If you have Peyronie’s disease with erectile dysfunction and penile curvature that hampers your sex life or causes pain, a penile implant could be the best solution. “Generally, placement of a penile prosthesis will fix the erectile function completely, and it can improve, or in some cases fully resolve, the penile curvature,” says Landon Trost, MD, a urologist specializing in Peyronie’s disease in Orem, Utah, and the president-elect of the Sexual Medicine Society of North America . Penile implants have a high success rate and are considered the gold standard for moderate to severe Peyronie’s when other treatments are not working. But they do require surgery, which can be a deeply personal choice to make.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291a7e405f-d65d-43db-abcd-6cccd3047d2f “The decision is certainly a big one,” says Sherita King, MD, the director of sexual medicine and prosthetic urology at Augusta University in Georgia. “A lot of men go through this procedure, and they just have to figure out how bad they want to get back to having penetrative intercourse, and if they’re willing to go through surgery to get there.”
What Is the Surgery Like? Surgery Information The surgery itself typically takes 45 minutes to an hour at a surgery center, hospital, or facility equipped for surgical procedures. You may be able to go home the same day or stay overnight, depending on your and your urologist’s preference. You may have mild pain for a few weeks. Talk to your doctor about when you can return to physical and sexual activity. Typically, this occurs after four to six weeks, but it may vary based on your situation and recovery timeline.e60dc2a1-f33c-4a05-9b50-8e3e8e597629846e12e9-273b-41ce-ab8e-efc3e0316b9b After surgery, you will learn how to use the device and how to feel comfortable with it, Helo says. Ask your doctor about precautions for future procedures, as well.
Benefits of Penile Implants Benefits In addition to helping curvature, an implant can help you have a reliable, adequate erection for sex, and it usually does not impact sensation or orgasm, Asafu-Adjei says. “This can bring confidence and enjoyment back to intimacy,” she says. “The great news is that most men and their partners find sex pleasurable and very fulfilling with the penile implant, with many studies showing a greater than 90 percent satisfaction rate after the procedure.”e60dc2a1-f33c-4a05-9b50-8e3e8e5976298c4ffb41-6a8f-4433-b5de-42742c95bb56 An implant may also reduce or eliminate the need for ongoing medications and injections, which can be cost-effective over time. Helo says that without insurance, costs can be significant (often tens of thousands of dollars), but insurance coverage is common when you are diagnosed with erectile dysfunction. Dr. Trost warns that the operation may not improve or restore length. In fact, after surgery, your erection may be shorter than before.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d106f0d8-b5ca-436b-91af-66581d26ed4f Additional treatment or surgery may be necessary if your penis has extreme curvature, he says.
Risks of Penile Implants Risks Penile implants are considered safe, with low probability of complications. There are some potential risks, however, including: Infection, which occurs in as many as 3 percent of implant recipientse60dc2a1-f33c-4a05-9b50-8e3e8e5976299b31d6ec-0a3f-4739-aa85-1d77c543c853 Mechanical failure over time, which may require replacemente60dc2a1-f33c-4a05-9b50-8e3e8e597629412b8db1-8b60-4b04-b5d4-4430f27c0774 Temporary pain, bruising, or swelling after surgerye60dc2a1-f33c-4a05-9b50-8e3e8e597629779c95ad-0aac-4464-9300-7c54092af666 Erosion, where part of the device presses through the skin or urethra, often related to infection or prolonged pressuree60dc2a1-f33c-4a05-9b50-8e3e8e597629412b8db1-8b60-4b04-b5d4-4430f27c0774 In rare cases, injury to nearby structures such as the urethra, bladder, or bowele60dc2a1-f33c-4a05-9b50-8e3e8e597629aa5c9bb8-0fed-4028-afdc-3e4905bfb6f3
Who Is the Ideal Candidate? Who It’s For Typically, men with Peyronie’s turn to implants when other treatments are not working. Sevann Helo, MD, an assistant professor of urology with the Mayo Clinic College of Medicine and Science in Rochester, Minnesota, describes the ideal candidate as a man who: Cannot get or keep an erection firm enough for sex Has not had success with other treatments, including injection therapies, medications, vacuum and stretching devices Is healthy enough for a minor surgery Has realistic expectations about the results and how implants operate. “The best candidate for a penile implant isn’t the man looking for perfection,” Dr. Helo says. “It’s the man who understands what the implant can realistically deliver and is ready to work with it.” The goal of surgery is not only to reduce curvature but also to create a functionally straight erection without pain.e60dc2a1-f33c-4a05-9b50-8e3e8e597629341b202a-97d0-4a34-8c67-b62e921f6ebb You may be a poor candidate for a penile implant, however, if you have Peyronie’s and a condition or factor that affects wound healing and increases your infection risk after surgery, says Denise Asafu-Adjei, MD, MPH , the director of men’s health and male reproductive medicine at the University of Chicago. These may include: Being immunocompromised Obesity Smoking Poorly controlled diabetes Mental health issuese60dc2a1-f33c-4a05-9b50-8e3e8e59762993020d4f-5f89-4af2-98f9-63d67fac1e05 Urinary problemse60dc2a1-f33c-4a05-9b50-8e3e8e59762984680347-2199-45e9-a545-57c606581160 “Penile changes associated with inserting penile implants can be permanent, so patients should understand these implications,” Dr. Asafu-Adjei says.
