10054 Surgical Penile Implants

Overview

A surgical penile implant (also called a penile prosthesis) is a device that a surgeon puts inside the penis to make it firm enough for sex. It is used to treat erectile dysfunction (ED), which means trouble getting or keeping an erection firm enough for sex. The implant is completely hidden inside the body. There are two main types: one is bendable and you position it by hand, and the other is inflatable, with a small pump hidden in the scrotum (the pouch of skin that holds the testicles) that you squeeze to fill the implant with fluid. Surgery is only offered when other treatments have not worked or do not suit you.

No, it is not common. Only a small number of men with erectile dysfunction ever have an implant. It is usually a last option, after simpler treatments have been tried or ruled out.

It is mostly used by adult men whose erectile dysfunction has not improved with other treatments. This often includes men who have had prostate cancer surgery or radiation, men with diabetes, men who have had pelvic surgery or injury, and men with other health problems that affect blood flow or nerves. It is not used in children.

Symptoms

Common symptoms

• Trouble getting an erection, or an erection that is not firm enough for sex
• Erections that do not last long enough
• Loss of morning erections
• Worry, embarrassment or low confidence about sex
• Strain in a relationship because of sexual difficulties

Symptoms in children

• Penile implants are not used in children, so the symptoms above do not apply in the same way.
• If a child or teenager has concerns about their penis or urination, speak to their doctor, who can check for other causes.

Symptoms in older adults

• Erectile difficulties become more common with age, often linked to heart and blood vessel health, diabetes, or medicines for other conditions.
• Older adults may also have other health problems that need to be checked before any surgery.
• It is never too late to ask for help, and a doctor can talk through the risks and benefits at any age.

Causes

Main causes

• Damage to the nerves or blood vessels that control erections, for example after prostate cancer surgery or pelvic surgery
• Diabetes, which can harm nerves and blood flow over time
• Heart and blood vessel disease, high blood pressure, or high cholesterol
• Radiotherapy to the pelvis
• Injury to the pelvis or penis
• Some medicines, and long-term heavy smoking or alcohol use
• Psychological causes such as anxiety or depression, which can play a part on their own or alongside physical causes

Risk factors

• Diabetes that is not well controlled
• Smoking
• Being overweight or not being physically active
• Previous surgery or radiation in the pelvic area
• Conditions that weaken the immune system, which raise the risk of infection after any surgery

When to see a doctor

See a doctor urgently if:

• Any sign of infection after implant surgery, such as fever, redness, swelling, warmth or pus around the wound
• The device stops working, feels broken, or causes pain
• You cannot pass urine
• An erection that stays painful and does not go down

Book a routine appointment if:

• Erectile difficulties that bother you or your partner
• Erections that have become weaker or less reliable over months
• Other treatments for erectile difficulties have not helped, or you want to know about all the options
• You have questions about what having an implant would mean for your sex life, your body or your relationship

Diagnosis

There is no single test that says you need an implant. Instead, your doctor will talk with you about your health, your medicines, your erections and your goals, and examine you. They will usually check whether simpler treatments might work first. If you are thinking about surgery, you will be referred to a specialist (a urologist, a doctor who treats urinary and sexual problems). The specialist will explain what the operation involves and what results you can realistically expect, so you can decide together.

Tests that may be done

• A conversation about your medical history, medicines and lifestyle
• A physical examination
• Blood tests to check things like blood sugar, cholesterol and hormone levels
• Checks of your blood pressure and overall heart health, especially before surgery
• Sometimes a scan of blood flow in the penis, or a trial of a treatment that opens blood vessels
• Routine tests before an anaesthetic if surgery goes ahead

What to expect at your appointment

Appointments are private and confidential. You may be asked personal questions, which is normal and helps your doctor help you. You do not have to decide anything at the first visit, and it is fine to take a partner with you or to ask for more time.

Treatment

Treatment usually starts with the simplest options and moves on only if they do not work for you. Lifestyle changes and treating underlying conditions such as diabetes or high blood pressure come first. Next come treatments your doctor can prescribe or fit, such as medicines that help blood flow, a vacuum device that draws blood into the penis, or small injections. Surgery is considered when these options have not worked, cause side effects you cannot manage, or are not suitable for you.

