The malleable penile prosthesis is a safe and efficient treatment for erectile dysfunction. It offers simple activation and long‑lasting performance, enabling the patient to resume a satisfactory sexual life. Learn more below.
After several negative experiences during intercourse caused by erectile dysfunction and after attempting treatments with oral medication and injections, a man can regain the security he needs for his sexual quality of life with a malleable penile prosthesis.
Unlike other treatment options such as medication or vacuum pumps, implantation of a penile prosthesis provides a permanent solution for men who are unable to obtain or maintain an erection sufficient for satisfactory sexual intercourse.
To understand how the malleable penile prosthesis works and whether it is the appropriate treatment for your case, read below what Dr. Paulo Egydio has to say about it.
What is the malleable or semi‑rigid penile prosthesis?
The malleable or semi‑rigid penile prosthesis is a flexible cylinder inserted into the corpora cavernosa of the penis that can be manipulated and positioned upright for sexual activity.
The malleable prosthesis keeps the patient’s penis elongated. Furthermore, its flexibility allows the organ to be normally placed downward or sideways when not in use, accommodating it inside the underwear with discretion and comfort.
The primary objective of the penile implant is to restore the patient’s ability to have satisfactory sexual relations, thereby improving his quality of life and emotional well‑being.
There are different sizes, models and diameters of penile prosthesis, and the choice of implant must respect the particularities of each patient’s anatomy.
If the penis is shortened and thinned due to internal fibrosis, it may be necessary to place an implant that is smaller and thinner than ideal. Therefore, inserting a prosthesis larger than the patient’s penis will not be possible.
What is the difference between the malleable penile prosthesis and the inflatable prosthesis?
The main difference is that the malleable prosthesis keeps the penis constantly elongated, whereas the inflatable prosthesis allows the user to control the onset and duration of the erection through activation of a pump.
Although both are effective options for treating erectile dysfunction, the malleable penile prosthesis is more practical and reliable because it does not require additional mechanisms to function. The inflatable prosthesis is more sophisticated: to achieve an erection, the man activates the pump, filling the cylinders with saline solution from the reservoir; to return to flaccidity, it is necessary to depressurise the pump.
When is the malleable prosthesis indicated?
The malleable penile prosthesis is indicated for men with severe erectile dysfunction who do not respond satisfactorily to other treatment lines, such as oral medication and penile injections.
The urologist will guide the patient and help him understand whether this model is most suitable for his needs and expectations or whether the inflatable implant is the better option.
Profile of the patient eligible for the malleable prosthesis
In general, indication for the malleable penile prosthesis is quite broad. However, the following profiles may receive greater benefit from this model:
- Patients with a long and thin penis who require greater calibre to achieve sufficient firmness for penetration.
- Patients with longer life expectancy, as there is a lower risk of mechanical failure, although it is also indicated for elderly patients.
There are also contraindications for patients with certain conditions:
- When there are restrictions preventing expansion of the penile cylinder.
- When there is motor restriction or lack of motor dexterity that prevents operation of inflatable devices.
- When the patient is in poor general health.
How does the malleable penile prosthesis work?
The prosthesis acts as an axial rigidity complement, providing resistance for penetration.
The operation of the malleable penile prosthesis is entirely mechanical. Manual manipulation of the penis—inside which there is a silicone cylinder with flexible metal rods—is sufficient.
Day‑to‑day life
The rods keep the penis in a permanent or semi‑rigid erection. Some men prefer to conceal the penis as much as possible; to do so, simply wear tight‑fitting underwear and position the penis near the groin.
It is worth remembering that, regardless of the implant model, your penis will no longer have the same degree of flaccidity as before.
Is the malleable penile prosthesis noticeable under underwear?
The malleable penile prosthesis is not noticeable when wearing briefs, swimming trunks, shorts, or trousers, provided the man chooses tighter underwear.
By wearing boxer briefs, for example, it is possible to keep the penis more restricted, close to the groin, in whichever position the man finds most comfortable (sideways or downward).
Is it possible to detect the malleable penile prosthesis by touch?
In some cases, it is possible to feel the presence of a penile prosthesis by touch, but this generally occurs only in very intimate situations.
