Penile Implant: Surgery, Types, Side Effects, Risk, Recovery

A penile implant is a device placed surgically within the penis and scrotum to help men with erectile dysfunction achieve an erection. It can be of two types: 

1. Inflatable: The implant consists of two cylinders in the penis, a pump in the scrotum, and a fluid reservoir under the lower abdominal muscles. As an individual presses the pump in the scrotum, it transfers fluid from the reservoir to the cylinder, mimicking an erection. 

2. Semi-rigid: Also known as a malleable penile implant, it involves implanting two flexible rods into the penis. The implants remain constant in size and rigidity, maintaining a semi-rigid state. However, individuals can adjust the rods to different positions as needed during sexual activity. 

Anatomy and Physiology of the Penis

The penis is a complex organ in males responsible for sexual intercourse and urination. It has three primary parts:

1. Root: This part of the penis, which is attached to the body, is not externally visible. The urethra, connecting to the bladder, runs through the entire length of the penis.

2. Body (Shaft): The elongated part of the penis between the root and the glans. It has three cylinders of erectile tissue, which include:

1. Two Corpora Cavernosa: These are cylindrical structures that run along the length of the penis. They fill will blood to create an erection during arousal. 

2. One Corpus Spongiosum: It is a spongy tissue that runs along the underside of the penis and surrounds the urethra. It extends beyond the corpora cavernosa to form the glans.  

3. Glans: It is the rounded tip of the penis, more commonly known as the head. The glans also includes the urethral opening (where the urethra ends). It allows the expulsion of urine and semen. 

Doctors recommend getting penile implant surgery when other treatments, like medications and penis pumps, do not provide positive results. These prosthetics are used to treat the following conditions: 

1. Erectile dysfunction (hard to get and keep an erection).

2. Peyronie’s disease (buildup of scar tissue inside the penis that causes curved and painful erections).

Contraindications for penile implants may vary depending on the specific patient's circumstances. These are as follows: 

1. Infections like urinary tract infections or pulmonary infections. 

2. Poorly controlled diabetes or serious heart disease.

A penile implant offers a reliable solution for ED, enabling men to achieve and maintain an erection suitable for sex. It does not alter the sensation of the penis or affect the ability to orgasm and ejaculate. The primary benefits of the procedure are as follows: 

1. Outpatient Procedure: People can usually return home on the same day.

2. Safe: The low risk of complications associated with the implant makes it a compelling choice for those seeking long-term satisfaction.

3. Longevity: Many penile implants last more than 20 years without needing replacement.

4. High Satisfaction Rates: According to a study by Wong et al., 2022, the satisfaction rate of penile prostheses is as high as 75% to 98%. The partner satisfaction rate is 85.4%. 

5. Natural Appearance: When activated, the implant makes the penis stiff and erect, resembling a natural erection in visibility and function.

Preparing for a penile implant involves understanding the steps involved both before and on the day of the operation. Individuals must closely adhere to their doctor’s instructions to ensure a successful procedure.

Before Penile Implant Surgery 

Patients will meet their urologist to ask questions and address any concerns. The doctor will discuss the type of implant suiting the individual’s needs and lifestyle. The following is what one can expect during this visit: 

On the Day of Penile Implant Surgery 

Patients arrive at the hospital or surgical centre and finalise any necessary paperwork. On the day of the procedure, several key preparations will occur, which include the following: 

The penile implant operation is performed under general anaesthesia (the patient sleeps during surgery) or spinal anaesthesia (blocks pain in the lower part of the body). The complete procedure takes about 45 to 90 minutes and may involve the following steps: 

1. Catheter: The healthcare team inserts a catheter (tube) into the patient’s bladder through the penis to collect urine. 

2. Incision: The surgeon makes a small incision either at the base of the penis, in the lower abdomen, or just below the glans. 

3. Insertion of the Implant: They stretch the spongy tissue in the penis. Next, this tissue is replaced with the cylinders from the penile implant. The pump is implanted into the scrotum, and the reservoir is placed under the lower abdominal wall.

