Penile implant surgery (Insertion of a penile prosthesis (inflatable or malleable))
An operation to place a device inside the penis that allows a man with long-standing erectile dysfunction to get an erection when other treatments have not worked.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A penile implant is a device placed inside the penis to allow an erection when other erectile dysfunction treatments have not worked.
- It is generally a final-line option and is not reversible — natural erections cannot usually be restored afterwards.
- It does not change sensation, orgasm or fertility, and does not treat the underlying cause of erectile dysfunction.
- Infection and, over years, mechanical wear are the main concerns; choose a surgeon who does this operation regularly and ask about partner involvement and satisfaction.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Allows a reliable, on-demand erection when other treatments have failed
Other treatments (tablets, injections, vacuum device) have not been tried or fairly considered first.
Expect pain, swelling and bruising. A catheter may be in place overnight. Take painkillers as advised, rest, and wear supportive underwear.
Clear wound-care and infection-warning instructions with an urgent contact route.
Expect pain, swelling and bruising. A catheter may be in place overnight. Take painkillers as advised, rest, and...
Swelling and discomfort gradually ease. Keep the wound clean and dry as instructed, and avoid sitting on hard...
Most men return to light activity and desk work. Avoid heavy lifting, cycling and vigorous exercise. The device...
At a review, you are usually shown how to inflate and deflate the device and, if healing is complete, cleared to...
What is penile implant surgery?
Penile implant surgery places a device (a prosthesis) inside the penis to allow an erection in men whose erectile dysfunction has not responded to other treatments such as tablets, injections or a vacuum device. It is generally considered a final-line treatment.
The most common type is a three-piece inflatable implant: two cylinders sit inside the penis, a small pump sits in the scrotum, and a fluid reservoir sits in the lower abdomen. Squeezing the pump moves fluid into the cylinders to create an erection, and a release valve returns the penis to a soft state afterwards. A simpler malleable (bendable) implant is firmer all the time and is positioned by hand.
An implant replaces the natural erection mechanism in the part of the penis it occupies, so it is not reversible: once the natural erectile tissue has been used for an implant, going back to natural erections is not usually possible. It does not change sensation, orgasm, ejaculation or fertility, and it does not treat any underlying cause of erectile dysfunction. Choosing it is a significant, considered decision.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Implant types compared
| Type | Erection | Trade-off |
|---|---|---|
| Three-piece inflatable | Most natural; firm or soft on demand | Most parts; small chance of mechanical failure over years |
| Two-piece inflatable | Firm or soft on demand | Simpler; range of firmness slightly less |
| Malleable (bendable) | Always firm; bent for use | Simplest and fewest parts; always rigid, less discreet |
The right type depends on hand strength and dexterity, your anatomy, previous surgery and personal preference. Your urologist should talk through the options with you, ideally including your partner.
Preparing for your surgery
- See a urologist who specialises in this surgery; confirm that other treatments (tablets, injections, vacuum device) have genuinely been tried or are unsuitable.
- Discuss the options fully, ideally with your partner, including that the operation is not reversible.
- If you have diabetes, work with your team to get blood-sugar control as good as possible, as poor control raises infection risk.
- Stop smoking well beforehand; smoking increases the risk of healing and infection problems.
- Tell the team about all medicines, including blood thinners, and about any past pelvic or penile surgery.
- A urine sample is checked and treated if infected, and you may have skin or nasal checks to reduce infection risk.
- Arrange a lift home, time off work and loose, supportive underwear for recovery.
What happens
The operation is done under general or spinal anaesthetic. Through a small cut, usually where the penis meets the scrotum or in the lower abdomen, the surgeon places the cylinders inside the natural erectile chambers of the penis. For an inflatable device, the pump is positioned in the scrotum and the reservoir in the lower abdomen.
Strict measures are taken to reduce infection, including antibiotics, careful skin preparation and a 'no-touch' technique with coated devices. The implant is usually left deflated while you heal. The operation generally takes one to two hours and most men go home the same day or after one night, often with a catheter overnight and a light dressing.
You will be shown how to work the device at a later appointment, once healing allows, usually around six weeks. The implant is not used for sex before then.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Other treatments (tablets, injections, vacuum device) have not been tried or fairly considered first.
- An active infection anywhere, or poorly controlled diabetes, which markedly raises the risk of implant infection.
- You are not ready to accept that the operation is not reversible.
- Significant cognitive or dexterity problems that would make operating an inflatable device unsafe (a malleable device may be considered).
- Unrealistic expectations about size, sensation or restoring natural function.
Delay surgery if…
- You have any active infection, including a urine or skin infection.
