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Penile Implants

Medically Reviewed November 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What are Penile Implants?

Penile implants are surgical devices that are inserted into the penis to enable men who have erectile dysfunction (ED) to have an erection. There are different types of penile implant, including bendable rods which are placed on either side of the penis, and inflatable implants. The rods keep the penis firm but flexible while an inflatable device allows the man to control his erections. Penile implant surgery is not usually recommended until other erectile dysfunction treatments, such as oral medications, injections and hormone therapy, have been tried first.

Penile implants are also used in phalloplasty. A phalloplasty is the medical term for the construction, or reconstruction, of a penis. The term also encompasses the artificial modification of the penis via surgery. This procedure is commonly performed on men who have undergone female to male (FTM) gender reassignment and men who have congenital conditions which affect the size, function or growth of the penis, or men who have lost their penis in an accident, trauma or to cancer. The penile implant, which enables erections, is always the final stage of phalloplasty and can only be put in place when you have full feeling in your penis, which may take up to a year.

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Words from our clients:

"I was extremely satisfied with the care and treatment I received at the Cadogan Clinic. My surgeon was friendly and informative and explained the procedure fully. My procedure went very well and with the excellent care of the nursing staff, I made a speedy and full recovery. Would recommend to anyone."

Eva Berry

"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"

Scarlett Elliott

"The girls on the reception at the clinic were very pleasant and professional. The nurse who took out my stitches after my surgery was just lovely and took me through step by step what she was doing and she also recommended a great cream to use to help with healing."

Georgina Nolan

“I was treated with care and provided with thorough knowledge about the procedure I was undertaking. My surgeon was very methodical (a perfectionist) and I felt I received A class treatment."

Courtney O'Sullivan

"Outstanding experience from the first appointment to being discharged. Very professional, friendly and a fantastic outcome."

Gemma Stevenson

"Reception staff very welcoming and efficient. Both nurses who I dealt with were fantastic, and the whole team (anaesthetist, surgeon etc) were friendly but professional, and really put my mind at ease. That I was able to stay later than I perhaps needed after my surgery to fit in with my husbands schedule was greatly appreciated."

Emma Davies

How do Penile Implants work?

Penile implants are devices installed in the penis which allow a man to achieve and maintain an erection for penatrative sex.

When a man becomes sexually aroused, all the muscles in the penis relax, allowing the blood flow to increase into the penile arteries. The blood then fills the two chambers that are inside the penis, called the Corpora Cavernosa. When these chambers fill with blood, the penis becomes rigid and erect. The erection ends when the muscles finally contract, and the blood can flow back out the penile veins.

During penile implant surgery, the surgeon will stretch the tissue in the Corpora Cavernosa that would normally fill with blood during an erection. Then the implant, customized to the measurements of your body, will be put inside the penis. If a two-piece inflatable device is being used, a pump and a valve will be implanted inside the scrotum, while a three-piece device will also include a fluid reservoir above or under the wall of the abdomen.

An inflatable device can be inflated to create an erection and deflated if an erection is not required. A three-piece inflatable device uses a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve inside the scrotum, and two inflatable cylinders placed inside the penis. The saline solution is pumped from the reservoir into the cylinders, causing the penis to become erect. The valve inside the scrotum is then released to drain the fluid back into the reservoir, causing the penis to become flaccid. A two-piece inflatable model works in a similar way, but with this type of penile implant a fluid reservoir is part of the pump implanted in the scrotum.

Bendable or semi rigid penile implants can bend the penis away from the body for sex and back towards the body to conceal it.

The best type of penile implant will be chosen depending on personal preference and medical history. Your surgeon will discuss which option they feel is best for you before going ahead with penile implant surgery.

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Why do people get Penile Implants?

Erectile dysfunction: Also known as impotence, erectile dysfunction is the inability to achieve and/or maintain an erection. An erection is a direct result of increased blood flow into the penis, stimulated by sexual thoughts and arousal, or direct contact with the penis. Men who suffer from erectile dysfunction may struggle to achieve or maintain an erection due to a number of physical or mental conditions or emotional states.

