Penile Prosthesis Placement: understand how the procedure is performed

The placement of the penile prosthesis is carried out with the penis erect, after reconstruction of the organ, to restore rigidity and guarantee support of the glans. Although it does not increase the original size, the procedure can help in the attempt to regain part of the dimensions eventually lost to fibroses or trauma, according to individual assessment.

Men with an indication for penile prosthesis placement usually have several doubts about the procedure — among them, whether the surgery is done with the penis flaccid or erect. This curiosity is natural, but it is essential to seek information in reliable medical sources, such as Dr. Paulo Egydio’s blog. If you want to understand whether the penile implant is performed with the organ flaccid or erect and whether the prosthesis reaches the tip of the penis, keep reading. We will clarify all of this.

Function of the penile prosthesis

The function of the penile prosthesis is to restore vertical rigidity to penises compromised by fibroses caused by Peyronie’s disease or by injuries resulting from falls and accidents. Is penile prosthesis placement done with the organ flaccid or erect? Penile implant surgery is performed with the penis erect, and this procedure takes place after reconstruction. That order must be respected, because only with reconstruction to recover the penis dimensions is it possible to determine the size and diameter of the prosthesis, avoiding drooping of the glans. The importance of implanting the prosthesis after penile reconstruction is so great that Dr. Paulo addressed it in 2022 during the European Association of Urology Congress.

Does the prosthesis reach the tip of the penis?

Yes, the penile prosthesis goes all the way to the tip of the penis. The reason is that the corpus cavernosum— the internal structure responsible for rigidity—extends to the base of the glans. For that reason, the prosthesis must be placed to the end of the corpus cavernosum to stabilize the glans and prevent it from drooping.

Does the penile prosthesis increase penis size?

One of the main questions about penile surgery is whether the implant changes the size of the penis. In reality, the penile prosthesis does not enlarge the penis; its function is to restore rigidity to the organ. What happens in many cases is that the penis is already reduced in size, usually due to fibroses caused by Peyronie’s disease or by trauma from vigorous sexual intercourse, sports activities, or accidents. The penile implant surgery aims to make it possible to recover, totally or partially, the original dimensions, but the result depends on factors such as the extent of the fibroses, individual anatomy, and the technique adopted. To achieve this result, it is essential that the reconstruction stage be completed before the prosthesis is placed. Only then does the urologist select the most suitable model for the case and perform the positioning.

What is the nerve limit during penile prosthesis placement?

The so-called “nerve limit” represents the maximum point where it is possible to operate safely during surgery without compromising penile sensitivity. The nerves and blood vessels responsible for glans sensitivity run along the entire length of the penis and, during prosthesis placement, these structures are carefully isolated and preserved. This is one of the fundamental steps in surgical preparation. With the nerves and vessels protected, the surgeon makes incisions in the tunica albuginea—the region where the fibroses that cause shortening and penile deformities are located. These cuts aim to expand the penile tissue, always respecting the safe limit within which the nerves can accompany the lengthening without being damaged. Read more: Malleable Penile Prosthesis: Does the Penis Stay Hard All the Time? See more details about the nerve limit in the video below.

Complete your pre-analysis with Dr. Paulo Egydio, penile prosthesis specialist

If you still have questions, you can fill out our pre-analysis form. Dr. Paulo Egydio has more than 25 years of experience in penile reconstructive surgery and can clarify your questions in accordance with current medical guidelines.