Penile prosthesis (implant)
A penile prosthesis is a device placed inside the penis during surgery so you can have a firm erection whenever you want one. The most common type is a three-piece inflatable implant controlled by a small pump hidden in the scrotum.
Also called Penile implant, Inflatable penile prosthesis, IPP, Three-piece implant, Malleable penile implant, Semi-rigid rod implant, AMS 700, Titan implant
- Where
- Hospital operating room or outpatient surgery center
- Anesthesia
- General or spinal anesthesia
- Time in the room
- About 1 to 2 hours
- Hospital stay
- Same day or one night
- Going home with
- A urinary catheter during surgery, usually removed before you go home or the next morning; some surgeons leave a small scrotal drain overnight
- Back to normal
- About 2 to 3 weeks for daily life; the implant is first used about 4 to 6 weeks after surgery
- Back to work
- About 1 week for desk work; 4 to 6 weeks for heavy lifting
Overview
Erectile dysfunction (ED) means trouble getting or keeping an erection firm enough for sex. It is very common and has many causes, including diabetes, blood vessel disease, and treatment for prostate cancer. A penile prosthesis is a medical device placed inside the penis that lets you make an erection on demand. The American Urological Association advises that men with ED be told about all treatment options, including an implant, and choose together with their doctor. You do not have to try every other treatment first.
The most common type is the three-piece inflatable implant. Two soft cylinders sit inside the erectile chambers of the penis. A small pump sits in the scrotum, between the testicles, and a fluid reservoir sits out of sight behind the lower belly wall. Squeezing the pump moves fluid into the cylinders and the penis becomes firm. Pressing a release button sends the fluid back and the penis softens. The other main type, the malleable implant, uses two bendable rods: the penis is always firm, and you bend it up for sex and down for daily life.
In studies, men with implants report some of the highest satisfaction of any ED treatment, and most partners are satisfied too. The implant is completely hidden. No one can see it, and in daily life most people cannot tell it is there.
There are trade-offs to understand. An implant is permanent: placing it changes the spongy erectile tissue, so natural erections and ED pills or injections usually no longer work well afterward. It does not make the penis longer than your natural erections were. Infection is uncommon but serious, and mechanical parts can wear out over many years.
The parts of your body involved
Inside the penis are two long, spongy chambers side by side, called the corpora cavernosa. During a natural erection they fill with blood. Each chamber is wrapped in a tough, stretchy sleeve called the tunica albuginea. Underneath them runs a third, smaller chamber, the corpus spongiosum, which surrounds the urethra (the tube that carries urine and semen) and widens into the head of the penis. An implant's cylinders go inside the two erectile chambers. The pump goes in the loose skin of the scrotum, and the reservoir goes into the space behind the lower belly wall, next to the bladder.
- Erectile chambers (corpora cavernosa)
Two spongy tubes that fill with blood in a natural erection. The implant cylinders sit inside them.
- Tunica albuginea
The tough sleeve around each erectile chamber. Small openings in it let the surgeon place the cylinders, and stitches close it.
- Spongy chamber and urethra
The corpus spongiosum surrounds the urine tube and forms the head of the penis. The implant does not go here, so the head does not become firm.
- Head of the penis (glans)
Keeps its normal feeling after an implant. It stays softer than the shaft during an implant erection.
- Scrotum
The pouch of skin that holds the testicles. The implant pump sits here where you can reach it.
- The space behind the lower belly wall
A natural space between the pubic bone and the bladder (or a pocket under the belly muscles) where the reservoir sits.
Why it’s done
Men choose an implant when other treatments do not give them reliable erections, cause side effects, or do not fit their lives. Many say what they want most is to stop planning sex around a pill, an injection or a pump device.
- Pills do not work or cause side effects
Pills such as sildenafil and tadalafil need working nerves and blood flow. After prostate surgery, radiation or long-standing diabetes, they may not be enough.
- Injections are not a good fit
Injections into the penis work for many men, but some find them painful, hard to do, or get scarring or prolonged erections from them.
- Erectile dysfunction after cancer treatment
Implants are a common, reliable option after prostate, bladder or rectal cancer treatment when erections have not come back.
- Peyronie's disease with weak erections
When curvature and ED occur together, an implant treats both. The surgeon can straighten the penis around the cylinders during the same operation.
- Spontaneity and reliability
Once you are healed, the implant can be inflated in under a minute and stays firm as long as you want, without timing medicines.