- Your diabetes is poorly controlled and could be improved first.
- You are still smoking and could stop before surgery.
- Blood-thinning medication has not been reviewed.
- You have not had a full discussion, ideally with your partner, about the permanence and limits of the procedure.
Alternatives to discuss
- Oral medicines (PDE5 inhibitors such as sildenafil or tadalafil).
- Injections into the penis or pellets placed in the urethra.
- A vacuum erection device with a constriction ring.
- Treating underlying causes such as hormone problems, and psychosexual support or counselling.
- Accepting no surgical treatment if the risks outweigh the benefits for you.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Allows a reliable, on-demand erection when other treatments have failed
- High long-term satisfaction reported by many men and their partners
- The inflatable type gives a discreet result that is firm only when wanted
- Does not require tablets, injections or a vacuum device each time
- Sensation, orgasm and the ability to ejaculate (if present beforehand) are usually unchanged
Risks & complications
- Pain, swelling and bruising of the penis and scrotum for some weeks
- A scar at the surgical site
- Needing to wait around six weeks before using the device and resuming sex
- The erect penis sometimes feeling or looking a little shorter than expected
- Infection of the implant, which often means the device must be removed
- Mechanical problems with an inflatable device over the years (for example fluid leak from a part)
- Difficulty operating the pump, particularly if hand strength or dexterity is limited
- Numbness or altered sensation that is usually temporary
- The device wearing through the tissue (erosion), needing removal
- Serious infection making you very unwell
- Loss of penile tissue in severe infection, especially in higher-risk men such as those with poorly controlled diabetes
The two issues that matter most are infection, which usually means removing the device, and mechanical wear of inflatable implants over the years. Poorly controlled diabetes, smoking, revision surgery and previous infection all raise the risk. Ask your surgeon how often they do this operation, their own infection and revision rates, which coated device they use, and what the plan is if the implant becomes infected or fails.
Published figures to discuss
Satisfaction is high in most series, but infection and mechanical failure are the key risks and vary with the device, the surgeon's experience and your own health, particularly diabetes control, smoking and whether this is a first implant or a revision. The figures below are cautious ranges from published series and UK patient information; first-time, antibiotic-coated implants in lower-risk men sit at the better end.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Implant infection (first-time surgery) | Roughly 1–3% with modern coated devices (BAUS band around 1 in 50 to 1 in 100) | Higher for revision surgery (reported around 6% or more) and in poorly controlled diabetes or smokers; usually means removing the device. | Penile implant surgery: managing complications (review) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Mechanical failure of an inflatable device | Around 5% at 5 years in some reports, with cumulative failure rising over longer follow-up | Often a fluid leak from one component; may need revision or replacement. | Penile implant surgery: managing complications (review) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Erosion of the device through tissue | Uncommon (BAUS band around 1 in 50 to 1 in 100) | Usually requires removal of the device. | Penile implant surgery: managing complications (review) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Need for removal or revision surgery | Roughly 1 in 10 to 1 in 50 over time (BAUS band) | Reasons include infection, mechanical failure and erosion. | Penile implant surgery: managing complications (review) — PMCpmc.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
The first weeks are about healing, not using the device. Pain, swelling and bruising of the penis and scrotum are expected, and the implant is left deflated until you are shown how to use it, usually around six weeks.
- Swelling and bruising of the penis and scrotum for a few weeks
- Discomfort that improves steadily with painkillers
- A period of several weeks before the device is used or sex resumes
- Some men noticing the erect penis feels slightly shorter than before
- Gradually growing confidence operating the pump
Aftercare
- Take prescribed painkillers and finish any antibiotics.
- Keep the wound clean and dry exactly as instructed, and watch for redness, heat or discharge.
- Wear supportive underwear and avoid heavy lifting, cycling and strenuous exercise in the early weeks.
- Do not use the device or have sex until your surgeon confirms it is safe, usually around six weeks.
- Attend the appointment where you are shown how to work the device.
- Tell any future surgeon or scan team that you have an implant before other procedures.
- Report any sign of infection or wound problems promptly.
- Blood-sugar control optimised (if diabetic)
- Smoking stopped well beforehand
- Urine checked and any infection treated
- Lift home and time off work arranged
- Loose, supportive underwear ready
- Date for the 'how to use the device' appointment noted
- Clinic contact number for problems saved
Scars and how they heal
There is usually a single scar where the penis meets the scrotum, or in the lower abdomen, depending on the approach. It is generally discreet once healed. Because an implant sits beneath the skin, signs such as redness, heat, swelling or discharge at the wound matter and should be reported, as they may signal infection.
