Penile Implant Surgery for Erectile Dysfunction

Erectile dysfunction (ED) can result from various medical conditions — some minor, others more severe. Sometimes, it can make achieving a natural erection impossible, which might lead men to explore alternative treatments, like erectile dysfunction surgery with a penile implant.

A penile implant presents a permanent solution to erectile function issues. It can help men successfully have sexual intercourse and may support ejaculation, but it’s costly and not without risks. Potential complications can be serious, which is why ED surgery is usually viewed as a last-choice option — not a quick fix.

Curious about erectile dysfunction surgery? We’ll get into how penile implants work, how effective they are and what to consider before scheduling the procedure. We’ll also answer common questions about ED surgery, starting with the most important one.

Erectile dysfunction surgery is a procedure meant to correct erectile function issues, namely, being unable to get or maintain an erection. New procedures for erectile dysfunction are constantly in development, with penis prostheses and inflatable implants among the most common surgical options.

The most popular form of erectile dysfunction surgery involves penile implants, including inflatable devices and rigid erection prosthetics. The other type is called penile revascularization.

Here’s what to know.

What Is a Penile Implant?

A penile implant is a device or prosthetic that’s surgically placed or implanted inside the body. This is a permanent solution to erectile dysfunction that can help men either simulate an erection or always be hard enough for sexual intercourse.

Types of Penile Implants

The two main types of penile implants are inflatable implants and malleable implants.

• Inflatable implant. Inflatable penile implants consist of one or two inflatable cylinders inserted into the penis and a pump unit placed in the scrotum (the sac holding your testes). You inflate the implant by squeezing the pump, which moves fluid from a reservoir into your penis to create an erection hard enough for sex, then deflate it after you finish.

• Malleable implant. Malleable implants (sometimes called non-inflatable implants) provide permanent hardness. With this ED surgery, a surgeon places two semi-rigid rods into incisions made at the base of the penis. Since malleable implants are always firm, they’re more detectable under clothing. But you can bend the rods to help conceal them.

Can You Get Hard With a Penile Implant?

The main purpose of an inflatable penile implant is to allow you to get hard when you want to have sex. With a non-inflatable implant, however, you won’t technically get hard because the prosthetic makes you always hard enough to have sex — mechanically speaking, at least.

Who Are Penile Implants For?

An erectile dysfunction implant might be recommended in cases where injuries or serious health conditions have made erections permanently impossible.

These include:

• Peyronie’s disease (painful erection)

• Prostate cancer

• Radical prostatectomy (surgical removal of the prostate gland)

• Spinal cord injury

• Diabetes

• Traumatic injury to the urethra, head of the penis or another part of the genitals

If you’re healthy, young or just finding out that you may need ED treatment, it’s unlikely that this will be one of the first suggestions offered to you. So definitely talk to your healthcare provider about what remedies might be best.

Will a Penile Implant Make You Bigger?

The types of penile implants used for erectile dysfunction surgery won’t make your penis bigger. There are penis-enlargement implants, but this is a different procedure.

See our guide to penis-enlargement surgery for more info about the types, risks and outcomes.

What Is Microsurgical Penile Revascularization?

Penile revascularization (sometimes called vascular reconstruction) is a surgical procedure that doesn’t implant a device but instead improves the vascular plumbing to the penis, so to speak.

Vascular reconstruction bypasses blocked arteries in the penis by connecting arteries lower in the abdomen instead, ensuring adequate blood flow for an erection. This less-common technique is generally only used when erectile dysfunction is caused by traumatic injury.

Surgery isn’t always necessary for ED caused by vascular issues — in most cases, it’s not. Our blog has tips for improving blood flow to your penis.

How the surgical procedure works depends on the type of implant being used. But both surgeries have a couple of things in common:

• The patient is given a urinary catheter and put under general anesthesia.

• Incisions are made to enter the genital area.

If a malleable implant is being used, it’ll be inserted into the spongy tissue of the penis that normally fills with blood to achieve an erection.

For an inflatable penile prosthesis surgery, the surgeon will insert the inflatable cylinder (or cylinders, depending on the brand) into the spongy tissue of the penis and the pump into the scrotum.