4. Closing the Incisions: Once the prosthesis is in place, the surgeon closes the incisions with dissolvable sutures.

It is normal to experience pain and swelling in the penis and scrotum for about one week after surgery. Tenderness may last for up to six weeks. Patients should follow the doctor’s instructions both in the hospital and at home to ensure a smooth and quick recovery. 

Recovery in Hospital 

After penile implant surgery, most patients can return home the same day. They must arrange for someone to drive them home. During their time in hospital, they can generally expect the following: 

1. Immediate Post-Op Care: After the surgery, patients are moved to the recovery room, where the anaesthesiologist checks their vital signs, such as breathing and heart rate. 

2. Pain Management: Individuals are given pain relievers to manage discomfort from the incision and the placement of the implant.

At-home Recovery

Patients can return to work a week after surgery. However, if the job is physically demanding, it can take about two to four weeks to recover and resume work. During this recovery period, it is important to follow the post-operative instructions: 

1. Take pain relievers to manage discomfort and antibiotics to prevent infections for a week.  

2. To alleviate pain and swelling, apply an ice pack to the affected area for up to 10 minutes several times throughout the day.

3. Avoid physical and sexual activity for four to six weeks. 

4. Position the penis upward toward the belly button to prevent it from curving downward. 

First Follow-up Appointment

The first follow-up appointment after penile implant surgery is scheduled two weeks after the procedure. During this visit, the surgeon will check the surgical site for healing, assess pain levels, and discuss recovery progress. 

The next follow-up session is scheduled six weeks after surgery. The surgeon instructs how to use the penile implant. 

The penile implant procedure is generally safe and effective. However, like all surgeries, it does carry potential risks and complications. Here are some common issues that can occur:

1. Infection: It usually occurs within the first three months of surgery and requires the removal of the implant.  

2. Haematoma: Bleeding inside the penis can lead to the formation of a haematoma, requiring additional surgery.

3. Implant Problems: Mechanical failure can occur over time, leading to a need for surgery to remove or replace the implant (7.14% of cases). The newer models have improved significantly in terms of durability. 

4. Erosion: The implant may break through the skin of the penis or the urethra. It is rare (0.79%) but requires surgical repair if it occurs.

5. Changes in Penis: Some men report a decrease in penis sensation (8.73%) or a loss in the size of their penis (18.53%). 

When to call a doctor?

After undergoing penile implant surgery, patients should monitor their recovery and look out for signs of complications. They should seek medical advice if they experience any of the following: 

1. A fever above 100℉

2. Infection signs like redness, swelling, or warmth around the surgical site 

3. Persistent and heavy bleeding from the incision site 

4. Worsening pain 

The penile implant surgery cost in India varies significantly based on multiple factors. The price starts from ₹ 1,20,000 with an average expense of ₹ 1,40,000. The maximum cost can reach ₹ 2,00,000.

Note: These figures are approximate. Patients considering this procedure should consult HexaHealth experts for accurate costs. 

Factors that affect the penile implant surgery cost are as follows: 

1. Type of Implant: Different types of penile implants are available, including inflatable and malleable devices. Inflatable implants are generally more expensive due to their complexity and functionality.

2. Doctor’s Expertise: Highly experienced surgeons charge more for their services. 

3. Geographic Location: Costs can vary depending on where the surgery is performed. Urban centres or metropolitan cities are expensive due to the higher costs of living. 

4. Type of Hospital: Private facilities are costlier than public ones. Medical centres equipped with advanced technology may also have higher fees.

5. Additional Medical Expenses: These include the cost of anaesthesia, pre-surgical tests, post-surgical medications, and any necessary follow-up visits. Each of these components adds to the final bill of the procedure.

Penile implants offer a durable solution for men struggling with erectile dysfunction. It is particularly beneficial for those who have not had success with other treatments. The procedure results in high patient and partner satisfaction due to the restoration of sexual function. 

HexaHealth streamlines the process for patients considering penile implant surgery, from decision-making through recovery. By partnering with leading urologists and reputable clinics, we ensure that each individual receives the highest standard of care. Contact us TODAY! 

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