Penile prosthesis surgery is indicated for men who have already sought other alternatives but still cannot achieve a quality erection. Discover the essential care before and after this erectile-dysfunction treatment.
Erectile dysfunction is a condition that affects the ability to achieve or maintain an erection rigid enough for penetration. When clinical treatments do not deliver the expected results, implanting a penile prosthesis can be considered a surgical alternative when other therapies have not been satisfactory.
The prosthesis is a device surgically implanted in the corpora cavernosa of the penis. It is a well-established treatment, yet it still causes concern among patients—after all, it is penile surgery.
To better understand the procedure and assess whether it is the most suitable option for your case, see below the pathway to regain your sexual life, including all pre- and postoperative care.
Indications and contraindications for penile implants
The indication for a penile prosthesis applies to men with erectile dysfunction who do not obtain satisfactory improvement with clinical treatments such as sildenafil, tadalafil or injections.
These are usually older patients who present conditions such as hormonal imbalance, diabetes, penile fibrosis or who have undergone pelvic surgery such as prostatectomy.
Although considered safe, the procedure has contraindications. Men who are not in good health, who have severe clotting disorders, uncontrolled chronic diseases or psychological conditions that hinder adherence to treatment are generally not candidates.
The surgery is also not recommended for those seeking aesthetic changes, such as penile enlargement, because the goal of the procedure is to treat erectile dysfunction.
Only after a complete analysis of the case can it be determined whether the patient should undergo this surgery.
Which penile implant is most recommended for surgery?
With two implant types available, it is necessary to evaluate which is most appropriate for each case—always with the help of a physician. Check the advantages and disadvantages of each model:
| Criterion | Malleable prosthesis | Inflatable prosthesis |
| Surgery cost | More affordable | More expensive |
| Durability | High | Medium-low |
| Ease of use | Simpler | Requires learning to activate the pump |
| Natural appearance | Constant semi-rigid state (less discreet) | Controlled erection (more natural look) |
| Limitations | May cause discomfort in daily situations | Requires hand dexterity and strength |
| Risks | Higher risk of penile erosion | Higher risk of hydraulic system failure |
Evaluation and pre-operative stage
Seeking a urologist for a detailed evaluation of erectile dysfunction is fundamental. The physician will perform tests that help identify the best treatment. Most of the time, the tests performed include:
- Penis measurement
- Palpation
- Drug-induced erection
- Rigidity test
- Penile Doppler
The Doppler is particularly important in surgical cases to assess blood flow within the penis and detect fibrosis that may be hindering erection.
With all tests completed, it is time to discuss the best prosthesis model. Factors considered include patient preference, lifestyle, existing medical condition and costs.
In addition, the study of penile anatomy is taken into account, considering anatomical factors that influence implant performance.
With the surgical strategy and prosthesis choice defined, the procedure date is scheduled.
This surgery does not require extensive preparation. As with any operation, blood and urine tests and a cardiology evaluation are needed to prevent complications.
The patient is instructed to clean the pubic area with antibacterial soap for two days before surgery and to take prophylactic medication.
An eight-hour fast of both solid and liquid foods is required before the operation.
The surgery takes 2 or 3 hours and usually does not require an overnight hospital stay.
How penile prosthesis surgery is performed
First, the patient receives a sedative for light sleep. Next, the physician shaves the pubic hair in the operating room.
Then, the surgical procedure begins based on the appropriate techniques for the case, according to clinical and surgical findings.
If tests have indicated the presence of fibrosis, it is treated before placing the prosthesis, by expanding penile tissue. In some cases, micro-cuts in the tunica albuginea are made to correct curvature and adapt the space for the implant, as evaluated intraoperatively.
The prosthesis cylinders are introduced after the reconstruction step.
The malleable prosthesis is inserted at once, from the base of the penis to the tip of the glans. The inflatable prosthesis is placed deflated; the surgeon must test it and check for expansion restrictions before finishing.
During the procedure, neurovascular structures are preserved as much as possible to maintain penile sensitivity, always respecting technical and anatomical limits.
Post-operative period
Post-operative care for a penile implant is not complicated, but it must be followed correctly to avoid complications.
On the same day, the patient returns to the physician. The surgery is evaluated and instructions are given so that healing and adaptation to the device occur in the best possible way.
