Initially, you'll talk to your doctor or a urologist about penile implants. During your visit, your doctor will likely:
- Review your medical history. Be prepared to answer questions about current and past medical conditions, especially your experience with ED. Talk about any medications you're taking or have taken recently, as well as any surgeries you've had.
- Do a physical exam. To make sure penile implants are the best options for you, your doctor will do a physical exam, including a complete urologic exam. Your doctor will confirm the presence and nature of ED, and make sure that your ED can't be treated in another way. He or she will also try to determine whether there's any reason that penile implant surgery is likely to cause complications. Your doctor will also examine your ability to use your hands, since some penile implants require greater manual dexterity than others.
- Discuss your expectations. Make sure you understand what the procedure involves and the type of penile implant that suits you best. Your doctor will also explain the benefits and risks, including potential complications. Ideally, you'll include your partner in the discussion with your doctor.
Types of penile implants
There are two main types of penile implants:
- Inflatable implants. Inflatable devices, the most common type of penile implant used, can be inflated to create an erection and deflated at other times. Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis. To achieve an erection, you pump the fluid from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. The two-piece model works in a similar way, but the fluid reservoir is part of the pump implanted in the scrotum.
- Semirigid rods. Semirigid devices are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment. A positionable penile implant is a semirigid device with a central series of segments held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.
Other special designs can provide increased length or fit a shortened penis. Some inflatable penile implants are also available with antibiotic coatings, which might help reduce the risk of infection.
Comparing implant types
When choosing which type of penile implant is right for you, consider your personal preference and your medical history. Your doctor might suggest one type of design over another based on factors including your age, risk of infection, and health conditions, injuries or medical treatments you've had in the past.
Sep. 06, 2013
|Type of implant
- Creates the most natural, rigid erection
- Provides flaccidity when deflated
- Requires the most extensive surgery of any implant
- Has more parts that could malfunction than does any other implant
- Requires a reservoir inside the abdomen
- Requires a less complicated surgery than does the three-piece implant
- Provides flaccidity when deflated
- Deflation requires less dexterity than does a three-piece implant
- Requires more extensive surgery than does a semirigid implant
- Is mechanically more complicated than is a semirigid implant
- Provides less firm erections than does a three- piece implant
- Is easy to surgically implant
- Has a low chance of malfunction due to the small number of parts
- Is easy to use for those with limited mental or manual dexterity
- Results in a penis that is always slightly rigid
- Puts constant pressure on the inside of the penis, which can cause injury
- Can be difficult to conceal under clothing
- Montauge DK. Prosthetic surgery for erectile dysfunction. In: Wein AJ, et al. Walsh: Campbell's Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/119551792-3/801941680/1445/26.html#4-u1.0-B978-0-7216-0798-6..50025-X--cesec13_1966. Accessed Dec 23, 2010.
- Eid JF. What is new for inflatable penile prostheses? Current Opinion in Urology. 2009;19:582.
- Erectile dysfunction. Cornell University Sexual Medicine Program. http://www.cornellurology.com/sexualmedicine/ed/implant.shtml. Accessed Dec. 23, 2010.
- Wolter CE (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 18, 2010.