Gender confirmation surgery: If a person has a diagnosis of gender dysphoria (a condition where a person has a strong sense of disassociation between their gender identity and biological sex) then they may undergo FTM gender reassignment surgery. This often includes phalloplasty (the construction of a penis). Penile implants can be used at a later date to enable the new penis to achieve and maintain an erection.

Trauma: Men who have experienced trauma to the penis, caused by burns, road traffic accidents, complications arising from circumcisions or as a result of penile fracture, can have penile implants as part of reconstructive surgery.

Congenital conditions: There are several congenital conditions which may require phalloplasty surgery with penile implants. These include aphallia, when a person is born without a penis, and micropenis, where the penis is abnormally small but normally structured.

What are the different types of Penile Implants?

As mentioned above, there are three different types of penile implants.

Three-piece inflatable

A three-piece inflatable device uses a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve inside the scrotum, and two inflatable cylinders placed inside the penis. When an erection is required, water is pumped into the cylinders and the valve released with the erection is no longer needed.

A three-piece inflatable creates the most natural, rigid erection and gives the penis complete flaccidity once the penile implant has been deflated.

Two-piece inflatable

A two-piece inflatable penile implant works in a similar way to a three-piece, but this time a fluid reservoir is part of the pump implanted in the scrotum. However the two-piece provides less-firm erections than a three-piece and only provides partial flaccidity when deflated.

Semi rigid rod

Bendable rods are implanted into both sides of the penis. These rods keep the penis firm but flexible. They are easy to use, which makes this type of penile implant easy to use for those who may have limited manual dexterity. There is also a lower chance of malfunction compared to the inflatable implants as there are a smaller number of parts involved in semi rigid rods. The downside to semi rigid rods is that it results in a penis that is always slightly rigid, so not always easy to hide under clothing. It puts a constant pressure on the penis, which puts this penile implant at a higher risk of causing injury than inflatable alternatives.

What is the recovery time from Penile Implants?

Penile implant surgery is an invasive surgery and it takes around six weeks to fully recover from this particular procedure.

In the immediate aftermath of surgery, you will need to take prescription painkillers and sometimes an injection will be given to the scrotum to ease pain for 48 to 72 hours. It is normal for mild pain to persist for a number of weeks after surgery. You may also be prescribed antibiotics.

After surgery, you will be given instructions on how to care for the surgical site and how to use your penile implant. In the three to six weeks after surgery you will be advised to inflate and deflate your penile implant to practice using them and stretch the area surrounding the cylinders.

Depending on the type of job you do and the type of implant that you have, you may be able to return to work a few days after your penile implant surgery.

Strenuous physical activity and sexual activity can usually be resumed between four and six weeks post surgery.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

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How long does a penile implant last?

A penile implant lasts between 15 and 20 years, depending on the type of implant you have. After this time, you will need to have your implant replaced if you wish to continue to have erections. However a penile implant can malfunction and break. If this is the case, it may need to be replaced sooner.

Can you get an erection with a penile implant?

Yes, it is possible to get an erection with a penile implant. Penile implants can be used in order for the penis to become erect, allowing penetrative sex to take place. It is worth noting that penile implants cannot increase the size of the penis. In some cases, penile implants may actually lead to a small loss in overall penis length.

What is the average size of a penile implant?

The average length of the cylinders used in penile implants is 17 cm. However penile implants are customized to the measurements of your body to ensure that your penile implant fits as it should. This ensures the best possible result from your penile implant surgery.

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What are the risks?

The most common side effects from hydrocortisone injections is pain or swelling in the joint where the injection was given. This is temporary and usually resolves in one to two days. There may also be some mild bruising at the injection site.

As hydrocortisone shots are injected straight into the joint, the medicine does not travel around your body. However sometimes hydrocortisone may get into your blood and as a result there is a very slim chance you may experience a serious side effect. Potential side effects include: depression, mood changes, infection, deep vein thrombosis (DVT), eyesight changes, diabetes or complications of diabetes, and Cushing’s syndrome. Some of these side effects may happen after a few days while others may not present until months after treatment. These are all very rare side effects.

It is extremely rare to have an allergic reaction (anaphylaxis) to a hydrocortisone shot.

Penile Implants