- Scarred erectile tissue
After severe priapism or removal of an infected implant, scarring can make other treatments useless. An implant can restore function and help keep length.
Other options
- ED pills
Sildenafil, tadalafil, vardenafil and avanafil help many men. They are taken before sex (or daily for tadalafil) and need some working nerves and blood flow.
- Penile injections
A small needle injects medicine (such as alprostadil or a mixture of medicines) into the side of the penis, producing an erection in about 10 to 15 minutes. Very effective, but some men dislike the needle or develop scarring.
- Urethral pellet
A tiny pellet of alprostadil is placed in the tip of the urethra with an applicator. Less effective than injections for many men, but needle-free.
- Vacuum erection device
A plastic tube and pump draw blood into the penis, and a band at the base holds it. No medicines or surgery, but some men find it awkward and the erection can feel cool or hinged at the base.
- Treating the causes
Exercise, weight loss, stopping smoking, better diabetes control, treating low testosterone if present, and counseling can improve erections for some men, alone or along with other treatments.
- Malleable (bendable) implant
A simpler implant with two bendable rods and no pump. Easier to use with limited hand strength, fewer parts to fail, but always semi-firm. It is placed in the same operation described here, without the pump and reservoir.
Getting ready
Tick items off as you go. Your checklist is saved on this device only.
Weeks before
The week before
The day before
The morning of
In the operating room, step by step
Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.
1. Anesthesia and antibiotics
You lie on your back on the operating table. You are given general anesthesia (fully asleep) or a spinal anesthetic (numb from the waist down, with medicine to make you sleepy). Antibiotics run through your IV.
After the operation
Right afterward
- Waking up
You wake with a dressing, ice packs on the scrotum and a catheter in your bladder. The penis may look partly erect because the implant was left partly inflated.
- Pain control
Expect real soreness in the scrotum and penis. Your team uses several medicines together, including a numbing block, so you need as little opioid medicine as possible.
- Catheter and drain
The catheter usually comes out the same evening or the next morning. If a small drain was placed, it comes out before you leave.
- Passing urine
You will be asked to pass urine before going home to make sure the bladder empties.
- Deflating the implant
If the implant was left partly inflated, the team deflates it before you go home or at your first visit.
- Going home
Most men go home the same day or the next morning with pain medicine and, in many practices, a few days of antibiotic pills.
At home
- Pain
The first week is the hardest. Most men need regular pain medicine for several days, then only now and then. Some soreness when the pump is touched can last several weeks.
- Ice
Use a cold pack over your underwear for about 20 minutes at a time, several times a day, for the first 2 to 3 days.
- Swelling and bruising
The scrotum often swells and turns purple or yellow. It can look alarming. It settles over 2 to 3 weeks.
- Position
Many surgeons ask you to wear snug briefs that hold the penis pointing up toward your belly button for several weeks. This helps the cylinders heal in a good position.
- Showering and the wound
You can usually shower after 48 hours. Pat the incision dry. Avoid baths, hot tubs and pools until your surgeon says the wound is healed, usually about 4 weeks.
- Pump care
Do not try to inflate the implant until your team teaches you. Some surgeons ask you to gently pull the pump down into the scrotum once or twice a day in the early weeks so it heals in an easy-to-reach spot.
- Bowels
Pain medicine can cause constipation. A stool softener and plenty of water help. Avoid straining.
- Activity and lifting
Walk every day. Avoid lifting more than about 10 to 15 pounds, hard exercise, cycling and horseback riding for about 4 to 6 weeks.
- Driving
You can drive when you are off opioid pain medicine and can sit and brake comfortably, often after about a week.
- Sex
Sex starts after the implant is activated, usually 4 to 6 weeks after surgery, once your surgeon confirms you are healed.
Recovery timeline
- Day 0Surgery
Home the same day or the next morning. Ice, rest and pain medicine.
- Days 1 to 3Swelling peaks
The catheter is out. The scrotum is most swollen and sore. Short walks around the house.
- Week 1Turning the corner
Pain starts easing. Many men return to desk work and driving around now.
- Weeks 1 to 2Wound check
A first visit to check the incision and the pump position.
- Weeks 2 to 4Bruising fades
Swelling goes down and walking feels normal. The pump becomes easier to feel.
- Weeks 4 to 6Activation visit
Your surgeon or nurse teaches you how to inflate and deflate the implant. You may be asked to practice inflating it once or twice a day for several weeks.
- Weeks 6 to 8Using the implant
Once cleared, you can use the implant for sex. It may feel awkward at first. Most men get comfortable with the pump within a few weeks.
