An implant offers a reliable route to erection when conservative treatments for erectile dysfunction have not helped. The surgical prosthesis sits inside the penis and creates rigidity by mechanical means rather than by natural blood expansion.
There are two main designs. Inflatable models use a small pump in the scrotum that moves fluid into cylinders, so firmness and timing are under user control. Malleable rods are bendable silicone devices that hold shape without pumping.
The guide focuses on day-to-day function, what surgery involves and what recovery usually looks like. It explains how the device affects shape, sensation and sexual activity, and it sets realistic expectations: restoration of function, not increased size.
Readers in the UK will find clear, medically accurate information on candidacy, likely outcomes, and common concerns such as safety and perceived length changes. The aim is to help people make informed choices with practical detail and calm language.
Key Takeaways
- Purpose: restores reliable erections when other options fail.
- Types: inflatable and malleable systems work differently.
- Function: mechanical rigidity replaces natural tumescence.
- Expectations: improves activity, not size; results vary by health.
- Considerations: surgery, recovery time and risks should be discussed with a clinician.
Understanding erectile dysfunction and when an implant becomes a treatment option
Many men reach a point where tablets and suction devices no longer deliver reliable results. Erectile dysfunction means persistent difficulty getting or keeping an erection firm enough for sex. For some, this remains true even when oral drugs or a vacuum pump are used correctly.
Conservative options can fail for several reasons. Poor arterial flow, nerve injury, scarring or fibrosis and post-surgical changes — for example after prostate surgery — may stop standard therapies working. Complex health problems can also interfere with success.
- Refractory dysfunction means failure of appropriate doses, timing and technique with medications or a pump.
- An implant becomes a treatment choice when the person wants a predictable, long-term solution and is fit for a surgical procedure.
- Peyronie disease can cause curvature and scarring that limits intercourse and contributes to erectile problems.
Other indications include deformity, traumatic injury, priapism-related damage and reconstructive pathways after gender surgery. Decision-making is collaborative, weighing goals, relationships and what the person sees as a successful sexual outcome. For further options and clinical context see effective treatment options.
What is a penile implant
Contemporary options provide dependable shaft firmness by replacing erectile tissue that no longer works. Patients will see the same treatment called a penile implant, penis implant or penile prosthesis in NHS and clinic literature. All refer to devices placed inside the corpora cavernosa to produce rigidity for intercourse.
Penile implant vs penile prosthesis: what the device is designed to do
The main aim is simple: create reliable rigidity so the person can have penetrative sex even when the body cannot produce a natural erection. The device does this by inflating cylinders or by holding bendable rods inside the shaft.
It does not guarantee extra length beyond the person’s anatomy. Nor does it restore spontaneous, body-driven erections without using the device. Skin sensation and orgasm usually remain, but these topics are covered later.
| Feature | Inflatable system | Malleable (rod) system |
|---|---|---|
| How it works | Pump moves fluid to cylinders for erection | Silicone rods positioned manually for firmness |
| User control | On-demand inflation and deflation | Simple bend-and-position use |
| Surgical placement | Cylinders in corpora cavernosa; pump in scrotum | Rods replace erectile tissue inside the shaft |
| Suitability | Preferred for those wanting a more natural flaccid state | Considered for simpler mechanics and fewer moving parts |
Types of penile implants available today
Options today focus on how the device behaves day-to-day — inflation, concealment or fixed support.
Inflatable systems: cylinders, pump and reservoir
An inflatable penile implant usually contains two cylinders placed inside the corpora. A small scrotal pump moves fluid into those cylinders to create rigidity.
The reservoir holds the fluid under the lower abdominal muscles. When deflated, fluid returns to the reservoir so the shaft appears softer.
Two-piece versus three-piece inflatable designs
Two-piece systems combine pump and reservoir functions, while three-piece models keep the reservoir separate. The three-piece model often gives a more natural flaccid state and firmer rigidity when filled.
Malleable (non-inflatable) rods explained
Malleable implants use two flexible silicone rods. The user positions the penis manually for intercourse; the rods keep a constant firmness when in place.