Because the penile tissues are not removed for insertion of the prosthesis, the man continues to have the corpora cavernosa filled with blood when aroused, which leaves the penis warmer and more sensitive. Therefore, when touching, both the man and his partner will experience the same sensations. The difference is that the penis will remain erect throughout the intercourse, even after orgasm.
During sexual activity
During sexual activity, the man should position the organ forward or upward in order to carry out masturbation or penetration in the most pleasurable manner.
The erection lasts as long as he wishes, including after orgasm and ejaculation, making it possible to prolong sexual relations.
Advantages of the malleable prosthesis for men
The main advantage that the penile prosthesis offers men is the restoration of erectile function. Erectile dysfunction can have a significant impact on anyone’s self‑confidence and self‑esteem.
With a penile prosthesis, many patients find a safe solution that allows them to regain confidence in their ability to achieve and maintain an erection during satisfactory sexual relations.
Below are additional advantages of the penile prosthesis for men:
- Permanent solution: unlike other treatment options for erectile dysfunction, the penile prosthesis offers a permanent solution. Once implanted, the prosthesis can provide consistent and reliable erections.
- Simplicity of use: the implants are designed to be simple to use and require little effort from the user.
- Improved quality of life: by restoring the ability to have satisfactory sexual relations, the prosthesis can help men feel happier, more confident and more satisfied in all aspects of their lives.
Does the prosthesis present any disadvantages?
Malleable penile implants are excellent for restoring sexual function, but depending on one’s viewpoint, they may present some disadvantages:
- Permanent rigidity: the penis remains in a constant semi‑rigid state, and some men may feel uncomfortable, especially when wearing tight clothing.
- Less natural appearance: because the model does not allow penile flaccidity, compared with the inflatable prosthesis, the appearance of the penis at rest is less natural.
- Higher risk of erosion: in rare cases, the rod exerts more pressure than the tissues can withstand, which may favour this surgical complication, particularly in patients with a history of penile surgeries, poorly controlled diabetes or prolonged catheter use.
How is the malleable implant surgery performed?
The surgery to implant the penile prosthesis is relatively simple compared with other types of urological surgeries:
- Preparation: before surgery, the patient will receive specific instructions from the surgeon on how to prepare. This may include fasting from food and liquids for a certain period and discontinuation of certain medications.
- Anesthesia: prior to surgery, the patient will undergo general or regional anesthesia, depending on the preferences of the surgeon and the patient.
- Incision: the surgeon will make an incision in the penis to access the corpora cavernosa, the spongy tissues responsible for erection. The location and size of the incision may vary depending on the type of penile prosthesis to be implanted.
- Implantation of the prosthesis: once the corpora cavernosa are accessible, the surgeon will implant the penile prosthesis. For malleable prostheses, a flexible rod is inserted into the corpora cavernosa, providing rigidity when bent upward.
- Closure of the incision: after insertion of the prosthesis, the surgeon will close the incision with surgical stitches or absorbable sutures. This will help promote proper healing and prevent infection.
- Recovery: after surgery, the patient will be taken to the recovery room, where he will be closely monitored while recovering from anesthesia. Depending on the type of surgery and the patient’s individual response, full recovery may take weeks, during which postoperative follow‑up with the surgeon will occur.
Implantation of the malleable prosthesis using the Egydio Technique
The implantation of the malleable penile prosthesis using the Egydio Technique is performed after reconstruction of the penis. This technique optimises dimensions, leaving the penile anatomy suitable for achieving good rigidity and penetration.
During surgery, the tunica albuginea is expanded to the nerve limit, which makes it possible to implant cylinders of larger calibre and length, without the use of grafts or extenders.
The choice of the ideal size of the prosthesis is decided during the procedure, according to the limit of tissue optimisation.
How is postoperative adaptation?
In general, adaptation to the semi‑rigid penile prosthesis may take up to six months for some patients.
In the postoperative period, men may feel some pain. Thanks to the anaesthetic block performed for the surgery, this pain is not very intense and, if necessary, analgesics may be prescribed for relief.
Several days after the procedure, the patient returns to the urologist to check how recovery is progressing.
Within 60 days, the patient is cleared to gradually resume activities, including sexual intercourse.
The main change the patient will notice is that the penis will have better vertical firmness. Thus, when he penetrates, there will be low risk of slippage and/or bending.
There is also no danger of developing erectile dysfunction, as the prosthesis guarantees rigidity.
