Penile implants for erection problems

Penile implants (or penile prostheses) involve the placement of a permanent device, which give a man the ability to have an erection. These devices are implanted through a surgical procedure, and have been available since the early 1970s.

How penile prostheses differ

Inflatable (also called hydraulic implants) typically include the use of an internal pump system, saltwater, inflatable plastic cylinders, and a chamber (or reservoir) to hold the saltwater. Depending upon the model of the implant, it might include two or three pieces. When a man desires an erection, he squeezes an internal pump that is usually hidden inside his scrotum. The saltwater fills the cylinders, which inflates the penis. After intercourse, the man “deflates” the erection either by pressing a valve, which is connected to the pump, or bending the penis. The saltwater is then released back into the reservoir. While three-piece implants have larger reservoirs (which may aid in the strength of an erection), when not in use, it has been reported that the penis may appear to be more fuller than normal.

Semi-rigid implants generally include a type of metal or plastic rod that is implanted, which causes the penis to hang at an angle, so that it is close to being fully erect. However, the penis can be bent, so that it can be concealed under clothing.

Rigid implants use the same type of materials as semi-rigid implants, but the penis is permanently hard and erect, so it is not as discreet.

Other factors

While inflatable implants may be more complicated to implant, they seem to have gained in popularity because they allow a man to control when he wants (or does not want) an erection.

All three types of implants may erode over time, and there is the possibility that an inflatable device may stop working correctly. Cornell University reports that about 15% of men needed re-operation (over a 10-year period), which means that 85% of men still had their original implant after 10 years.

Cornell University also reports that the chance of post-operative infection may be low. But if infection does occur, the device may need to be removed, which can lead to scarring or shorten the length of a man’s penis. If this occurs, a man may not be able to get another implant.

What penile prostheses do not do

Penile implants do not lengthen the size of a man’s penis. And while they may make it easier for a man to have intercourse if he has erection problems following prostate cancer treatment, they generally do not increase a man’s desire to have sex.

It is important to discuss the pros and cons of the different penile implants with your loved one’s doctor. It is also important to carefully discuss your expectations before you make a decision.

Updated 10/11

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Bostwick DG, Crawford DE, Higano CS, Roach M, eds. American Cancer Society’s Complete Guide to Prostate Cancer. Atlanta, GA: American Cancer Society Health Promotions; 2005.

Cornell University. Penile Implants. Accessed December 6, 2008.

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