- 3 monthsSettled
Soreness is gone for most men. A follow-up visit checks function and satisfaction.
- Long termLiving with it
Most implants keep working for many years. Tell any future doctor about your implant before a urinary catheter or pelvic surgery.
What it feels like
Choosing an implant is often an emotional decision as much as a medical one. Many men have lived with ED for years. The recovery is uncomfortable but predictable, and the day the implant is first used often brings a mix of nerves and relief.
Deciding
Some men feel sad about giving up the hope of natural erections. Others feel relieved to stop trying treatments that have not worked. Some worry what their partner will think.
What helpsTalk it through with your surgeon and partner. Ask to speak with a man who has an implant; many practices can arrange this.
Waking up
The scrotum feels full and sore, and the penis may look semi-erect from the partly inflated implant. The catheter can feel strange or give a constant urge to urinate.
What helpsIce and regular pain medicine help. The catheter usually comes out within a day.
The first days at home
Many men are shocked by how swollen and purple the scrotum gets. Walking and sitting are uncomfortable, and getting up from a chair takes effort.
What helpsThis is expected. Keep icing, wear supportive briefs, and take your pain medicine on schedule for the first few days.
Weeks 2 to 4
Impatience sets in. The penis may feel firmer, cooler or different to touch, and some men worry the implant is in the wrong place.
What helpsHealing takes time. The tissue around the implant settles over weeks. Raise any worries at your follow-up visit.
Activation day
Men often feel nervous. The pump can still be tender, and the first few squeezes may hurt. It can feel awkward to learn in front of a nurse.
What helpsGo slowly. It gets much easier with practice, and the tenderness fades. Your partner can learn too.
The first time having sex
Many men feel anxious it will not work or will look unnatural. The head of the penis stays softer than the shaft, and the erection may feel a little shorter than you remember.
What helpsTake your time, use lubricant, and talk with your partner. Most couples adjust quickly.
Months later
Many men say they forget the implant is there day to day. Some miss the spontaneity of natural erections; most value being able to have sex when they choose.
What helpsIf anything feels off, such as the pump being hard to find or the implant not fully deflating, your surgeon can check it.
How well it works
Success means an erection firm enough for sex whenever you want one, and a device you can use comfortably. In published studies, satisfaction with inflatable implants is high, commonly reported for more than 8 in 10 men and most partners.
- Firmness and control
Once healed, the implant produces a firm erection that lasts as long as you leave it inflated, and it softens when you deflate it.
- Feeling, orgasm and ejaculation
An implant does not change skin sensation, orgasm or ejaculation. If you could reach orgasm and ejaculate before surgery, you usually still can.
- Length
The implant fills the length of your erectile chambers as they are now. It does not add length, and many men feel the erection is a little shorter than the natural erections they remember.
- Follow-up
Typical visits are at 1 to 2 weeks, at activation (4 to 6 weeks) and around 3 months, then as needed.
- Durability
Most implants keep working for 10 years or more. If a part fails, it can usually be replaced in another operation.
Risks
Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.
Common
Nearly all men have swelling and bruising of the scrotum and penis, which settles over 2 to 3 weeks.
Pain is strongest in the first week and usually fades over 4 to 6 weeks. Some men have mild tenderness at the pump for a few months.
Many men notice the implant erection is a little shorter than the natural erections they remember. This is often due to the scarring and disease that caused the ED in the first place.
The head of the penis does not fill with the implant, so it stays softer than the shaft. Some men find ED pills help the head fill a little.
Less common
Infection of the implant usually means it has to be removed. A new implant is sometimes placed at the same time or months later. The risk is higher with poorly controlled diabetes, repeat implant surgery, and spinal cord injury.
Over years, a cylinder, tube or pump can leak or wear out, and the implant stops inflating. A second operation replaces the faulty part or the whole device.
Blood can collect in the scrotum. Most settle on their own; a few need draining.
The pump can ride up and become hard to reach, or the reservoir can shift and be felt in the groin. Sometimes a small operation is needed to reposition it.
In the early months the implant can partly inflate by itself (auto-inflation). It is usually fixed by deflating fully and, sometimes, adjusting the reservoir.
A small number of men have pain that lasts beyond 3 months. Most improve with time.
Rare
A cylinder or pump can wear through the skin or into the urethra. This needs surgery and usually removal of the affected part.
Injury to the urethra, bladder, bowel or a blood vessel while placing the cylinders or reservoir is rare.
