Unlike what many men imagine, sex with a penile prosthesis can preserve important aspects of intimacy, although the way an erection is achieved becomes different. Understand what erections are like after the implant and the special day-to-day care that can help with adaptation to sexual life after the procedure.
After all, what is sex like with a penile prosthesis? This is a very common question among men who face problems related to erectile function, since this surgery brings significant changes to penile function and directly affects sexual life.
A penile prosthesis may be a therapeutic alternative for men with erectile dysfunction in selected situations, with the potential to restore the penile rigidity needed for sexual intercourse after individualized medical evaluation.
But will the experience of having sex after surgery be the same as before? What changes in sex after a surgical procedure like this?
Keep reading below and see the main information about sex with a penile prosthesis.
What changes in sex with a penile prosthesis?
The use of a penile prosthesis, in many cases, does not prevent sexual activity, but it changes the way the erection occurs. With the implant, the erection no longer depends exclusively on sexual stimulation.
Patients with a prosthesis may achieve an erection in a controlled way, through activation of the device, which may provide adequate rigidity for sexual intercourse, depending on the case and on adaptation to the device.
Another characteristic of the device is the possibility of greater control over how long the erection is maintained. Even after ejaculation, the penis may remain erect until the man deactivates or deflates the prosthesis.
This predictability and control are often considered valuable by many patients.
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First time having sex with a penile prosthesis: what to expect?
To adapt better to the implant, the patient needs to do something very important, which happens gradually: train the mind.
For a good first time with a penile prosthesis, and for all sexual activity, the man needs to be erotically stimulated. That is why caresses and foreplay are welcome. This may also favor greater comfort, involvement, and sexual response during intercourse.
Remember that lubrication is essential. The couple needs to be well lubricated or use a lubricant so that penetration can happen more smoothly and comfortably, especially during the initial adaptation period.
After all, what is eroticization?
Eroticization is the process by which stimuli — such as images, sounds, smells, touch, or situations — become sexually arousing.
For many people, arousal is linked to the ability to have an erection. However, in men with a penile prosthesis, the erection no longer depends exclusively on these stimuli, since it can be controlled through the device.
This may bring more predictability and control over the erection, which may favor the couple’s sexual adaptation.
Even so, eroticization remains important during intercourse because it increases penile sensitivity and involvement in the intimate moment.
In this way, the sensation of pleasure may be preserved — and may even be intensified, and some men report improved confidence and self-esteem after the procedure.
In this way, the sensation of pleasure may be maintained, varying according to physical, emotional, and relational factors.
Remember: although a penile prosthesis reduces the exclusive dependence on eroticization to obtain an erection, it is still important to cultivate a healthy and satisfying sex life. This may include exploring different forms of intimacy and sexual pleasure.
Read also: Male sexual health: 6 tips for better performance in bed
What is an erection like with a penile prosthesis?
With a penile prosthesis, the erection occurs differently from a natural erection. Instead of depending on blood flow, it is produced by a mechanical mechanism.
Most devices are made up of cylinders implanted in the corpora cavernosa, which are filled with fluid through a pump positioned in the scrotum.
When activated, the system may provide penile rigidity compatible with sexual intercourse.
Although the sensation may differ from a natural erection, some patients report satisfactory adaptation to sexual life after the procedure.
Even so, eroticization remains important because it increases libido and contributes to sensitivity and pleasure during intercourse.
Ejaculation with a penile prosthesis
With a penile prosthesis, ejaculation is usually preserved, since the device does not act directly on this process, because it is controlled by the nervous system.
The prosthesis is designed to restore the erection without affecting the production or release of semen during climax.
Thus, in many cases, the implant does not prevent ejaculation from being maintained.
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It is important to remember that ejaculation and orgasm are different processes. Orgasm is the brain response associated with pleasure, while ejaculation is the release of semen through the urethra.
With a penile prosthesis, ejaculation is usually preserved. Orgasm, in many cases, may also be preserved, because it depends on neurological and brain mechanisms that are not directly replaced by the prosthesis.
What is it like to live with a penile prosthesis implant?
Living with a penile prosthesis implant may bring important changes, especially for men with persistent erectile dysfunction.
One possible impact reported by some patients is improved confidence and self-esteem. The prosthesis provides greater control over erectile function, allowing an erection to be achieved in a predictable way without depending on temporary solutions.
As a result, the man regains the rigidity needed for penetration, which may favor greater confidence during sexual intercourse.
In many cases, this predictability may facilitate adaptation to sexual life after the procedure.
Choosing the right prosthesis
The most appropriate type of penile prosthesis depends on the patient’s anatomy and overall health conditions.
Below, learn about the main types of penile prosthesis and how each one adapts to different needs:
Malleable penile prosthesis
The malleable penile prosthesis is made up of metal rods covered with silicone, flexible and implanted inside the penis, keeping it in a semi-rigid state.