What Types of Penile Implants Are Available? Implant Types There are two main types of penile implants: inflatable and semirigid devices.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c3d76b-ef7a-48b3-a019-3ae688ed0a2f Inflatable Devices This is the most common type of penile implant. Saline solution is pumped from a reservoir implanted in or near the scrotum into inflatable cylinders inside the penis to achieve an erection. After sex, you release a valve in the scrotum to drain fluid from the cylinders. Two versions of the inflatable device exist: a two-piece one that has a combined reservoir and pump plus the cylinders and a three-piece mechanism that has a reservoir separate from the pump plus the cylinders.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c3d76b-ef7a-48b3-a019-3ae688ed0a2f Three-piece implants are more common and provide maximum flaccidity when not in use, strong rigidity during an erection, and a natural feel.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bdd3fa1a-7fba-4b40-8674-be2622f0ff5b Implant types may have subtle differences, based on their brand.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a7fa9136-b521-42cd-8e3f-748f1d7a7144 “So it’s worth discussing the options with your surgeon to determine which is the best fit for you,” Helo says. Semirigid Devices This type of implant remains firm. But you bend the rod away from the body for sexual activity and toward the body when not in use.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c3d76b-ef7a-48b3-a019-3ae688ed0a2f “Inflatable devices are generally preferred because they look and feel more natural,” Helo says.
The Takeaway Penile implants are a surgical option that can help treat Peyronie’s disease when other treatments have not shown results. The goal of a penile implant is to allow you to have an erection, and it also may reduce painful curvature. The most common implants are inflatable devices, and semirigid, adjustable rods also are available. Not everyone is a good candidate for a penile implant, and the surgery to insert it can have risks in some cases. Ask your doctor if it’s the right option for you and what your recovery timeline might look like.
Questions to Ask Your Doctor Do I need any treatments before the implant procedure to correct curvature? Will I need additional procedures to correct the curvature? Am I a good candidate for an implant? Which type of implant is best for me? What results should I expect? What are the risks in my specific case? How many of these surgeries have you performed?