The head of the penis can droop over the ends of the cylinders. This can be corrected with a small operation.
Very rarely the head of the penis or skin loses its blood supply, mostly in men with severe diabetes or when other procedures are done at the same time.
Clots in the legs or lungs are rare after this surgery. Walking early helps prevent them.
Call your care team or go to the emergency room if
- Fever of 101°F (38.3°C) or higher, or shaking chills
- Redness, warmth or firm swelling around the incision or scrotum that spreads, or any pus or bad-smelling drainage
- Pain that gets worse after the first week instead of better, especially pain at the pump or in the penis
- The scrotum swells quickly or becomes tense, very painful and dark purple
- You cannot pass urine for 6 to 8 hours or your bladder feels full and painful
- Any part of the implant shows through the skin, or the skin over the pump or penis tip becomes thin, dark or breaks open
- Calf pain or swelling, chest pain or sudden shortness of breath (call 911)
Questions to ask your surgeon
- How many penile implants do you place each year?
- Is an inflatable or a malleable implant better for me, and why?
- Where will you make the incision, and where will the reservoir go?
- What is my personal risk of infection, and what do you do to lower it?
- What length and firmness should I realistically expect?
- Will you straighten any curve at the same time?
- Will I go home the same day, and will I have a catheter or drain?
- When will the implant be activated, and who will teach me to use it?
- What happens if the device stops working, and what does the manufacturer's warranty cover?
- Can my partner come to the activation visit?
- What should I tell other doctors before future procedures, such as a catheter or prostate surgery?
Words you may hear
- Erectile dysfunction (ED)
- Trouble getting or keeping an erection firm enough for sex.
- Corpora cavernosa
- The two spongy chambers inside the penis that fill with blood during an erection. The implant cylinders go here.
- Tunica albuginea
- The tough sleeve around each erectile chamber.
- Inflatable penile prosthesis (IPP)
- A three-piece implant with two cylinders, a pump and a reservoir.
- Malleable prosthesis
- An implant made of two bendable rods, with no pump.
- Cylinders
- The two soft tubes inside the penis that fill with fluid to make an erection.
- Pump
- A small bulb in the scrotum that you squeeze to inflate the implant. It also has the release button.
- Reservoir
- A small fluid-filled balloon behind the lower belly wall that stores the fluid when the implant is soft.
- Activation
- The first visit, about 4 to 6 weeks after surgery, when you learn to inflate and deflate the implant.
- Auto-inflation
- When the implant partly inflates by itself without you pumping it.
- Erosion
- When part of the implant wears through the skin or the urethra.
- Modeling
- Bending the inflated implant firmly against a curve to straighten the penis.
Common questions
Will my penis be longer?
No. An implant fills your erectile chambers as they are. It does not add length, and many men feel the erection is a little shorter than the natural erections they remember. Some surgeons ask you to inflate the implant daily for a few weeks after activation to help the tissue stretch. Ask your surgeon what to expect for you.
Can other people tell I have an implant?
Not in normal life. Everything is inside the body. With the inflatable type, the penis hangs soft when deflated. A partner may feel the pump in the scrotum, and in locker rooms no one can tell.
Can I still have an orgasm and ejaculate?
Yes, if you could before. The implant does not affect skin feeling, orgasm or ejaculation. If you had prostate removal surgery, you will have orgasms without ejaculation, as you did before the implant.
Will ED pills or injections still work after an implant?
Usually not, and you will not need them for firmness. Placing the cylinders changes the spongy tissue, so natural erections generally do not return. Some men use a pill to help the head of the penis fill a little.
How long does an implant last?
Most keep working for 10 years or more, and many much longer. When a part wears out, it can usually be replaced through the same incision.
Is it safe to have an MRI or go through airport security?
Most modern implants are labeled safe for MRI under set conditions. Tell the MRI staff and carry your implant card. Implants rarely set off airport metal detectors.
What if I have diabetes?
Many men with diabetes have implants with good results. Your infection risk is lower when your blood sugar is well controlled, so your surgeon may ask you to improve your sugar levels before surgery.
Sources this page draws on
- American Urological Association, Erectile Dysfunction: AUA Guideline (2018)
- European Association of Urology, EAU Guidelines on Sexual and Reproductive Health
- Sexual Medicine Society of North America, Patient information on penile implants and erectile dysfunction
- Urology Care Foundation, Erectile Dysfunction (ED)
- MedlinePlus (U.S. National Library of Medicine), Penile prosthesis
Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.