In addition to dressing care, some rest is required in the first few days. The post-operative recovery time is 7 to 10 days for return to work if it does not require physical effort; after 30 days physical activities can resume and sexual activity can usually resume between 45 and 60 days, depending on each patient’s healing.
Patients with an inflatable prosthesis return after 28 days for follow-up and training on its proper use.
The sutures on the penis are absorbable, so there is no need to remove them. During recovery, it is very important to watch for signs of complications from penile prosthesis surgery, which require prompt medical attention. Main signs include:
- Hematomas
- Bleeding
- Implant infection
- Penile pain
- Prosthesis extrusion
Patient and partner adaptation
Recovery after implantation also involves an emotional adjustment process for the patient and within relationships.
Psychological support in the postoperative period can help the patient and partner deal with the psychological impact of the implant, regain self-esteem and overcome unrealistic expectations.
Partner support is crucial to create mutual understanding and strengthen the affective bond, which contributes to resuming sexual life.
Expected results and quality-of-life impact after implantation
By placing a penile prosthesis, the surgery aims to restore erectile function in selected cases, which can positively reflect on patients’ quality of life, according to the literature.
Patient testimonials on penile prostheses are supported by several studies:
- In 2022, the journal Sexual Medicine published a study showing that the prosthesis helps restore masculine identity, boost confidence and self-esteem, and reduce depressive symptoms in over 80 % of patients, especially those with Peyronie’s disease.
- A 2019 study in the Journal of Sexual Medicine found that more than 85 % of men reported high sexual satisfaction after implantation, with a positive impact on their partners’ sexual quality of life.
- A publication in the International Journal of Impotence Research (2014) showed improvements in all quality-of-life domains (functional, personal, relational and social), strongly correlating good prosthesis performance with partner well-being.
How much does penile prosthesis surgery cost?
Penile prosthesis surgery can be free in the public health system, but only the malleable prosthesis is offered, and waiting lists are long.
Health-insurance plans may cover part or all of the procedure. Generally, insurers also limit options and provide only the malleable implant included in the national list.
For private or partially self-funded treatments, cost varies according to the prosthesis type. A locally made malleable prosthesis costs about BRL 5,000, while imported models can exceed USD 2,000. Inflatable prostheses, manufactured abroad, average USD 10,000.
Besides the device, factor in other expenses: consultations, surgeon fees, hospitalization, anesthesia and hospital supplies.
Therefore, when deciding on a penile prosthesis, plan your finances in advance to ensure safe and complete treatment through the postoperative period.
What are the alternatives to a penile prosthesis?
The penile implant is generally the last resort for treating erectile dysfunction and usually shows a good patient satisfaction rate because, besides being effective, it is definitive.
If the patient is dissatisfied with the prosthesis, functional reassessment and implant replacement are possible. Following the physician’s guidance is essential for adaptation.
Before surgery is indicated, the urologist will likely recommend medications such as sildenafil and tadalafil or injections applied directly into the penis. The aim of these medications is to induce erection with sexual arousal.
Dr. Paulo Egydio specializes in penile prosthesis implantation
Men who have noticed a lack of penile firmness in most sexual encounters can consult Dr. Paulo Egydio for guidance.
The urologist and andrologist has treated such cases for more than 25 years. He perfected the surgical procedure that allows the introduction of a larger, wider prosthesis, known as the Egydio Technique.
Thousands of implants have been placed in patients worldwide, along with positive reports about resuming sexual life after penile prosthesis.
Start your pre-assessment with urologist Dr. Paulo Egydio
Do not neglect your sexual quality of life. Dr. Paulo Egydio can provide empathetic and discreet care, avoiding embarrassment and offering a perspective of regaining pleasure.
Contact the doctor and begin to change your life. Simply fill out the form to receive a personalized pre-assessment within 24 hours.
Learn more:
- Sexual Health: Egydio Medical Center EMC
- How Not to Fail at the Right Moment? Tips to Avoid Impotence
- When Is a Penile Prosthesis Necessary in Curvature Surgery?
- What Causes Hormonal Disorders in Men? Find Out!
- Penile Prosthesis: Detailed Advantages and Disadvantages
- Penile Prosthesis Rejection: Risks and Cases
- Does prostate removal affect ejaculation? What changes in sexual life
- Penile Prosthesis Maintenance: Do I Need Frequent Replacements?