Self-care at home

• Keep blood sugar, blood pressure and cholesterol in a healthy range if you have these conditions
• Stop smoking, and cut back on alcohol if you drink a lot
• Stay physically active and aim for a healthy weight
• Talk openly with your partner about what feels good and what you need
• Try to reduce stress and get enough sleep
• Take any regular medicines as agreed with your doctor, and ask your pharmacist whether any of them can affect erections

Medical treatments

Your doctor can discuss treatments that improve blood flow or help support an erection, including tablets, a device that uses gentle suction, and small injections or pellets placed in the penis. Some men use a combination of these. Hormone treatment may help if tests show low hormone levels. Each option has benefits and side effects, and your doctor or pharmacist can explain how to use it safely. If none of these work well enough, or you cannot use them, surgery may be discussed.

When is surgery considered?

An implant may be offered when other treatments have not worked or cannot be used, when you have had surgery or radiotherapy in the pelvis that has damaged erections, or when you and your specialist agree it best fits your needs. It is a permanent step, so you will have a full discussion first about the benefits, the risks, recovery time, and what sex will feel like afterwards. You should always feel free to ask questions or say no.

Living with this condition

After the operation you will have some swelling and bruising, and you will be shown how to use the device. You may be advised to keep it partly inflated at first and to avoid heavy lifting for a few weeks. Most men can go back to normal daily activities within a few weeks, and to sex after about four to six weeks once your specialist confirms it is safe. The implant is hidden inside the body, so it does not show, and you can still pass urine normally.

Lifestyle tips

• Follow your surgery team's advice about wound care and when to return to exercise
• Build up activity gradually, and avoid heavy lifting or cycling until you are told it is safe
• Keep up your heart health, blood sugar and weight goals
• Learn the pump or positioning technique at your own pace, and ask for extra practice if you need it
• Be patient with yourself — getting used to the device takes a little time for most people

Diet and exercise

A balanced diet and regular movement help your heart, blood vessels and recovery. Aim for moderate activity such as walking most days, and eat plenty of vegetables, fruit, whole grains and lean protein, with less processed food and sugary drink. If you have diabetes, keeping your blood sugar steady also helps protect the healing process. Ask your doctor before starting a new exercise plan after surgery.

Mental health and emotional wellbeing

Sexual difficulties can affect confidence, mood and relationships, and many men feel embarrassed, anxious or low. These feelings are common and treatable. Talking to your doctor, a specialist nurse, a counsellor or a sex therapist can help, as can talking with your partner. If you feel hopeless, very low, or have thoughts of harming yourself, reach out for help right away — contact your doctor, a local crisis service, or your local emergency number.

Prevention

You cannot always prevent the need for an implant, because some causes such as prostate cancer surgery or injury cannot be avoided. But looking after your heart and blood vessels can lower the chance of erection problems getting worse. That means not smoking, keeping active, staying at a healthy weight, limiting alcohol, and getting conditions like diabetes and high blood pressure treated.

Vaccines

There is no vaccine for erectile difficulties or for needing an implant. Staying up to date with routine vaccinations is still good general health advice, especially before any surgery.

Screening programmes

There is no routine screening test for erection problems, but regular health checks for blood pressure, cholesterol and diabetes can catch problems early. If you have diabetes or heart disease, keep your regular review appointments.

Complications

If left untreated

• Erectile difficulties usually stay the same or slowly get worse without treatment
• Ongoing strain, worry or distance in a relationship
• Low mood, anxiety or loss of confidence
• Not having an implant does not put your physical health in danger — it is a quality-of-life decision, not an emergency

Long-term outlook

Most men who have an implant are satisfied with it and say it improved their sex life and confidence. The device usually works well for many years, though it may need repair or replacement eventually. Infection or mechanical problems happen in a small number of cases and can be treated, sometimes by removing and later replacing the device. Your specialist team will explain the risks for your particular situation, and they will support you through recovery.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.