This allows the penis to be manually positioned upward during intercourse and downward when not in use.
In practice, adaptation to sexual life varies according to the type of prosthesis, anatomy, and the patient’s perception. At the time of intercourse, simply adjusting the position makes penetration possible.
This is a common option for men with erectile dysfunction, including cases associated with Peyronie’s disease.
Inflatable penile prosthesis
The inflatable penile prosthesis, as the name suggests, is made up of cylinders inserted into the corpora cavernosa, a pump implanted in the scrotum, and a fluid reservoir in the body.
When the pump is activated, the fluid is transferred to the cylinders, promoting the erection.
After sexual intercourse, simply press the device again so that the penis returns to a flaccid state.
Read more: Understand how the inflatable penile prosthesis works
Articulating penile prosthesis
Finally, the articulating prosthesis is a variant of the inflatable prosthesis that has a flexible joint in the middle of the penis. This allows the penis to be bent upward or downward, providing greater flexibility and comfort during use.
When should a man use a penile prosthesis?
Penile prosthesis implants are indicated for men who face significant challenges related to erectile function and who have not been successful with other treatments.
Some situations in which the procedure may be considered include:
- Loss of firmness: difficulty obtaining or maintaining an erection suitable for sexual intercourse.
- Difficulty with penetration: inability to achieve penetration due to erectile dysfunction.
- Failure of other treatments: when medications or other approaches do not present satisfactory results or cause side effects.
In these cases, a penile prosthesis may be considered a therapeutic alternative for selected cases of erectile dysfunction.
How is penile prosthesis implantation performed?
The surgical procedure may vary according to the patient’s anatomy, the severity of the case, and the type of prosthesis chosen. However, it generally follows these steps:
- Preparation: cleaning and sterilization of the genital area, in addition to anesthesia to ensure patient comfort
- Access to the area: making an incision, usually subcoronal (below the glans), to access the inside of the penis
- Tissue preparation: careful dissection of the tissues to create space for the prosthesis
- Implantation: insertion of the device into the corpora cavernosa, preserving the structures
- Fixation: positioning and stabilization of the prosthesis with absorbable surgical sutures
- Completion: after placement of the prosthesis, the incisions are carefully closed with surgical sutures, and a dressing is applied to the operated area to promote healing.
Recovery from penile prosthesis surgery usually takes around 60 days, but it may vary depending on each patient’s progress.
In the first five days, closer medical follow-up and some rest are necessary.
The patient must follow instructions regarding dressing changes and hygiene, and showering is usually allowed. The sutures are absorbed by the body.
Throughout the first month, if recovery is satisfactory, the patient may resume daily activities, such as working and doing light exercise.
Between 45 and 60 days, sexual activity is usually allowed.
Complete healing may take longer, and its evolution varies according to each patient’s characteristics.
Read more: Learn what recovery from penile prosthesis surgery is like
What are the best positions for sex with a penile prosthesis?
Regarding sexual positions, there are generally no specific restrictions after recovery, as long as the patient follows individualized medical guidance. After recovery and with proper guidance, the couple may gradually resume intimacy.
If the couple experiences any initial difficulty, positions in which the man has more control — such as being on top — may be more comfortable until more confidence is gained.
Regardless of the type of prosthesis, some precautions during intercourse are important; many of them, in fact, should already have been part of the routine before surgery.
This includes using appropriate lubricants, preferably water-based, to facilitate penetration and masturbation, in addition to reducing the risk of irritation.
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Recommendations for sex with a penile prosthesis
A penile prosthesis may have a positive impact on quality of life and self-esteem in some patients. Check out some important recommendations:
Keep an open dialogue with your partner
Talk honestly about the sexual experience before, during, and after intercourse. This communication is essential so that both partners feel comfortable and safe.
During the first experiences after surgery, dialogue becomes even more important, since the couple will be adapting to how the device works.
Related: Have you started dating and feel embarrassed to talk about the penile prosthesis?
Talk to your doctor
During the postoperative period, it is essential to maintain medical follow-up and follow all instructions until clearance is given to resume sexual life.
The urologist may also provide guidance on the use of the prosthesis, helping the patient in the process of adapting to the device in daily life.
A penile prosthesis is a therapeutic alternative for men with erectile dysfunction in selected situations.
Sexual health is an important part of overall well-being, and medical evaluation may be indicated when there are complaints or doubts.
In cases of erectile dysfunction or doubts about the procedure, evaluation with a specialist may help define the most appropriate approach.
Schedule your appointment with Dr. Paulo Egydio, who has extensive experience with penile implants and curvature correction surgeries, and may guide you in the recovery of self-esteem and quality of life.
