Individualized Evaluation
Medical history, examination, current medications, cardiovascular factors, and selected tests.
Erectile dysfunction is a persistent or recurring difficulty achieving or maintaining an erection sufficient for sexual activity. In severe cases, firmness may be greatly reduced or absent, and the impact on sexual life tends to be greater.
Severe describes the intensity and impact of symptoms. Refractory describes an insufficient response after proper evaluation and genuine treatment attempts, with appropriate guidance, dosage, technique, timing, and sexual stimulation.
Vascular, metabolic, hormonal, neurological, medication-related, and emotional factors may coexist.
The initial dose, inappropriate timing, lack of stimulation, or poor adherence may resemble treatment failure.
Medications, injections, a vacuum device, and psychosexual support may be discussed depending on the case.
Medical history, examination, current medications, cardiovascular factors, and selected tests.
PDE5 inhibitors may be considered when there are no contraindications and guidance on proper use is provided.
Alternatives that require an appropriate indication, training, adaptation, and discussion of risks and limitations.
It may be discussed when other options fail, are not tolerated, are unsuitable, or when the patient expresses an informed preference.
A penile implant is a device surgically placed within the erectile chambers of the penis to provide sufficient mechanical firmness for sexual activity. All components remain inside the body.
After implantation, firmness depends on the device. Removal without replacement generally does not restore the previous natural erection, so alternatives, risks, recovery, and expectations must be discussed before surgery.
There are malleable and inflatable implants. The choice considers anatomy, erectile function, fibrosis, previous surgeries, manual dexterity, daily routine, and informed preference.
The main goal of an implant is to provide more predictable mechanical firmness. It addresses firmness but does not replace every aspect of desire, pleasure, and sexual response.
The device provides sufficient firmness for penetration through its operation.
The response no longer depends directly on the immediate effects of medications or injections.
When fibrosis or curvature is present, surgery may include selected reconstructive maneuvers.
The indication does not depend solely on the severity of erectile dysfunction. It considers treatment response, health conditions, anatomy, the ability to operate the device, and an informed decision.
When oral medications, intracavernosal injections, or other options do not provide sufficient firmness despite proper guidance and use.
When other approaches cause unwanted effects, have contraindications, or do not meet the patient’s needs following medical counseling.
In selected cases, the implant addresses firmness, and surgical planning may include additional strategies for deformities that make intercourse difficult.
All three designs share the same primary goal: providing firmness. They differ in their mechanism, internal components, the state of the penis outside intercourse, and how they are operated.
The penis remains consistently firm. The rods are positioned for intercourse or placed against the body at other times.
Combines cylinders and a scrotal pump without a separate abdominal reservoir. The system is activated and deactivated manually.
Fluid moves from the reservoir into the cylinders when the pump is activated. After intercourse, the system is deactivated to allow greater flaccidity.
| Feature | Malleable | Two-Piece Inflatable | Three-Piece Inflatable |
|---|---|---|---|
| Components | Flexible rods. | Cylinders, pump, and integrated reservoir. | Cylinders, pump, and separate reservoir. |
| How It Provides Firmness | Remains firm and is positioned manually. | Inflated and deflated using the pump. | Inflated and deflated using the pump. |
| Outside Intercourse | Manually positioned against the body. | Allows firmness to be reduced after deactivation. | Provides greater flaccidity when deactivated. |
| Operation | Does not use a pump. | Requires operation of the scrotal pump. | Requires operation of the scrotal pump. |
The names below are internationally documented examples presented solely to organize device types. Inclusion does not constitute a ranking, recommendation, confirmation of availability, or confirmation of regulatory approval in Brazil.
Examples of documented product lines:
Examples of documented product lines:
Examples of documented product lines:
Examples of documented product lines:
The Egydio Institute is not affiliated with the brands mentioned on this page and does not universally recommend any one brand. The names appear solely to explain which designs and product lines exist.
Dr. Paulo Egydio’s clinical experience guides the assessment of the type, dimensions, and characteristics best suited to each patient’s anatomy, clinical condition, fibrosis, previous surgeries, manual dexterity, and goals.
The decision also considers available evidence, regulatory status and availability in Brazil, hospital protocols and resources, benefits, limitations, risks, and the patient’s informed preference. The recommendation is individualized and does not constitute a commercial endorsement of a manufacturer or product line.
Learn about the differences between models and which points should be discussed before choosing a device. The videos are educational and do not replace evaluation or informed consent.
No single model is best for everyone. A malleable implant has a simpler mechanism and fewer components. An inflatable implant allows control over firmness and provides greater flaccidity when deactivated. The choice depends on clinical conditions, anatomy, ease of operation, and the patient’s preferences.
The components are implanted internally. How noticeable bulk or firmness is under clothing varies with the model, anatomy, and positioning. An inflatable implant tends to provide greater flaccidity when deactivated; a malleable implant remains firm and is positioned manually.
Its primary function is to provide firmness, not to enlarge the penis. The device is selected according to the available anatomy. When fibrosis, curvature, or shortening is present, reconstructive maneuvers and their limitations may be discussed, without promising restoration of size.
The implant addresses firmness. It is not intended to create or restore desire, sensation, orgasm, or ejaculation. These functions depend on conditions present before surgery and other factors that must be evaluated to align expectations.
Yes. As with any implantable device, wear, mechanical failure, infection, or another complication may require revision, replacement, or removal. Durability and risk vary with the model, clinical condition, surgery, use, and follow-up.
No. Manufacturers and product lines have different designs, dimensions, and characteristics. The choice depends on compatibility with the anatomy, clinical conditions, regulatory status and availability, the hospital, the team’s experience, and the patient’s informed preference.
The preliminary assessment gathers information about erectile function, treatments already tried, the presence of fibrosis or curvature, and the patient’s expectations. It helps guide the next contact but does not confirm a surgical indication or select a brand or model.
This page brings together recommendations from urological guidelines, institutional materials, and official manufacturer documentation solely to classify device types and product lines.
Medical Review: Dr. Paulo Henrique Egydio — CRM-SP 67.482 · RQE 19514.
Institution: Egydio Institute.
Last Updated: September 2026.
Educational content. It does not replace an appointment, examination, informed consent, or an individualized treatment recommendation. Brands, product lines, and regulatory status should be confirmed before surgery.
