Deciding together with your physician whether a malleable penile prosthesis or inflatable penile prosthesis is the best option is essential to support safe, case-appropriate recovery of erectile function.
Penile implants are established devices for managing erectile dysfunction and sexual satisfaction, whether a malleable penile prosthesis or an inflatable penile prosthesis.
Men who struggle to achieve or maintain an erection at the crucial moment may need an implant in severe cases, which can occur at different stages of life.
Keep reading to learn whether you might need a penile prosthesis and, if so, how to make the important decision between a malleable penile prosthesis or inflatable penile prosthesis.
Pros and cons of the malleable penile prosthesis
The malleable penile prosthesis is made of flexible metallic rods covered with silicone. These features provide malleability while preventing complete penile flaccidity. Learn more about this clinical indication:
Pros of the malleable prosthesis
- Can be easily positioned manually to the erect position;
- Being a single, durable piece, it has a lower chance of mechanical failures over time;
- Treatment cost may be covered by public health systems and is often reimbursed by insurance.
Cons of the malleable prosthesis
- Keeps the penis elongated or semi-rigid at all times;
- Volume may need to be concealed with snug underwear for greater discretion.
Pros and cons of the inflatable penile prosthesis
The inflatable penile prosthesis gives the patient control over erection. It contains a pump and a reservoir with saline solution that fills the cylinders when activated. However, it is a more delicate device that requires additional care for durability. See below:
Pros of the inflatable prosthesis
- Allows inflating and deflating the penis when desired;
- Offers a natural and discreet appearance, as deflation leaves the penis close to a flaccid state.
Cons of the inflatable prosthesis
- Typically shorter durability due to risk of hydraulic failure;
- In case of leakage or malfunction, reoperation may be required;
- Patients must learn proper inflation/deflation to use and preserve the implant.
Which penile implant is best?
Both the malleable penile prosthesis and the inflatable penile prosthesis are used to manage erectile dysfunction, aiming to provide sufficient rigidity for sexual activity.
Each model has advantages and disadvantages depending on the patient’s anatomy and the financial resources available for the procedure.
Two Turkish specialists—Dr. Ege Şerefoğlu, Editor-in-Chief of the International Journal of Impotence Research, and Dr. Ahmet Albayrak, a reference in urologic and penile aesthetics surgery—concur with Dr. Paulo Egydio: the best prosthesis is the one most appropriate for each case.
Selection criteria
The personalized choice between a malleable penile prosthesis or inflatable penile prosthesis requires careful analysis of clinical, functional, and personal factors, always with urologist guidance.
Patient profile
A malleable prosthesis is often indicated for men with limited manual dexterity and for patients with longer life expectancy, as it is less prone to mechanical failure.
An inflatable prosthesis suits patients seeking the most natural appearance, with no tissue restrictions for cylinder expansion, and for those with shorter life expectancy.
Implant cost
Malleable prostheses, especially national models, are generally more affordable and may be covered by health plans or public systems. Inflatable prostheses can be considerably more expensive and often require additional investment.
Penile anatomy
In cases of extensive fibrosis or when the penis is anatomically long and thin, a malleable prosthesis may be preferable to provide rigidity across different sexual positions.
Health conditions
Patients with comorbidities such as diabetes, obesity, spinal cord injury, or neurological diseases may favor the malleable option due to lower surgical complexity and reduced failure risk.
The inflatable model requires more complex handling for activation, which may be challenging for those with physical limitations.
Medical counseling
Choosing the prosthesis should be done with a urologist, who can clarify questions, align expectations, and explain risks and benefits of each model.
Preoperative assessment is essential to consider each patient’s anatomical and functional aspects.
The physician may also discuss potential impacts on self-esteem and relationships, helping maintain realistic expectations about outcomes.
What to expect after penile prosthesis implantation?
After implantation, the main goal is functional recovery, seeking the penile rigidity necessary for sexual intercourse, depending on clinical conditions.
In most cases, sensitivity, orgasm, and ejaculation are maintained (if the prostate is present).
From an aesthetic standpoint, anatomy and prosthesis model determine the postoperative appearance. Note: in both models, cylinders occupy the corpora cavernosa and do not enlarge penile size.
Some patients report improved confidence and well-being in intimate relationships, but results vary according to clinical profile and individual expectations.
Extra tips for making the right decision
To choose between a malleable penile prosthesis or inflatable penile prosthesis, arrive prepared for your consultation and consider questions such as:
- Which model fits my anatomy best?
- Are there contraindications in my case?
- What is recovery and adaptation like?
- What is the average durability? Will it need replacement?
- What is the risk of mechanical failure?
- Is the prosthesis covered by my insurance?
- What are the total estimated costs for each implant?
- What are the risks and success rates for this model?
- What will sexual activity be like with this prosthesis?
These questions help clarify practical doubts and align expectations with reality.
Patients may also involve their partner in the decision-making process to share concerns and perspectives, which can support postoperative adaptation.
Dr. Paulo Egydio supports you throughout the process
Dr. Paulo Egydio has broad experience in penile prosthesis surgery and managing erectile dysfunction, with a career consolidated over more than two decades.
With a friendly and objective approach, the physician performs an individualized assessment—from history taking to penile examinations—to recommend the most appropriate prosthesis among models and brands he knows and trusts.
The patient can take the necessary time to make a well-informed decision that best aligns with expectations.
Book your consultation
For a specialized evaluation of erectile dysfunction treatment options, contact Dr. Paulo Egydio. The consultation helps assess indications for implantation and clarify questions for a safe, informed decision.
Read more:
Types of inflatable penile prosthesis: choose the right model
Penile prosthesis price: current values
Erectile dysfunction and penile prosthesis: FAQs and treatments
