Knowing exactly what a penile prosthesis is is essential for men who face erectile dysfunction and are looking for treatment. Discover everything about this device.
What is a penile prosthesis? This is one of the main questions asked by men who receive this treatment recommendation, and it must be well understood so the patient does not feel frustrated.
First developed in the 1930s, this device can help a man achieve firmer erections—ideal for penetration—and may also protect the penis against fibrosis. The implant can be a valid alternative for some men, contributing to the rehabilitation of sexual function in selected cases.
Below, learn what a penile prosthesis is, how the implant works, when it is a treatment option, and the potential benefits for male sexual health.
What is a penile prosthesis?
A penile prosthesis (or penile implant) is a device designed to treat functional problems of the penis.
The implant is carefully inserted inside the corpora cavernosa during penile surgery. The purpose is to reinforce the structure and provide vertical firmness so that, during intercourse, partners can reach climax.
What is a penile prosthesis for?
Placing a penile prosthesis is one of the last-line treatment options for severe erectile dysfunction.
When properly indicated, the implant can restore the penile rigidity required for vaginal or anal penetration, depending on the patient’s sexual practice. This resource may help improve sexual function, according to each clinical case.
Types of penile prosthesis
Two types of penile implants are used to treat severe erectile dysfunction: malleable and inflatable.
Although both provide the necessary rigidity, they work differently.
Malleable prosthesis
A malleable prosthesis is made of silicone surrounding metal filaments. This combination allows the penis to bend both for penetration and for resting positions.
In addition to ensuring erection, this type of prosthesis keeps the penis lengthened due to its materials. However, it does not mean the penis stays constantly erect: when positioned toward the groin inside underwear, it looks natural.
Inflatable prosthesis
The inflatable implant has three parts: a saline reservoir, a pump, and paired cylinders. When the pump is activated, saline fills the cylinders, making the penis erect. When the pump is not activated, the penis looks flaccid.
Although versatile, this type of prosthesis is delicate and subject to mechanical failure. In some cases, a second operation is needed to replace the device.
When is the implant indicated?
The penile prosthesis is indicated for men who face severe erectile dysfunction. That is, patients who did not achieve satisfactory results with other treatments—such as medications like sildenafil or tadalafil and penile injections.
In these cases, the cause is organic rather than psychological, with deep sequelae affecting penile elasticity and blood flow. Conditions such as Peyronie’s disease, diabetes, cardiovascular problems, and neurological disorders may favor this option.
Thus, implantation can be considered a therapeutic alternative in specific situations, according to careful medical evaluation.
Contra-indications
Although effective, a penile prosthesis may not be the best option for certain patients:
- When erectile dysfunction improves with medication, injections, or therapy
- When the patient’s overall health is fragile
- When the patient has a known rejection to prosthesis materials
- When there is any untreated infection in the genital or urinary region
How does the penile implant work?
The mechanism depends on the chosen model, but both aim to allow the man to control erection, achieving rigidity for penetration.
It is also important to emphasize that the implant does not increase penile size. The procedure aims to restore erectile capacity, and the final size with the prosthesis depends on the patient’s original anatomy and the condition of local tissues and nerves.
Which implant to choose?
Choosing a penile prosthesis depends on factors such as penile anatomy and overall health.
In general, the malleable implant is more suitable for penises with extensive fibrosis, because inflatable models may have filling restrictions.
It is also necessary to consider whether the patient has reduced manual dexterity or strength, since operating an inflatable prosthesis requires hand pressure. In addition, men with longer life expectancy may prefer models with greater durability.
After discussing these points with the urologist, the patient’s preference is respected.
How is penile prosthesis surgery performed?
The surgery to implant a penile prosthesis begins with a detailed assessment by a urologist.
If the patient receives surgical indication, some pre-op care is needed, such as proper local hygiene and preventive antibiotics.
On the day of surgery—lasting two to three hours—the patient receives light sedation. The surgeon makes an incision, treats fibrosis (if present), and dilates the cavernosal tissue. Next, the cylinders are positioned while preserving the corpora cavernosa.
For inflatable devices, it is essential to inflate the prosthesis before surgical closure.
Recovery is generally straightforward but requires post-operative care and follow-up. Rest, hygiene, pain control, and activity restrictions are fundamental for healing.
After about 60 days, most patients can resume their normal life, including sexual activity.
Post-implant expectations
In many cases, the implant aims to restore penetrative functionality, respecting each patient’s anatomical and clinical limits. This means sexual life can improve, provided that indication and post-operative recovery suit the patient’s profile.
Men often report:
- Discreet scar
- Penis without deformities (such as curvature, shortening, or tapering)
- Preserved temperature and sensitivity
- Orgasm and ejaculation unchanged
Restoring sexual function can also positively impact psychological well-being in some cases.
Regain sexual quality of life with Dr Paulo Egydio
Dr Paulo Egydio is a urologist and andrologist with a PhD from USP and fellowships at Mayo Clinic and Cleveland Clinic (USA). He has been treating erectile disorders for 25 years, including cases that may require a penile prosthesis, providing humanized, evidence-based care.
In addition to mastering surgical technique, he listens to patients’ concerns and offers technical guidance to support informed decision-making.
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