How surgeons select the right size for the body
Surgeons measure internal shaft length and choose the largest safe size for the individual anatomy. Correct sizing reduces risk of buckling, migration or poor cosmetic result.
| Feature | Inflatable (three-piece) | Malleable rods |
|---|---|---|
| Main components | Two cylinders, scrotal pump, separate reservoir | Two bendable silicone rods in corpora |
| Day-to-day look | More natural flaccid state when deflated | Constant semi-rigid posture; easier to conceal under clothing |
| User action | Operate pump to transfer fluid from reservoir to cylinders | Position penis manually for intercourse |
| Suitability factors | Good for those wanting adjustable rigidity and concealment | Better for limited dexterity or previous scarring |
- Trade-offs: inflatable systems favour concealment and adjustability; malleable rods favour simplicity.
- Choice depends on health, prior surgery, manual dexterity and personal preference.
How penile implant surgery works from consultation to operating theatre
“The journey from clinic to theatre begins with careful assessment and frank discussion of realistic outcomes.” The clinic visit covers medical checks, imaging if needed and choice of device. Consent, lifestyle planning and time off work are agreed up front.
Pre-operative assessment and realistic expectations about length
Clinicians measure internal shaft length and explain why perceived penis length can change after the procedure. The aim is reliable function rather than enlargement.
What happens during the procedure
During surgery, the surgeon has two hollow chambers to work with. Cylinders placed sit inside the corpora cavernosa to provide even rigidity along the shaft.
Where components sit in the body
In inflatable systems the pump sits under the loose skin of the scrotum between the testicles. Tubing connects the pump to a reservoir usually tucked beneath the lower abdominal muscles.
| Component | Typical position |
|---|---|
| Cylinders placed | Corpora cavernosa (shaft) |
| Pump | Scrotum (subcutaneous) |
| Reservoir | Under lower abdominal muscles |
Longevity and revision
Many devices last around 20 years, though results vary. If wear or malfunction occurs, revision or replacement surgery restores function. Practical aftercare planning helps recovery and reduces risks.
How to use a penile implant to get an erection
Most users learn a simple routine to produce and end an erection with their device. Training usually happens during follow-up so the person gains confidence and avoids common mistakes.
Inflating with the scrotal pump
To inflate, the user presses the pump under the scrotal skin. Each squeeze transfers fluid from the reservoir into the shaft cylinders until the desired firmness is reached.
Do not press the testicles hard. The pump sits between them and is designed for safe handling. The erection can be kept for as long as wanted, even after orgasm.
Deflating and returning fluid to the reservoir
To deflate, the user depresses the valve on the pump. That action lets fluid flow back into the fluid reservoir beneath the lower abdomen and restores a more flaccid state.
Using malleable rods for sex
Malleable systems work differently. The person simply positions the rods up for sex and bends them down afterwards for comfort and concealment.
Hardness does not change with these rods, so timing and positioning are the main actions needed.
“The device gives reliable control; most find the learning curve short with hands-on guidance.”
- Key points: pump operation, valve deflation and rod positioning.
- Clinicians teach safe technique and timing to reduce anxiety and improve outcomes.
| Action | Inflatable devices | Malleable rods |
|---|---|---|
| Create erection | Squeeze scrotal pump to move fluid from reservoir to cylinders | Manually position rods upward for intercourse |
| Maintain erection | Remain inflated until valve pressed; can last any chosen time | Firmness constant; maintained by rod position |
| Return to flaccid | Press valve to return fluid to reservoir | Bend rods down for everyday comfort |
Recovery, aftercare and timeline back to sexual activity
Recovery after the operation follows a predictable timeline, but individual healing rates vary. Early guidance helps men plan time off and arrange support at home.
First one to two weeks: pain, swelling and skin sensitivity
In the first one to two weeks most people notice soreness and bruising around the wound. Pain is usually worst in days three to seven and then eases.
Swelling and heightened skin sensitivity are common. Gentle cleansing and dressings protect the surgical site while tissues settle.