What Are Major Concerns Men May Have? Concerns Here are some common questions people with Peyronie’s disease have about implants. Will it feel natural? “I think many men have misconceptions that they will not be able to have normal sensation or orgasm, that the devices will be easily visible to others, and that the act of sexual intercourse will feel very mechanical,” says Trost. “These are not accurate for the majority of men.” Dr. King notes that if you could ejaculate before the procedure, you will continue to be able to do so after the operation. Will my partner be able to tell? Generally, implants are designed so partners do not feel any major differences during sex but may be able to feel the device if you are not erect. Implants can remain rigid for as long as needed, which can eliminate much of the anxiety and pressure regarding intercourse. “Men who have partners often come in with them to wade through all the details of the procedure and how the device works,” King says. “By coming in person, partners can have a clearer picture of what to expect with the implant.” Will it stop working? “Modern implants are very reliable,” Helo says, “but just like your car, parts can break down over time. Many last 10–15 years or longer, though some men may eventually need a replacement.” About 11 percent of men need another operation after five years, and about 16 percent need one at 10 years.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a331938d-fcd9-49cc-9bb4-c2abbba6f5db
Resources We Trust Mayo Clinic: Penile ImplantsCleveland Clinic: Peyronie’s DiseaseMichigan Medicine: The Truth About Penile Implants UCLA Health: Penile ImplantsYale School of Medicine: Treatment of Peyronie’s Disease
What Is the Surgery Like? Surgery Information The surgery itself typically takes 45 minutes to an hour at a surgery center, hospital, or facility equipped for surgical procedures. You may be able to go home the same day or stay overnight, depending on your and your urologist’s preference. You may have mild pain for a few weeks. Talk to your doctor about when you can return to physical and sexual activity. Typically, this occurs after four to six weeks, but it may vary based on your situation and recovery timeline.e60dc2a1-f33c-4a05-9b50-8e3e8e597629846e12e9-273b-41ce-ab8e-efc3e0316b9b After surgery, you will learn how to use the device and how to feel comfortable with it, Helo says. Ask your doctor about precautions for future procedures, as well.
Benefits of Penile Implants Benefits In addition to helping curvature, an implant can help you have a reliable, adequate erection for sex, and it usually does not impact sensation or orgasm, Asafu-Adjei says. “This can bring confidence and enjoyment back to intimacy,” she says. “The great news is that most men and their partners find sex pleasurable and very fulfilling with the penile implant, with many studies showing a greater than 90 percent satisfaction rate after the procedure.”e60dc2a1-f33c-4a05-9b50-8e3e8e5976298c4ffb41-6a8f-4433-b5de-42742c95bb56 An implant may also reduce or eliminate the need for ongoing medications and injections, which can be cost-effective over time. Helo says that without insurance, costs can be significant (often tens of thousands of dollars), but insurance coverage is common when you are diagnosed with erectile dysfunction. Dr. Trost warns that the operation may not improve or restore length. In fact, after surgery, your erection may be shorter than before.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d106f0d8-b5ca-436b-91af-66581d26ed4f Additional treatment or surgery may be necessary if your penis has extreme curvature, he says.
Risks of Penile Implants Risks Penile implants are considered safe, with low probability of complications. There are some potential risks, however, including: Infection, which occurs in as many as 3 percent of implant recipientse60dc2a1-f33c-4a05-9b50-8e3e8e5976299b31d6ec-0a3f-4739-aa85-1d77c543c853 Mechanical failure over time, which may require replacemente60dc2a1-f33c-4a05-9b50-8e3e8e597629412b8db1-8b60-4b04-b5d4-4430f27c0774 Temporary pain, bruising, or swelling after surgerye60dc2a1-f33c-4a05-9b50-8e3e8e597629779c95ad-0aac-4464-9300-7c54092af666 Erosion, where part of the device presses through the skin or urethra, often related to infection or prolonged pressuree60dc2a1-f33c-4a05-9b50-8e3e8e597629412b8db1-8b60-4b04-b5d4-4430f27c0774 In rare cases, injury to nearby structures such as the urethra, bladder, or bowele60dc2a1-f33c-4a05-9b50-8e3e8e597629aa5c9bb8-0fed-4028-afdc-3e4905bfb6f3
Who Is the Ideal Candidate? Who It’s For Typically, men with Peyronie’s turn to implants when other treatments are not working. Sevann Helo, MD, an assistant professor of urology with the Mayo Clinic College of Medicine and Science in Rochester, Minnesota, describes the ideal candidate as a man who: Cannot get or keep an erection firm enough for sex Has not had success with other treatments, including injection therapies, medications, vacuum and stretching devices Is healthy enough for a minor surgery Has realistic expectations about the results and how implants operate. “The best candidate for a penile implant isn’t the man looking for perfection,” Dr. Helo says. “It’s the man who understands what the implant can realistically deliver and is ready to work with it.” The goal of surgery is not only to reduce curvature but also to create a functionally straight erection without pain.e60dc2a1-f33c-4a05-9b50-8e3e8e597629341b202a-97d0-4a34-8c67-b62e921f6ebb You may be a poor candidate for a penile implant, however, if you have Peyronie’s and a condition or factor that affects wound healing and increases your infection risk after surgery, says Denise Asafu-Adjei, MD, MPH , the director of men’s health and male reproductive medicine at the University of Chicago. These may include: Being immunocompromised Obesity Smoking Poorly controlled diabetes Mental health issuese60dc2a1-f33c-4a05-9b50-8e3e8e59762993020d4f-5f89-4af2-98f9-63d67fac1e05 Urinary problemse60dc2a1-f33c-4a05-9b50-8e3e8e59762984680347-2199-45e9-a545-57c606581160 “Penile changes associated with inserting penile implants can be permanent, so patients should understand these implications,” Dr. Asafu-Adjei says.
