Prosthetic Urology FAQs

Penile implant surgery may need to be delayed or reconsidered in patients with uncontrolled diabetes mellitus, active infections, or certain psychological conditions, as these factors can increase the risk of prosthetic infection, other complications or dissatisfaction¹. Patients must be carefully selected through comprehensive evaluation to ensure optimal outcomes and minimize post-operative complications².

Inflatable penile prosthesis (IPP) surgery typically does not add penile length; in fact, some men report a slight decrease in length after the procedure. Length restoration or modest gains are only possible in complex cases using high-risk surgical techniques.

Penile prostheses are effective for treating erectile dysfunction, but they come with risks such as infection, mechanical failure, and potential dissatisfaction due to reduced penile length. Surgery is required, and some patients may need future revisions or replacements.

Inflatable and non-inflatable penile implants are surgical treatments for erectile dysfunction, offering reliable, natural-feeling erections when other therapies fail. Inflatable models allow on-demand rigidity, while semi-rigid rods provide a permanently firm penis that can be positioned manually.

Yes, men with a penile implant can get an erection. The implant replaces the function of natural erectile tissue, allowing rigidity sufficient for sexual activity.

Penile implants are designed to restore erectile function, not increase penis size, and most men do not experience a significant gain in length. In fact, some men report a perceived or actual decrease in length following standard implantation.

Thanks to modern technology, most women cannot tell if a man has a penile implant, especially during sexual activity or visual inspection, particularly with inflatable types.

A penile prosthesis is a surgically implanted device that helps men with erectile dysfunction achieve an erection. It mimics the natural erectile function either through inflatable cylinders or a bendable rod inside the penis.

Penile implants are typically considered for men with erectile dysfunction (ED) who have not responded to or are not suitable for less invasive treatments, or who prefer a definitive solution.

A penile implant is a medical device surgically placed inside the penis to help men with erectile dysfunction (ED) achieve an erection when other treatments haven’t worked. It offers a long-term, reliable solution for sexual function.

Yes. For men with incontinence and erectile dysfunction after prostate treatment, the AUA/GURS/SUFU guideline states that clinicians may offer a concomitant or staged procedure.¹ Men considering surgery for both conditions should be counselled about a possible increased risk of complications.⁷

Yes, in many cases. The 2026 EAU Guidelines include penile implants among the treatments after radical prostatectomy.⁴ They describe a two-piece inflatable prosthesis as a possible option when reservoir placement carries a high risk of complications, for example after previous abdominal surgery.⁷ The AUA guideline gives kidney transplant as one example of such a risk and allows a two-piece inflatable model to be considered if a hydraulic device is desired.⁸

Yes. Penile implants include two-piece inflatable and semi-rigid devices as well as three-piece inflatable devices.¹ According to the 2026 EAU Guidelines, the two-piece inflatable prosthesis can be a viable option for patients at high risk of complications with reservoir placement, such as after previous abdominal surgery.³

From the outside, a penile implant is hidden: all parts sit inside the body. With an inflatable implant the penis is soft and hangs naturally when deflated and firm when inflated; a malleable implant keeps the penis firm and is bent down for daily wear.¹ ²

According to the 2025 EAU Guidelines on Sexual and Reproductive Health, massage is not recognized or recommended as an effective treatment for erectile dysfunction¹. The guidelines mention massage only in other contexts, such as helping a drug spread after an injection to treat priapism and penile massage and stretching after Peyronie's disease surgery, not as a therapeutic intervention for ED².

The 2025 EAU Guidelines on Sexual and Reproductive Health do not specifically recommend any natural drinks for the treatment of erectile dysfunction (ED).¹ Current evidence-based recommendations focus on addressing underlying risk factors and medical treatments rather than natural drinks.²

Erections that disappear too quickly (detumescence) are often caused by underlying vascular issues, psychological factors, or medication side effects, and can be effectively treated with various therapies including oral medications, injections, or penile implants in severe cases.¹,²

According to the 2025 EAU Guidelines, the prevalence of premature ejaculation is not affected by age, while aging is listed as one possible cause of delayed ejaculation. Men with erectile dysfunction, which increases with age, often experience concurrent ejaculatory problems that can affect sexual satisfaction.