Several factors go into determining the total cost of penis implant surgeries, including the type of surgery for ED you’re getting and whether you have insurance. 

A 2019 study in the journal Urology Practice estimated the cost of penis implants to be somewhere between $10,000 and $20,000 without medical insurance. This would include the device itself, as well as the bill for the surgeon, the hospital or clinic where the surgery is performed, anesthesiology fees and other costs.

Of course, insurance coverage could make the price tag much more tolerable. But unfortunately, ED surgery isn’t always covered by insurance. 

Medicare is the most common insurer for such surgeries, but it’s only for people 65 and older and those with disabilities.

In a study of 127 men seeking commercial (non-Medicare) insurance coverage for their surgery for ED, 48 percent were denied.

Even when covered by Medicare, men must follow specific criteria to get their erection surgery covered. For example, Medicare Part C coverage offered by BlueCross BlueShield says the patient must have a medical condition that directly contributes to their sexual dysfunction. And it’s only covered when other treatments have already been tried (and failed).

Penile implant surgery takes one to two hours, but recovery can be several weeks. 

Studies generally show high satisfaction with most modern types of penile implants. However, these satisfaction rates don’t always capture complications that can arise months or years later.

Risks of Penile Implant Surgery for ED

Complications of erectile dysfunction surgery may include:

• Mechanical failure of the device

• Infection

• Side effects from the healing process like pain and scar tissue

As with nearly all medical treatments, doctors tend to try the least invasive options first. So surgery is often a last resort.

What Penile Implant Surgery Can’t Fix

Erectile dysfunction is defined as the inability to achieve or maintain an erection firm enough for sexual activity. While it’s not unheard of in young men, ED gets more common with age.

The condition has psychological (sometimes relating to depression or anxiety), hormonal, vascular and neurologic causes. It’s also linked to diabetes, high blood pressure, heart disease, obesity and testosterone deficiency.

When you seek treatment for ED, your healthcare provider will probably examine you for these other mental health issues and medical conditions too.

If your erectile function is related to diabetes, for instance, lifestyle changes could be recommended first.

It’s important to keep in mind that although a penile implant can allow you to be hard enough for sexual intercourse, it won’t fix the underlying causes of ED.

Insurance companies often require patients to try other medical treatments before approving erectile dysfunction surgery. Why? Surgery is the most expensive and invasive. 

Alternatives may be effective — and not just at a lower cost to insurers but also at a much lower risk to the patient. 

Lifestyle modifications can be effective enough to restore erectile function. Weight loss, regular exercise, better nutrition and properly managing health conditions can improve sexual function in men suffering from ED.

Erectile dysfunction medications, known as PDE5 inhibitors, are first-line medical treatments for ED.

These prescription drugs include Cialis® (and its generic tadalafil), Viagra® (or generic sildenafil) and Stendra® (avanafil). They work to enhance the effects of nitric oxide to maintain erections.

Hims also has chewable ED meds in the form of hard mints that contain the same active ingredients as these other erectile dysfunction medications.

Going under the knife for any reason should be taken very seriously, and when it comes to ED surgeries, alternatives are available.

Here’s what to keep in mind when considering erectile dysfunction surgery:

• ED surgery usually involves implants. The most common erectile dysfunction surgeries insert either an inflatable implant or a non-inflatable prosthetic.

• It can be expensive. Erectile dysfunction surgery is expensive, potentially upwards of $20,000, and insurance may not cover the cost.

• Recovery can take weeks. While the procedure itself might be done in an hour or two, the recovery process for ED surgery can take weeks.

• Other treatment options are available. This type of surgery is usually a last resort for guys struggling with ED. Your provider might recommend trying lifestyle changes or medication first.

A healthcare professional — like a urologist — can help you determine the best line of treatment based on your medical history and current situation. But they’ll likely suggest trying a PDE5 inhibitor or two before throwing in the towel and looking into surgical options.

Check out our blog to learn more about sexual performance anxiety and the types of therapy that might help with psychological erectile dysfunction.