⚠ Get urgent help if…
- Spreading redness, heat, swelling or discharge at the wound — possible implant infection, seek help promptly
- A high temperature, shivering or feeling very unwell
- Severe or worsening pain not controlled by painkillers
- Being unable to pass urine
- Any part of the device showing through the skin
- A sudden change in the look or position of the penis
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a reliable erection that you can produce when you want and that allows satisfying sex, with high reported satisfaction among men and partners. The inflatable type aims to feel natural — firm when inflated and soft otherwise.
An implant does not restore natural erections, change penis size, alter sensation or orgasm, or treat any underlying cause of erectile dysfunction such as diabetes or hormone problems. Some men notice the erect penis feels slightly shorter than before. Because the natural erectile tissue is used for the device, the decision is effectively permanent.
Modern inflatable implants are reliable, but they are mechanical devices and a proportion develop a fault over the years, so some men eventually need a revision or replacement. Malleable implants have fewer parts to fail. Looking after the device, attending follow-up and acting quickly on any problem all help. Your surgeon should explain the expected lifespan of the specific device they use and what happens if it fails.
Combining with other procedures
Penile implant surgery is sometimes considered alongside other reconstructive surgery, for example after treatment for prostate cancer or for Peyronie's disease (curvature of the penis), where straightening may be done at the same time. These are specialist situations that a urologist should plan carefully.
Follow-up & long-term care
You will usually be reviewed in the early weeks to check healing, then again around six weeks to be shown how to use the device and to be cleared for sex. Longer-term follow-up focuses on how well the device works and spotting any problems early.
- Use the device as shown, and 'cycle' it as advised to keep it working well.
- Attend follow-up appointments and report problems early.
- Tell any future surgeon, dentist or scan team that you have an implant.
- Keep diabetes and general health well managed to reduce later infection risk.
- Discuss revision or replacement promptly if the device stops working as it should.
Revision and secondary surgery reality
- Inflatable devices are mechanical and a proportion eventually need revision or replacement.
- Revision surgery carries a higher infection risk than first-time surgery.
- An infected implant usually has to be removed; reimplantation is generally delayed and is more complex.
- Some loss of penile length can occur, especially after explant and later reimplantation.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear wound-care and infection-warning instructions with an urgent contact route.
- A structured appointment to teach safe use of the device before resuming sex.
- Honest long-term review of how the device works, with a plan for revision if needed.
- Support for the man and, where wanted, the partner, including realistic expectation-setting.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Surgeon and anaesthetist fees, and the surgeon's experience with this specific operation
- Theatre and facility charges, and whether you stay overnight
- The implant device itself, which is a significant cost and varies by type and brand
- Antibiotic-coated versus uncoated devices
- Follow-up appointments, including the session teaching you to use the device
- What is covered if the device becomes infected, fails or needs revision
- The operating surgeon's and anaesthetist's fees
- Theatre, facility and any overnight stay charges
- The cost of the implant device and which type or brand is included
- Follow-up appointments, including device training
- The policy if the implant becomes infected, erodes or fails — who pays for removal or replacement
- Cancellation policy and cover for complications
On the NHS? NHS funding for penile implants is limited to specific clinical circumstances that meet set criteria; many men have the surgery privately on a self-pay basis after other treatments have failed.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not making clear that the operation is irreversible and natural erections cannot be restored.
- Overstating satisfaction without explaining infection and mechanical-failure risks.
- No discussion of expected penis size or appearance after the implant.
- Not optimising diabetes control or smoking before surgery.
- No clear plan or cost agreement for what happens if the device fails or becomes infected.
Marketing red flags
- Promoting the implant as a quick fix without explaining it is final-line and irreversible.
- Guaranteeing satisfaction or a specific size.
- Downplaying infection risk, especially in diabetes or revision surgery.
- Pressuring a decision without offering or reviewing less invasive options first.
- Not naming the device or its expected lifespan and failure rate.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- How many of these operations do you do each year, and what are your own infection and revision rates?
- Which device would suit me, and why — inflatable or malleable?
- What happens if the implant becomes infected or stops working?
- How might my erect penis size or appearance change?
- How is my diabetes or other health being optimised to lower infection risk?
- Can my partner be involved in the discussion and the follow-up?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a penile implant reversible?
Will it change sensation, orgasm or fertility?
How soon can I have sex?
What is the main risk?
Will my penis be the same size?
Can I get this on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS England — Penile prostheses for end-stage erectile dysfunction (commissioning policy) BAUS — Implantation of penile prostheses patient leaflet Penile implant surgery: managing complications (review) — PMC Penile prosthesis infection: myths and realities — PMC Long-term survival and satisfaction with inflatable penile prosthesis — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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