Everything You Need to Know About Penile Implants for ED

How they work. The most common type of implant — made of silicone and custom-sized to each man’s anatomy — is inflatable, with two cylinders inside the shaft, a small pump in the scrotum and a fluid reservoir, for saline, placed near the bladder.

Winston says that when you want an erection, you press your finger against a button in the pump in the scrotum, which moves sterile fluid from the reservoir into the cylinders, creating a natural-looking, firm erection within 20 to 30 seconds. After you’ve climaxed, pressing a release valve returns the fluid to the reservoir, and the penis becomes soft again. After healing, Winston says most men barely notice it’s there. “It becomes second nature, like wearing a wedding ring.”

It’s permanent. Winston says that there’s one thing to know up front: It’s there to stay.

Once you have an implant, you will always need one in order to get an erection. Why? During surgery, the tissue that normally fills with blood during an erection is replaced with the implant. Even if the implant is removed, says Winston, you wouldn’t be able to go back to natural erections.

What to expect from surgery. Implant surgery can be done as an outpatient procedure under general anesthesia and usually takes one to two hours, according to Winston. Most men require four to six weeks of recovery time before using the device.

Winston says that insurance, including Medicare and most commercial plans, usually covers the procedure if medically indicated. A penile implant does not make your penis larger.

An older version of the implant is also available. Some men prefer the older version because the surgery is simpler due to the absence of a pump or reservoir (so fewer parts need to be inserted), says urologist Abraham Morgentaler, who has performed more than 2,000 implant surgeries. The older version is made of silicone and metal, creating a permanent, semirigid and bendable penis. These were commonly used before inflatable implants were available or reliable, but today, according to Morgentaler, they’re only used by about 10 percent of patients.

Using the semirigid type is pretty straightforward: When a person wants to have sex, Morgentaler says, he bends it, and when he’s finished, he bends it back into place so that it doesn’t stick out.

Winston says most people prefer the inflatable implant because it provides the most natural-looking and -feeling erection, both when inflated and deflated, allowing for a discreet, normal appearance.  

Risks to know about. Like any surgery, there are potential risks. Winston says the risk of infection is 1 to 3 percent. With an inflatable, there are a few other things to consider: mechanical failures like fluid leakage or a pump malfunction, which may necessitate a replacement; erosion or migration of the device, which is rare; and altered penile sensation, which is uncommon.

Implants can be used in the penis of transgender men, but they are at increased risk of moving out of position or even coming through the skin, says Morgentaler.

Now for the fun part. As Morgentaler, author of The Truth About Men and Sex: Intimate Secrets from the Doctor’s Office, puts it: “The men are always ready to go.”

A penile implant can restore spontaneity with almost instant erections. In contrast, ED meds can take 15 minutes to work on an empty stomach or six hours following a meal, according to Morgentaler, cohost of The Sex Doctors podcast. On top of that, he says, ED meds are only effective in two-thirds of men.

Morgentaler says penile implants can be a confidence booster. “When men lose their ability to have an adequate erection, whether involved with someone or not, they feel smaller,” he notes. “They are diminished. They feel they are not as manly, as virile.” The ability to get hard again can change all that.

Another advantage: The penis stays hard even after a man has had an orgasm. “As a rule, women take longer to have an orgasm, so it works better for women,” he adds. “A bionic penis solves a lot of problems. It’s a little-known secret that’s very effective.”

Winston calls penile implants one of the most successful and satisfying treatments in urology.

“You don’t have to give up on sex, even if you’ve tried everything else,” he says.