How Penile Implants Work
Penile implants for erectile dysfunction have been been continually improved and refined over the last 40 years, and implants designed specifically for people who have had gender-affirming Phalloplasty are in active development. Penile implants provide an erection by serving as a replacement for the spongy tissue inside the penis (corpora cavernosum) that normally fills with blood during an erection. They come in a variety of diameters and lengths.
Penile implant surgery is typically performed at stage 2 or 3 of Phalloplasty, at least 6-9 months following stage 1. Recovery time is about 6-8 weeks. Patients can resume sexual activity after clearance from the surgeon.
There are two kinds of penile implants: malleable implants and inflatable implant. Inflatable implants come in two styles: 2-piece or 3-piece.
Malleable Penis Implants
One or two bendable cylinders are inserted into the penis. The cylinders have a core of silver, Nitinol (nickel titanium) or stainless steel and are coated with silicone or a blend of silicone and Teflon. Malleable penile implants are always firm. They are bent into different positions for erect and flaccid states. Examples: Coloplast Genesis, Boston Scientific Tactra, Rigicon Rigi10 and ZSI 100 FTM.
How it works: For an
erection, simply bend the penis in the erect position. To end the
erection, bend the penis down. Erections can be of various degrees
depending on how the penis is bent.
Benefits:
- Easy to use: bend it up for an erection and bend it down when not in use.
- Simplest and least expensive penile implant procedure.
- With fewer mechanical parts, these implants can last more than 20 years.
2-Piece Inflatable Penile Implants
Inflatable penile implants are
comprised of two cylinders, a reservoir that holds saline and a
hydraulic pump to move the saline from the reservoir to the
cylinders, providing an erection. The release valve on the pump
drains the salt water out of the cylinders and back into the
reservoir. A 2-piece inflatable implant has the reservoir at one
end of the cylinders (at the base of the penis) and the pump and
release valve in the scrotum. Example: AMS
Ambicor.
How it works: Gently
squeeze the concealed pump in the scrotum several times. This
moves the saline solution from the reservoir into the cylinders.
As the cylinders fill, the penis becomes erect and firm. To end
the erection, gently bend the penis down for 6-12 seconds. This
transfers fluid back into the reservoir.
Benefits:
- Easy to use: pump it up for an erection, bend to deflate. (Some manual dexterity required.)
- Simplest and least expensive inflatable penile implant procedure
3-Piece Inflatable Penile Implants
3-Piece
inflatable implants have two cylinders, a reservoir and a pump and
release valve. Compared to 2-piece inflatable implants, the
reservoir in this type of implant is larger and implanted in the
abdomen. Examples: AMS
700 Series, Coloplast
Titan, ZSI
475 FTM.
How it works: Gently
squeeze the concealed pump in the scrotum several times. This
moves the saline solution from the reservoir into the cylinders.
As the cylinders fill, the penis becomes erect and firm. To end
the erection, simply press a "deflation site" on the pump.
Deflating the cylinders transfers the fluid back to the reservoir
and the penis becomes flaccid.
Benefits:
- Easy to use: pump it up for an erection, press the release valve to deflate. (Some manual dexterity required.)
- Easier to inflate than a 2-piece device due to larger, softer pump.
- Provides better rigidity than a 2-piece device and is therefore a good choice for those with large penises.
- Provides the best flaccidity of all implants when not in use.
- Creates the least amount of pressure on penile flesh when not in use, lessening risk of erosion.
Because there are more mechanical parts in a 3-piece device, there is a higher chance of mechanical failure compared to other implants. They have been known to fail in as little as three years, though research has indicated that they can last 10-15 years.
Choosing a type and brand of penile implant can be difficult because several factors need to be considered, such as your goals, size of the penis and scrotum, age and general health and surgery history.
Learn more about Penile Implants:
Last updated: 10/06/23
