How do inflatable and non-inflatable penile implants work?

Penile implants, also known as penile prostheses, are medical devices surgically inserted into the penis to help men with erectile dysfunction (ED) achieve a functional erection when other treatments such as medications or injections fail. These devices do not affect ejaculation, orgasm, or sexual sensation.

There are two main types of penile implants: inflatable implants and non-inflatable (semi-rigid) implants.

• Inflatable Implants: These are the most commonly used today and are available in 2-piece or 3-piece designs. The 3-piece implant includes two inflatable cylinders inserted in the penis, a fluid reservoir placed in the abdomen, and a pump located in the scrotum. When the pump is squeezed, saline fluid moves from the reservoir to the cylinders, creating an erection. To deflate, the fluid is returned to the reservoir. This type closely mimics natural erection and flaccidity and is discreet and highly concealable.
• The 2-piece implant combines the fluid reservoir and pump in one unit placed in the scrotum, making it easier to implant in patients with prior abdominal surgeries. It works similarly but may provide less rigidity compared to the 3-piece model.

• Non-Inflatable (Semi-Rigid) Implants: These involve bendable rods that are permanently firm but can be manually adjusted between an erect and resting position. They are simpler to use and implant and are a good option for patients with limited hand dexterity or those seeking a lower-cost, lower-maintenance solution. However, they may be harder to conceal under clothing and result in a constant semi-erect appearance.

Penile implants are highly effective and offer excellent satisfaction rates—up to 92–100% in patients and 91–95% in partners. They restore erectile function but do not interfere with orgasm, ejaculation, or sensitivity.

Overall, penile prosthesis implantation is a durable, safe, and patient-controlled solution for men with treatment-resistant ED, especially when personalized to the patient’s anatomy, health status, and preference.