What Types of Penile Implants Are Available? Implant Types There are two main types of penile implants: inflatable and semirigid devices.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c3d76b-ef7a-48b3-a019-3ae688ed0a2f Inflatable Devices This is the most common type of penile implant. Saline solution is pumped from a reservoir implanted in or near the scrotum into inflatable cylinders inside the penis to achieve an erection. After sex, you release a valve in the scrotum to drain fluid from the cylinders. Two versions of the inflatable device exist: a two-piece one that has a combined reservoir and pump plus the cylinders and a three-piece mechanism that has a reservoir separate from the pump plus the cylinders.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c3d76b-ef7a-48b3-a019-3ae688ed0a2f Three-piece implants are more common and provide maximum flaccidity when not in use, strong rigidity during an erection, and a natural feel.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bdd3fa1a-7fba-4b40-8674-be2622f0ff5b Implant types may have subtle differences, based on their brand.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a7fa9136-b521-42cd-8e3f-748f1d7a7144 “So it’s worth discussing the options with your surgeon to determine which is the best fit for you,” Helo says. Semirigid Devices This type of implant remains firm. But you bend the rod away from the body for sexual activity and toward the body when not in use.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2c3d76b-ef7a-48b3-a019-3ae688ed0a2f “Inflatable devices are generally preferred because they look and feel more natural,” Helo says.
The Takeaway Penile implants are a surgical option that can help treat Peyronie’s disease when other treatments have not shown results. The goal of a penile implant is to allow you to have an erection, and it also may reduce painful curvature. The most common implants are inflatable devices, and semirigid, adjustable rods also are available. Not everyone is a good candidate for a penile implant, and the surgery to insert it can have risks in some cases. Ask your doctor if it’s the right option for you and what your recovery timeline might look like.
Questions to Ask Your Doctor Do I need any treatments before the implant procedure to correct curvature? Will I need additional procedures to correct the curvature? Am I a good candidate for an implant? Which type of implant is best for me? What results should I expect? What are the risks in my specific case? How many of these surgeries have you performed?
What Are Major Concerns Men May Have? Concerns Here are some common questions people with Peyronie’s disease have about implants. Will it feel natural? “I think many men have misconceptions that they will not be able to have normal sensation or orgasm, that the devices will be easily visible to others, and that the act of sexual intercourse will feel very mechanical,” says Trost. “These are not accurate for the majority of men.” Dr. King notes that if you could ejaculate before the procedure, you will continue to be able to do so after the operation. Will my partner be able to tell? Generally, implants are designed so partners do not feel any major differences during sex but may be able to feel the device if you are not erect. Implants can remain rigid for as long as needed, which can eliminate much of the anxiety and pressure regarding intercourse. “Men who have partners often come in with them to wade through all the details of the procedure and how the device works,” King says. “By coming in person, partners can have a clearer picture of what to expect with the implant.” Will it stop working? “Modern implants are very reliable,” Helo says, “but just like your car, parts can break down over time. Many last 10–15 years or longer, though some men may eventually need a replacement.” About 11 percent of men need another operation after five years, and about 16 percent need one at 10 years.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a331938d-fcd9-49cc-9bb4-c2abbba6f5db
Resources We Trust Mayo Clinic: Penile ImplantsCleveland Clinic: Peyronie’s DiseaseMichigan Medicine: The Truth About Penile Implants UCLA Health: Penile ImplantsYale School of Medicine: Treatment of Peyronie’s Disease
