A penile implant, also known as a penile prosthesis, is used to treat men experiencing severe erectile dysfunction (ED) when conservative treatments (such as oral medications or vacuum erection devices) have failed. The primary function is to restore the mechanical ability to achieve an erection firm enough for successful sexual intercourse. The entire device is placed completely inside the body, remaining hidden from view.
Types of Penile Implants
Penile implants fall into two main categories, each offering a distinct approach to achieving rigidity. The inflatable penile prosthesis (IPP) is the most common type implanted today and provides a more natural-feeling erection by mimicking the natural hydraulic process. The semi-rigid, or malleable, rod is a simpler, non-hydraulic device involving paired rods that are permanently firm and require manual positioning. The choice depends on the patient’s dexterity, medical history, and personal preference for firmness and concealability.
How the Inflatable System Operates
The three-piece inflatable penile prosthesis is a closed-system hydraulic device composed of three distinct parts interconnected by small tubes. Two inflatable cylinders are surgically placed inside the corpora cavernosa, the chambers of the penis that normally fill with blood during an erection. A fluid reservoir, containing sterile saline solution, is implanted under the abdominal wall muscle or in the pelvis. A small pump and a release valve are positioned discreetly within the scrotum.
To achieve an erection, the user repeatedly squeezes the pump. This action mechanically transfers the saline fluid from the reservoir into the cylinders. As the cylinders fill, they expand, creating the rigidity necessary for sexual activity. When finished, the user presses the deflation valve on the pump. This allows the fluid to flow back out of the cylinders and return into the reservoir, returning the penis to a flaccid and concealed state.
How the Malleable Rods Function
The semi-rigid penile implant operates on a non-hydraulic principle without an internal mechanism. This system consists of two firm, yet flexible, silicone rods that are surgically placed within the corpora cavernosa. These rods often contain an inner core of wires or segmented joints, allowing them to be bent while maintaining constant firmness. The penis is always in a semi-rigid state.
The function of this device is entirely manual, relying on the user to physically manipulate the penis into the desired position. For sexual intercourse, the patient manually bends the penis upward and away from the body. When not in use, the penis is simply bent downward and folded close to the body for concealment under clothing. This device is particularly suitable for men with limited hand dexterity, as it eliminates the need to operate a complex pump and valve system.
Life After Implantation and Activation
The post-operative period involves a healing phase, typically lasting several weeks, and includes restrictions like avoiding heavy lifting. Patients must wait approximately four to six weeks before attempting to use the implant for sexual activity. This waiting time ensures internal healing and prevents damage to the device or surrounding tissue.
Prior to first use, patients receive training on how to operate the device. For the inflatable model, this involves learning the technique for locating and squeezing the scrotal pump and engaging the deflation valve. The implant does not alter natural sensation, ability to achieve an orgasm, or capacity to ejaculate, as it only affects mechanical rigidity. The ease of use and ability to achieve an erection “on demand” often results in high rates of patient and partner satisfaction.