months. Most patients can resume sexual activity and other strenuous activities 4-6 weeks post-op.
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Penile prosthetic implants are the most invasive and least popular ED treatment option and are typically reserved for patients who have had little luck with other treatments like PDE5 drugs, penis pumps, and herbal remedies. Although patients do achieve erections that are sufficient for sexual intercourse, they do not affect libido, sexual performance, sexual stamina, or sexual sensation.
However, these prosthetic devices have high satisfaction rates among the men who do have them placed. 90-95% of penile implant surgeries are considered successful, and about 70% of patients report general satisfaction with their decision to have one surgically inserted.
Talk to a board-certified plastic surgeon or urologist to determine your candidacy for this procedure. Remember that it is very important to remain realistic about what the surgery can and cannot achieve.
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Board Certified Urologist, Premier Medical Group

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Board Certified Urologist, Premier Medical Group
600 Stony Brook Court
Newburgh, NY 12550
(845) 437-5000
www.premiermedicalhv.com
Assess the severity of your erectile dysfunction and how it may be impacting your life.
Speak to a Care Coordinator 1 (844) 4ED-CURE
When men consider a penile implant to permanently treat their ED, they may wonder how their penis will look before and after surgery. As a man, I understand this question. As a physician, I know that what a penis with an implant looks like erect and flaccid is only part of the picture. Several decisions need to be made in choosing the right fit (literally and figuratively) when pursuing penile implant surgery. Although the most common implant a man will pursue is the inflatable penile implant, one needs to consider several factors, including the patient’s ability to use their hands along with what the erection will look like before and after the surgery. A universal truth among all types of penile implants is that they are totally concealed in the body. All parts of the devices are implanted inside the body.
A three-piece implant like the AMS 700™ Implant has three components. This three-piece penile implant has two hollow cylinders that look like heavy-duty balloons that are surgically implanted into the penis. A small pump and valve are inserted into the scrotum to transfer fluid into the cylinders, which causes them to inflate and become hard like a hose under pressure and produce an erection. The third component is a small reservoir containing a sterile solution that is inserted into the lower abdomen. This is where the saltwater or saline solution fluid resides when the penis is soft or flaccid. The fluid is pumped into the hollow cylinders in the penis via a series of tubes inside the body. The resulting erection is hard, full and straight. As you can see by the pictures, the penis looks like it has a natural erection.
When the erection is no longer required, the release valve on the pump in the scrotum is gently squeezed.
When the erection is no longer required, the release valve on the pump in the scrotum is gently squeezed to release the fluid back into the reservoir located in the lower abdomen. There are distinct advantages to the three-piece implant. It creates the most authentic-looking erection. The device is simple to use and enables the penis to return to a flaccid state after sexual activity has ended. Because a larger amount of fluid is transferred into the cylinders to obtain an erection, the AMS 700 Implant offers the possibility of superior rigidity. It also offers the best softness of the penile shaft when not in use and is often the most comfortable. Penises are flaccid a majority of the time so soft feel and total invisibility when not erect is an important consideration. As with all styles of penis implant, there is no waiting time required for an erection, so romantic spontaneity is preserved.

Penile implant photos of the AMS 700™ Implant, prepped and ready for procedure.

Boston Scientific AMS 700™ Penile Implant picture of patient after surgery with penis in soft and flaccid state and pumped, in erect state. These penile implant photos show that the cylinders, reservoir and pump are not visible when the device is deflated or inflated.

Post-surgery penile implant photos of patient’s AMS 700™ Implant with penis in flaccid and erect states. All patients are unique. The AMS 700™ Implant is currently the only penile implant on the market with cylinders that expand in girth and length.
(Images courtesy Dr. Singh.)
Boston Scientific offers two different three-piece implants. The AMS 700 LGX™ Implant is the only penile implant on the market with cylinders designed to expand in girth and length. The AMS 700 CX Penile Prosthesis allows controlled expansion of the cylinders which optimizes girth. In addition, I often use the AMS 700 CX Implant model to help treat men who have erectile dysfunction and who also suffer from curved erections.
For men who are looking for erections like when the penis engorges with blood (a more “physiologic” erection) where the penis stays flaccid until intimacy, there are two options: two-piece and three-piece implants. The AMS Ambicor™ Inflatable Penile Implant, a two-piece inflatable implant, consists of two hollow cylinders that are surgically inserted into the penis. Outside the body, photos show that this penile implant looks like a set of balloons connected by tubes to a pump. The small pump is inserted into the scrotum.
The pump transfers fluid into the cylinders inside the penis, causing the cylinders to inflate and create an erection.
By gently squeezing the pump implanted in the scrotum several times, the pump transfers fluid into the cylinders inside the penis, causing the cylinders to inflate and create an erection. The fluid in the cylinders can be transferred back by gently bending the penis downwards for about 10 seconds. This type of penile implant creates a natural-looking erection. It enables the penis to return to a flaccid state and enables excellent concealment. In addition, a surgeon may particularly encourage placement of an Ambicor Implant in a patient with a current or future pelvic organ transplant, limited finger or hand control or with known extensive prior lower belly surgery.

The AMS Ambicor™ Implant consists of a pair of fluid-filled cylinders that are implanted in the penis connected to a pump that is implanted in the scrotum. Squeezing and releasing the pump moves fluid to the cylinders, creating a rigid erection.
(Photos by Boston Scientific.)
The most basic model of implant per its simple mechanical design and relative ease to surgically place, is the Spectra™ Concealable Penile Implant by Boston Scientific. It is a semi-rigid penile implant. The Spectra Implant is just a pair of bendable cylinders placed inside the penis. Outside the body, this implant looks like a pair of simple rods. The implant can be manually lifted up for intercourse and manually pushed down when not in use. Sexual intercourse with a bendable or malleable penile implant feels natural.
Sexual intercourse with a bendable or malleable penile implant feels natural.
It is very easy to use, doesn’t have any mechanical parts and may be best suited for men who have problems with dexterity. When the rods are positioned for sexual intercourse, the penis looks straight and it is hard. There are certain disadvantages to this implant as the penis remains hard and full at all times, even when it is bent downward and resting against the body, so concealment under tight clothing may be considered a problem for some men. Note that the implant does not alter or enhance the length or width of the penis. Some of the three-piece cylinder implants expand in length and/or girth.

The Spectra™ Penile Implant consists of a pair of semi-rigid cylinders that are placed inside the penis. The implant can be manually lifted up for intercourse and then manually pushed down when not in use. (Photo by Boston Scientific.)
Each physician specialist will be able to make recommendations based upon their experience and each unique patient. Yes, what a penis looks like erect and flaccid is a consideration.
In the right set of surgical hands, a urologist who specializes in penile prosthetic surgery offers a restoration procedure that results in a very small scar, preservation of the length and girth of the natural penis and a long-term satisfactory solution to erectile dysfunction. In my experience, inflatable implants offer the highest satisfaction for both the male patient and his partner. Each physician specialist will be able to make recommendations based upon their experience and each unique patient. Yes, what a penis looks like erect and flaccid is a consideration. However, picking the right implant is a necessary and shared decision between the patient and his urologist. In my practice, our Men’s Health team takes the time to review each option, and even allows the patient to see and feel the differences of each penile implant option before making a decision.
This physician is a Boston Scientific consultant but was not compensated for the creation of this article.
Insurance Coverage for Penile Implants Dr. Walsh
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