Aftercare, early limits and why they matter
Aftercare aims to protect healing tissues, cut infection risk and keep the implant in the correct position. Avoid heavy lifting, strenuous exercise and swimming until cleared.
- Do: follow wound care instructions and rest when advised.
- Don’t: strain or lift for several weeks to reduce the risk of internal movement.
Device learning curve, follow‑up and when sex is usually possible again
Follow‑up appointments teach pump use and deflation technique. Operating the pump may feel unfamiliar at first; practice under supervision builds confidence.
Many clinicians allow sexual activity around the six weeks milestone, though surgeon advice and individual healing determine exact timing. Comfort and confidence grow with time.
“Seek prompt advice if pain worsens, fever develops or skin redness increases.”
Results and what sex feels like with an implant
Most people say intercourse feels the same or better after full healing. The main clinical gain is dependable erection and reduced unpredictability compared with tablets or injections.
Does it feel natural for patient and partner?
Firmness is mechanical, but skin warmth and touch usually remain unchanged. Partners often cannot tell the difference during sex once the person has adapted to using the device.
Orgasms, ejaculation and sensation
Orgasm and ejaculation pathways are generally preserved. The device alters rigidity rather than nerve‑driven sensation, so climax and penile skin feeling often stay the same.
Size, appearance and the soft glans
The glans typically does not become hard because cylinders sit in the shaft, not the head. This can change perceived length and size even when function improves.
Clinicians may suggest medication to boost blood flow to the glans if that helps cosmetic or functional concerns.
Satisfaction rates and common unmet expectations
Satisfaction rates are high, commonly reported around 80–90%+. Dissatisfaction usually follows perceived reduced length or girth, unmet expectations, or difficulty operating the device.
- Clinical result: reliable rigidity and improved confidence.
- Consideration: discussion before surgery shapes realistic expectations.
- Peyronie disease: devices can aid straightening and restore function in suitable cases.
“Reliable function often brings less anxiety and better sexual wellbeing.”
Risks, complications and safety considerations
Surgery carries predictable benefits but also specific risks that deserve clear explanation. The operation is established, yet the presence of any implant raises surgical and device-related concerns that patients should understand.
Infection and why removal may be needed
Infection after this procedure occurs in about 1–3% of modern series. When bacteria colonise the device surface or surrounding spaces, superficial antibiotics often are not enough.
In many cases removal and thorough cleansing followed by later replacement reduce ongoing infection and limit scarring that can shorten the penis.
Device faults, erosion and tissue injury
Device malfunction (fluid leaks, pump failure or cylinder issues) leads to revision in roughly 6–13% of patients over time. Less commonly, erosion, extrusion or perforation of penile tissue or the urethra can occur, especially after prior surgery or in scarred shafts.
Prompt review matters if there is increasing pain, skin breakdown or a new deformity.
“Individual risk varies with health, smoking, diabetes control and prior pelvic surgery.”
| Complication | Reported rate | Typical action |
|---|---|---|
| Infection | 1–3% | Device removal, washout, delayed replacement |
| Malfunction | 6–13% | Revision or replacement surgery |
| Erosion / tissue injury | Less common | Assess, possible repair or device removal |
Informed consent should balance high satisfaction and restored function against the chance of future procedures. Surgeons assess individual risk factors and explain personalised measures to reduce complications.
Conclusion
Conclusion — this closing note pulls together how a penile implant works, the patient journey and likely long-term outcomes.
It is a permanent surgical treatment for erectile dysfunction when medications and pumps fail. Inflatable models use cylinders, a scrotal pump and a reservoir. Malleable systems use bendable rods and simple manual positioning.
Expect dependable function rather than increased size or extra length. The typical path runs from consultation and surgery to weeks‑to‑months of recovery and supervised training before returning to sexual activity.
Devices often last many years but may need revision. Safety and satisfaction are higher when a urology team matches body, goals and risks, especially with prior surgery, scarring or Peyronie’s disease.
Discuss options carefully with specialists to choose the right device and plan realistic outcomes.
