If you've reached the point where oral medications haven't worked — or you simply want a permanent, on-demand solution for erectile dysfunction — a penile implant is worth understanding in detail. Most men who research it are surprised by how straightforward the procedure is, and how dramatically it changes their quality of life.
The inflatable penile prosthesis (IPP) has been available since the 1970s, and the technology has advanced considerably. Today's devices — including the AMS 700, which I implant as an AMS 700 Center of Excellence — are discreet, durable, and designed to last 15 or more years. Over 500,000 devices have been implanted worldwide, with a satisfaction rate that consistently exceeds 95% among both patients and their partners.
This guide will walk you through exactly what happens at each stage: the consultation, the surgery itself, and the recovery period. My goal is to give you honest, complete information so you can make the decision that's right for you.
Who Is a Candidate for a Penile Implant?
A penile implant is appropriate when erectile dysfunction is established, persistent, and has not responded adequately to other treatments. The most common candidates include men who:
- 1Have not had satisfactory results with oral PDE5 inhibitors (Viagra, Cialis, Levitra, or their generics)
- 2Experience ED as a result of radical prostatectomy or radiation therapy for prostate cancer
- 3Have diabetes-related or vascular ED that has not responded to medications or injections
- 4Prefer a permanent, medication-free solution with no planning around pills or injections
- 5Have Peyronie's disease requiring surgical correction alongside ED treatment
It's worth emphasizing that a penile implant does not affect urinary function, orgasm, or ejaculation. It replaces only the mechanical component of an erection — the ability to achieve and maintain rigidity — while leaving all sensation and sexual response intact.
Once a penile implant is placed, the natural erectile tissue is no longer functional. For this reason, implants are typically considered after other treatments have been tried. That said, for men whose other options have failed, there is no superior long-term solution.
Step 1: The Consultation
The consultation is a conversation, not a commitment. We'll review your medical history, prior ED treatments, and any relevant conditions — prostate cancer history, diabetes, cardiovascular disease, prior pelvic surgeries — that inform both candidacy and surgical planning.
We'll discuss device options in detail. The AMS 700 LGX and CX are the most commonly implanted inflatable prostheses; both consist of two cylinders placed inside the corpora cavernosa of the penis, a fluid reservoir in the lower abdomen, and a small pump concealed in the scrotum. I'll explain how the device works mechanically, what it feels like to use, and what the device does and does not change about sexual function.
This is also the time to discuss insurance coverage. Penile implant surgery is covered by Medicare and most major insurance plans when medically indicated — which it typically is when other treatments have been tried and documented. My office will assist with prior authorization as needed.
Step 2: Pre-Operative Preparation
Once you decide to proceed, pre-operative preparation is relatively straightforward. You'll undergo standard pre-surgical labs and clearance. In the days before surgery:
- 1Blood-thinning medications (aspirin, NSAIDs, warfarin, newer anticoagulants) will need to be paused — timing depends on the specific medication and will be coordinated with your prescribing physician.
- 2You'll shower with an antiseptic wash the night before and morning of surgery to reduce infection risk — infection is the most serious potential complication of penile implant surgery, occurring in roughly 1–3% of cases.
- 3Nothing to eat or drink after midnight the night before the procedure.
Step 3: The Surgery Itself
The procedure is performed under general or spinal anesthesia and takes approximately 45 to 90 minutes. It is almost always done as an outpatient procedure — meaning you go home the same day.
The surgical approach is typically through a small incision at the base of the penis or just below the pubic area. The corpora cavernosa — the two chambers that normally fill with blood during a natural erection — are dilated, and the cylinders are sized and placed. The reservoir is positioned behind the pubic bone, and the pump is placed in the scrotum, where it sits naturally and is not visible to others.
The incision is closed with absorbable sutures and the device is left in a partially inflated state for the first few weeks of healing.
"The most common thing I hear after the procedure is: 'I wish I had done this sooner.' The surgery itself is shorter than most men expect, and the recovery is more manageable than they feared."
Step 4: Recovery — What to Expect Week by Week
Soreness and swelling are expected and well-managed with oral pain medications. Most men are up and walking the day of surgery. A small drain or catheter may be in place briefly. Ice packs and scrotal support help with swelling.
Most men return to desk work within 5 to 7 days. Driving is typically cleared once you're off narcotic pain medication. Avoid strenuous activity, lifting, and any pressure on the surgical site.
At your follow-up visit, we'll begin the device activation process — I'll show you how to inflate and deflate the pump. This cycling helps the tissue conform to the device and accelerates the healing process.
Sexual activity can typically resume at 4 to 6 weeks post-operatively, once the surgical site has fully healed and you're comfortable with device operation. Most men find the device intuitive to use within a few sessions.
By three months, the vast majority of men report that the device feels completely natural. Sensation, orgasm, and ejaculatory function are unchanged. The device is ready for long-term use.
Understanding the Risks
No surgical procedure is without risk, and an honest conversation about them is part of every consultation I have with patients. The most important risks to understand are:
Infection occurs in approximately 1–3% of cases. It is the most serious complication because it typically requires device removal and a waiting period before reimplantation. Antibiotic-coated implants and meticulous surgical technique have significantly reduced this risk over the past two decades.
Mechanical failure of the device is uncommon — modern IPPs have a 10-year mechanical survival rate exceeding 90%. If a component fails, it can be replaced surgically; the procedure for revision is generally simpler than the original implant.
Erosion or migration of device components is rare, occurring in less than 1% of cases. Risk factors include prior pelvic surgery, radiation, and certain anatomic considerations that we assess pre-operatively.
Penile implant surgery is covered by Medicare and most commercial insurance plans when there is documented medical indication — typically failure of or contraindication to other ED therapies. My office assists patients with prior authorization and can help clarify your specific coverage before any commitments are made.
Why Surgical Volume Matters
Penile implant surgery is a technically demanding procedure, and outcomes — including infection rates, device positioning, and long-term satisfaction — are meaningfully correlated with surgeon experience. The AMS 700 Center of Excellence designation requires implanting a minimum of 25 inflatable penile prostheses annually with verified outcomes data. High-volume prosthetic surgeons demonstrate lower complication rates and higher patient satisfaction in published literature.
When evaluating any surgeon for this procedure, ask about their annual implant volume, their approach to infection prevention, and their experience with revision surgery — because revisions, while uncommon, do occur, and you want a surgeon who has managed them.
Is a Penile Implant Right for You?
The decision to proceed with a penile implant is personal, and it doesn't need to be rushed. For most men who have struggled with ED for years — tried medications that work inconsistently, dealt with the planning and unpredictability of other treatments — the implant represents a genuine restoration of spontaneity and confidence.
For men who have completed prostate cancer treatment and are navigating post-treatment ED, the implant is often the most reliable path to recovery of sexual function, particularly when other treatments have produced limited results.
The consultation is free of obligation. If you have questions — about candidacy, about the device, about your specific situation — a conversation is the right starting point.
Ready to Have a Conversation?
A consultation is informational, not a commitment. Everything discussed is confidential, and we'll answer every question you have before you make any decision.
Request a Consultation (504) 584-6990