How do penile implants work?

How do penile implants work?

Penile implant surgery is a procedure that helps men with erectile dysfunction who have failed to respond to other treatment forms.

Penile implant surgery involves placing the penis and scrotum inside a prosthetic device. This system helps the man get an erection and recover sexual control again.

We discuss the types of penile implants available in this article, and how they function. We also take a look at what a man can expect from having penile implant surgery.

Who is a candidate for penile implants?

The best candidates for this form of treatment are men with erectile dysfunction (ED), caused by a particular medical condition.

In most cases, however, mainly physicians attempt easier and less invasive therapies. If these treatments fail, men with ED can recommend surgery of the penile implants.

Types of implants

There are three main types of penile implants that may be offered to men with erectile dysfunction.
There are three main types of penile implants that may be offered to men with erectile dysfunction.

Penile implants are available in many different types. The type which is used depends on the man’s needs and preferences.

There are many considerations that need to be considered by the person and his doctor before determining the implant would be most appropriate, such as:

  • body size and type
  • the ages of the man and his partner
  • size of the penis, glans, and scrotum
  • any history of previous abdominal or pelvic surgery
  • the presence of colostomy
  • a history of kidney transplant
  • whether or not the penis is circumcised
  • overall health and well-being
  • life expectancy

There are three primary types of implants to the penis.

Three-piece inflatable pump

The three-piece inflatable pump involves placing two cylinders inside the penis, an inflatable pump inside the scrotum, and a tub in the abdomen filled with fluid. These components are all linked via special tubing.

Squeezing the pump inside the scrotum allows fluid to pass through the tubes from the container, causing an erection. As the release valve is pressed, fluid travels back into the container and out of the cylinder, leaving the penis flaccid.

A three-piece inflatable pump implant works when inflated and looks like a normal erection. The implant also feels normal and relaxed in flaccid environments.

Inflatable two-piece

This form of implant is identical to and operates in the same way as the three-piece inflatable system. However, the fluid in the scrotum is contained inside the pump instead of a separate jar filled with fluid.

But the inflatable two-piece device isn’t as rigid as the three-piece implant.

Semi-rigid or malleable rods

This method of penile implant requires the implanting of two flexible rods into the penis by an operator. The implants never change in size or rigidity, and retain a semi-rigid position. But they can easily be set in different positions.

The implants are normally bent downwards but when required for sexual intercourse, they can be straightened upwards.

While they are very easy to use, many men find it difficult to have their constant rigid state.

What is sex using an implant like?

When the implant is inflated or placed into place it has a similar feeling of both girth and stiffness to a man’s normal erection.

Some men complain that their erection doesn’t last as long as normal, although some newer implants have addressed this problem.

Another difference is that implants do not affect the head of the penis, meaning that it does not become hard.

The way sexual intercourse feels does not affect penile implants; nor do they impair a man’s ability to have an orgasm or ejaculate.

What to expect from surgery

A man talking with doctor about his health condition
A man may have to undergo some tests before surgery is scheduled.

Most of the men are understandably very worried about getting surgery on their penis. Knowing what to expect can be very helpful in reducing the anxiety before, during, and after the operation.

The doctor should have a thorough conversation with the man before scheduling the surgery about the:

  • risks
  • benefits
  • alternatives
  • types of implants
  • the recommended procedure
  • what to expect after surgery

If the man has determined the form of implant he needs, the physician should give him specific guidance about how to prepare for the surgery.

Even before the operation, a man will have to undergo several checks to ensure he’s well enough to have surgery.

Instructions before surgery may include:

  • not eating or drinking anything for a set amount of time before surgery
  • leaving valuables at home
  • shaving or cleaning the area
  • having someone available to drive home

The procedure itself usually lasts for 1–2 hours and takes place at a hospital or outpatient surgery center. It takes place under anesthesia to prevent the man from feeling what is happening.

The surgeon will make a cut in the penis under the head during the operation, and place the implant inside. It ‘s important to customize the implant size based on the size of both the body and the penis.

The surgeon makes small cuttings in the scrotum to insert the pump and valve for inflatable implants. If the surgeon installs a three-piece system, they may also make incisions to position the fluid container in the abdomen.

Recovering from implant surgery

Men who have this treatment should be allowed to go home on the same day. To avoid infection, they’ll need to take pain medicine to help with discomfort and antibiotics.

The doctor may give more instructions which may include:

  • waiting for 4–6 weeks after surgery before resuming sexual activity
  • keeping the penis pointing towards the belly button to prevent it from being curved downward
  • when and if stitches will need to be removed
  • when to resume physical activity, work, and exercise
  • instructions for using the implant

Also, the doctor should provide details on regular practice activities involving inflating and deflating the implant. These exercises will help stretch the surrounding tissue.

Remember that penile implants don’t raise the penis’ natural length. Sometimes an erect penis with penile implants would be significantly shorter than it was prior to surgery.


Penile implant surgery is quite invasive.

Although an implant may be a successful cure for ED, it may also decrease the natural reflex to get an erection. For some men, this means they’ll never get a normal erection again without ever using the implant.

However, most men and their partners are very satisfied with their implant and find it quite successful.

The implant’s life expectancy will depend on the particular instrument used. Approximately 60–80 percent of devices will continue to work 10 years.