Should I consider a penile implant to treat erectile dysfunction?

As a urologist, I perform a wide range of services for my patients, from routine checkups to lifesaving surgeries.

But some of the most moving moments I have are when my patients come to me in relieved tears because I’ve helped restore something that’s important to their quality of life: physical intimacy.

Erectile dysfunction (ED), which affects millions of people of varying ages, can be a reason couples can’t engage in the physical intimacy they wish they could. Fortunately, there are many ways we can treat ED.

Most people suffering from ED first get help from pills, such as sildenafil (Viagra) or tadalafil (Cialis). But if that doesn’t work, another option available is a penile implant.

What is a penile implant?

A penile implant is a device that can restore erections for patients. The most common version is a three-piece model:

• Two cylinders that are surgically inserted into the penis via an incision that’s a couple of inches long
• A pump inserted in the scrotum
• A reservoir of saline fluid implanted in the abdomen

To create an erection, a person would press repeatedly on the pump, which sends the saline fluid from the reservoir in the abdomen to fill the two balloon-like structures in the penis. The pump also has a release valve to deflate the cylinders when finished.

Who usually gets a penile implant?

Any patient who has tried at least one other treatment for ED can get a penile implant. Conventional practice at one time had been to treat penile implant as a method of last resort, and many patients still treat it as one due to its invasiveness, but there is no requirement that someone be unresponsive to all other treatments before moving forward with an implant.

Most of my patients who receive implants are middle-aged and older, when ED tends to be more prevalent. But ED can affect people at any age, and this option is available to anyone who needs it.

What happens during a penile implant surgery?

A penile implant surgery is performed as an outpatient procedure and usually takes two to three hours. The surgeries can be performed at most of The Ohio State University Wexner Medical Center’s outpatient centers.

Patients are under full anesthesia, and because we are operating on such a sensitive part of the body, recovery can take a while. You’ll be sent home with antibiotics and pain medications, and we recommend you take one to two weeks off work.

Once you’ve received your implant, we suggest you inflate and deflate it at least once a day to ensure it’s working properly, but avoid sexual activity for the first six weeks after surgery.

What are some of the benefits of a penile implant?

Penile implants restore patients’ ability to get and maintain an erection. Partners of those who have received a penile implant typically report that they can’t tell the difference in sexual experience because of the implant.

About 95% of those who receive penile implants are satisfied, and the implants are durable. Roughly 80% of those that have been implanted are functional more than 10 years later. You can get a replacement if one stops working.

With rare exceptions, the procedure is covered by insurance.

Are there drawbacks to penile implants?

The primary complaint I hear from penile implant patients is that the procedure does shorten the penis slightly compared to an erection before erectile dysfunction. But, as I tell my patients, it’s better to have a Chevy truck that runs than a Ferrari that sits in the garage.

As mentioned above, the device can eventually wear out or fail. There is also a very small (1% or so) risk of infection. In those cases, the device must be removed.

Why should I get my penile implant at the Ohio State Wexner Medical Center?

As an institution, we do about 100 penile implants a year. I’ve been doing this procedure my entire career, and the Ohio State Wexner Medical Center is designated as a Center for Excellence in it because of our high volume.

We’re also the only local provider to use the latest iteration of the penile implant, which features a better mechanical design and a pump that’s easier to press. That can be important for people who might struggle because of arthritis or tremors.