Penile Prosthesis (Penile Implant) Surgery

Penile Implant Surgery (Penile Prosthesis) — also known as the “penile implant” or “happiness rod” procedure — should always be carefully evaluated by a urology specialist, taking into consideration the patient’s age, expectations, underlying health conditions causing erectile dysfunction, and overall medical status.

When Is a Penile Prosthesis Recommended?

Penile prosthesis surgery can be considered for patients with severe erectile dysfunction, especially when regenerative treatments (such as shockwave therapy or stem cell applications) are unlikely to succeed. With appropriate patient selection, success rates and partner satisfaction can exceed 90%.

For patients with mild to moderate erectile dysfunction, ESWT (shockwave therapy) or SVF (stem cell therapy) often yield successful results. However, in older men or those with advanced erectile dysfunction who do not respond to these treatments, penile prosthesis surgery may be a suitable and effective option.

Types of Penile Prostheses

• Inflatable Penile Prostheses:This is the most commonly preferred type today. The three-piece inflatable model includes two hollow cylinders placed inside the penis, a fluid reservoir positioned in the lower abdomen, and a special pump placed in the scrotum. When the pump is pressed, the fluid from the reservoir fills the cylinders, producing an erection. These prostheses provide a natural look, allow manual control of erection, and are undetectable under clothing.
• Malleable (Bendable) Penile Prostheses:Made of medical-grade silicone, these prostheses remain semi-rigid at all times. Before intercourse, they can be straightened easily, and afterward, they can be bent down for concealment. While simple to use and mechanically reliable, they remain constantly firm, which increases the chance of being noticed externally.

The best choice depends on the patient’s age, manual dexterity, expectations, and anatomical structure. Inflatable prostheses have become more popular due to their natural feel and advanced technology, though they may rarely experience mechanical failure. Malleable models, on the other hand, are simpler and durable but may appear more noticeable under clothing.

How Is Penile Prosthesis Surgery Performed?

• The procedure is done under general or spinal anesthesia.
• Duration: approximately 30–60 minutes.
• A small incision is made either at the penoscrotal junction (where the penis meets the scrotum) or at the penopubic area.
• Depending on the type of prosthesis, the implant components are placed in the penis, scrotum, and occasionally the abdominal wall.
• Most patients are discharged the day after surgery.

Recovery After Penile Prosthesis Surgery

• Full recovery takes about 6–8 weeks, after which sexual activity can resume.
• Antibiotic medication prescribed by the urologist should be taken regularly.
• Avoid heavy exercise and activities that raise blood pressure during recovery.
• Smoking cessation is crucial to support tissue healing.
• For diabetic patients, blood sugar levels must be kept under excellent control after surgery.
• Before resuming sexual activity, the prosthesis must be checked by the urologist.

Final Notes

Penile prostheses do not affect sexual desire, orgasm, or fertility. They enable men with severe erectile dysfunction—and their partners—to regain a satisfying sexual life.

However, it’s important to note that penile implant surgery should be considered the last resort in erectile dysfunction treatment. Modern andrology now offers numerous non-surgical regenerative treatments with successful outcomes. The key is to recognize sexual dysfunction early and proceed with an appropriate, personalized treatment plan.