Surgery Overview
Penile implants to treat
erection problems (erectile dysfunction) are either
semirigid (noninflatable) or inflatable cylinders that replace the spongy
tissue (corpora cavernosum) inside the penis that fills with blood during an
erection. The implants come in a variety of diameters and lengths.
Noninflatable (or semirigid) implants are always firm. They can be bent
into different positions (outward to have sex and back toward the body to conceal
under clothing).
There are two kinds of inflatable implants. Both
have cylinders in the shaft of the penis, a reservoir that holds salt water,
and a pump to move the salt water from the reservoir to the cylinders. You
create an erection by pumping salt water out of the reservoir and into the
cylinders. The release valve on the pump drains the salt water out of the
cylinders and back into the reservoir.
- A three-chamber inflatable implant has the cylinders in the
penis, the reservoir in the belly, and the pump and release valve in the
scrotum. The reservoir in this type of implant is
larger and separate from the cylinders.
- A two-chamber inflatable
implant has the reservoir at the beginning of the cylinders (at the base of the
penis) and the pump and release valve in the scrotum.
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 (catheter) is inserted briefly up the urethra and into the
bladder to drain urine.
A three-chamber implant is usually more
reliable than a two-chamber implant. Inserting the three-chamber implant is a
slightly more complicated surgery.
What To Expect After Surgery
You likely will 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 typically return to strenuous physical activity
and sex after about a month. Inflatable implants usually are not inflated for a
month.
Why It Is Done
Penile implants are an option when
other, less invasive treatments for erection problems have not been successful
and further treatment is desired.
Implants may be the treatment of
choice for young and middle-aged men who have erection problems from physical
causes. Penile implants may be appropriate treatment for men who have erection
problems caused by:
- Diabetes.
- Pelvic
surgery.
- Blood vessel disease.
- Injury to the pelvis,
genitals, or spinal cord.
- Peyronie's disease, a curvature of the penis caused by scar tissue.
Because implants permanently change the tissue in the
penis, they are not used for men whose erection problems are
psychological.
How Well It Works
There is not enough evidence to say how well penile implants work. But experts agree that they are likely to help with erection problems. There are reports that most men are satisfied with the results.footnote 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. Noninflatable
(semirigid) implants do not increase the size of the penis or produce the
fullness of a natural erection.
Implants do not interfere with
ejaculation, although 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 who have diabetes, spinal cord injuries, or
urinary tract infections. If the infection is severe, the implant must be
removed.
Sometimes, pain may require removal of the
implant.
The most common cause of failure is leakage from the
cylinders. Other, less common complications include the following:
- Tissue near the implant may be injured
(erosion).
- The implant may break through the skin.
- The
implant may break.
- The implant may be positioned
incorrectly.
- The implant may be defective and not work.
What To Think About
When considering surgery for
erection problems, it is important to include your partner in your
decision.
It is important that you have realistic expectations
about the type of erections you can have with an implant. The use of penile
implants is declining as men consider the risks of surgery-including
infections-and as other options become available, such as vacuum pumps,
injections, and medicines.
No problems have been reported from the
shedding of silicone particles from the implants.
Semirigid
(noninflatable) implants are the least expensive option. This surgery is
usually covered by insurance policies and by Medicare.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Khera M, Goldstein I (2011). Erectile dysfunction, search date August 2009. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Credits
ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerChristopher G. Wood, MD, FACS - Urology, Oncology
Current as ofMarch 14, 2017