Post‑implantation care and restrictions
After penile prosthesis surgery, it is essential to follow specific care guidelines and observe certain restrictions to ensure smooth and successful recovery.
In the first days after surgery, it is important to rest and avoid physical activities that require great effort. This will aid proper healing of the incision and reduce the risk of complications. Other important care measures after implantation of the penile prosthesis include:
- Keep the area clean and dry at all times, and avoid wetting the region in the initial days until the physician grants permission.
- Avoid sexual activity for several weeks after surgery to allow complete healing of the incision and surrounding tissues.
- The physician should prescribe medication to help control pain and prevent infections after surgery.
- Attend all scheduled appointments with your surgeon to monitor recovery and ensure there are no complications.
- Remain alert to possible signs of complications, such as fever, intense pain, excessive bleeding or problems with prosthesis operation.
Following postoperative care and restrictions is crucial to ensure smooth and successful recovery. Remember that each person is unique and may have individual needs during the recovery process.
Possible surgical complications
Possible surgical complications of the malleable penile prosthesis include:
- Infection at the implant site;
- Risk of erosion;
- Glans droop.
These complications يمكن avoided through measures adopted during surgery, such as use of antibiotic solution and support of the corpora cavernosa and the glans.
Additionally, immediately after surgery the patient may experience temporary complications such as bleeding, bruising or pain.
Men with chronic diseases, such as diabetes, have a higher risk of complications.
Importance of medical follow‑up
After placement of the malleable penile prosthesis, the patient must attend follow‑up appointments with the physician, as this will ensure proper recovery and satisfaction with the procedure.
In the first weeks, the physician assesses healing, identifies possible signs of infection or rejection, and guides the patient regarding adaptation and use of the prosthesis. The physician may also offer guidance on sexual health, relationship quality and maintenance of self‑esteem during this period.
In the long term, the professional also monitors prosthesis durability, manages expectations and assesses any new alterations in penile anatomy.
Patient expectations
Expectation regarding the malleable penile prosthesis must be well oriented to avoid frustration.
It is very common for men to expect not only functional solution but also aesthetic or size improvements. However, it is essential to clarify that the prosthesis is not intended to lengthen or enlarge the penis; its purpose is to restore the rigidity required for penetration.
From a functional standpoint, the malleable penile prosthesis provides vertical firmness to the penis, preventing it from bending during sexual activity. This allows the patient to engage with greater confidence and predictability. There will be no changes in libido, ejaculation, orgasm, temperature or tactile sensation.
The emotional impact can be profound. Upon regaining the ability to maintain sexual relations, many patients report improved self‑esteem and relationships. Psychological support and open dialogue with health professionals and sexual partners are fundamental in this process.
How long does a malleable penile prosthesis last?
No study has yet determined exactly how long a malleable penile prosthesis lasts. Nonetheless, according to research published in the Asian Journal of Andrology, this type of implant is less expensive and has greater durability compared with the inflatable prosthesis.
Schedule your consultation with Dr. Paulo Egydio to regain autoestima and sexual health
Every man searching for treatment options for sexual impotence needs to know that there is a suitable treatment for his case and that it is possible to achieve a fulfilling sexual life again. The malleable penile prosthesis may be the ideal path.
This type of implant requires the recommendation of an experienced urologist who understands the patient. Dr. Paulo Egydio can help. He is an international reference in penile surgery, with thousands of satisfied men worldwide.
With a malleable prosthesis implant, you can regain your confidence, enjoy satisfying sexual relations and strengthen intimacy with your partner. Begin now a positive change in your sexual life. Contact the physician and receive feedback within twenty‑four hours.
Learn more:
- Male Self-Care: Why Is It Important for Health?
- Learn All About Enlarged Prostate: Causes, Diagnosis, and Recommended Treatments
- Does Stress Decrease Libido? Learn How to Identify and Treat It
- What Is Ejaculation? Answers to Your Main Questions
- Consequences of Male Sexual Abstinence and the Problems It Can Cause
- 10 Tips for Penis Care to Maintain Health and Prevent Infections and Diseases
- See What Causes Erectile Dysfunction and Available Treatments
- Prostate Surgery: What to Expect, Risks, and Recovery
- Gut Health and Sexual Function: The Connection