Erectile dysfunction can affect men at any age, but its prevalence increases significantly with advancing age: in the Massachusetts Male Aging Study, 52% of men aged 40-70 years had some degree of erectile dysfunction.¹ ² Men under 50 years with erectile dysfunction should be evaluated for cardiovascular disease risk, as it may be an early warning sign of underlying vascular problems.³

According to the 2025 EAU Guidelines, lifestyle changes and less invasive treatments are usually tried first; penile implants, which have one of the highest satisfaction rates (92-100% of patients), may be considered when these do not restore erectile firmness or when a patient prefers a definitive therapy.¹²

Inability to maintain an erection during sex is defined as erectile dysfunction (ED), which can result from various physical and psychological factors including cardiovascular issues, diabetes, or anxiety.¹ When other treatments fail, penile implants offer a highly effective solution with satisfaction rates of 92-100% for patients.²

Penile implants are considered the most effective treatment for erectile dysfunction when other therapies have failed, with satisfaction rates exceeding 90% among both patients and their partners.¹ ² ³

Penile girth may decrease with age due to various physiological changes and risk factors, including vascular conditions and hormonal changes¹. While the 2025 EAU Guidelines don't specifically address normal age-related girth changes, they recognize that penile implants can restore erectile function in men with erectile dysfunction, while noting that implants do not increase penile length².

Perceived smaller erect penis size can result from various factors including obesity, underlying medical conditions, or psychological concerns, with penile implants offering a potential solution for men with erectile dysfunction who experience penile shortening.¹,²

Erectile dysfunction (ED) can be caused by various physical and psychological factors including vascular problems, medication side effects, or anxiety, with treatment options ranging from lifestyle changes to penile implants for severe cases.¹ ²

The 2025 EAU Guidelines do not mention dehydration as a cause of erectile dysfunction or reduced penile size; they list vascular factors among the several causes of erectile dysfunction¹, and penile implants remain a highly effective option for persistent erectile dysfunction regardless of its cause².

Improving penile nerve function may involve multiple approaches including penile rehabilitation techniques with PDE5 inhibitors and intracavernous injections of platelet-rich plasma that can stimulate angiogenesis and nerve recovery¹, though evidence shows limited effectiveness of rehabilitation alone for spontaneous recovery².

Penile atrophy is primarily addressed through penile prosthesis implantation when associated with erectile dysfunction¹, while non-surgical approaches like penile traction therapy may help with penile shortening in other conditions². The 2025 EAU Guidelines do not support hormonal therapies for increasing penile size in adult men³.

Penile implants may be considered for erectile dysfunction when other treatments are unsuitable or have not worked, or when a patient prefers a definitive therapy, and they have one of the highest satisfaction rates of all ED treatments (92-100% of patients and 91-95% of partners with appropriate counseling).¹,²

Erections can occasionally occur during urological procedures and can be managed by the surgical team if needed; the 2025 EAU Guidelines on Sexual and Reproductive Health do not specifically cover this situation¹. Although the guidelines do not address erections during surgery, they do describe medicines used to treat or prevent priapism (prolonged, unwanted erections)².

According to the 2025 EAU Guidelines, damaged penile blood vessels causing erectile dysfunction generally cannot be directly repaired, but treatment options include medications, low-intensity shockwave therapy for mild cases, and penile implants for severe vascular damage.¹,²

Rigicon offers two advanced penile prosthesis lines: the Infla10® inflatable prosthesis with 96.4% one-year and 94.0% three-year survival rates from revision surgery, and the Rigi10™ malleable prosthesis with exceptional 99.2% three-year survival rates and innovative six-width sizing options for optimal anatomical customization.

Erections may fade quickly due to vascular, neurological, or psychological factors that affect the complex mechanisms maintaining penile rigidity¹. When conservative treatments fail to provide sustainable erections, penile implants offer a highly effective solution with satisfaction rates exceeding 90% according to the 2025 EAU Guidelines².

The 2025 EAU Guidelines on Sexual and Reproductive Health do not specify an average duration for erections, though they note that functional erections should achieve at least 60% rigidity recorded on the tip of the penis lasting for ≥ 10 minutes during nocturnal testing¹.

According to the 2025 EAU Guidelines, penile prosthesis implantation does not typically increase penile length, with most patients (72%) reporting a subjective decrease in penile length despite no statistically significant difference in measured stretched penile length.¹ ²

Insurance coverage for penile implant surgery depends on your country's health system and your plan. The 2025 EAU Guidelines do not address insurance; they describe a penile implant as an option for men who are not suitable for other drug treatments or prefer a definitive therapy, and who do not respond to other treatments.¹ Ask your urologist's office and your insurer what is covered before surgery.

Yes, men can typically experience orgasms after penile implant surgery as the procedure is designed not to affect orgasm or ejaculation.¹ Penile implants restore erectile function, although some men notice changes in penile sensation after surgery, which can improve over time.

The 2025 EAU Guidelines on Sexual and Reproductive Health do not provide specific recommendations regarding catheter use after penile implant surgery, as post-operative catheterization protocols are not explicitly addressed within the guidelines.¹

Yes, some types of penile implants can stay partially inflated. The three-piece inflatable devices can be adjusted to various degrees of rigidity based on patient preference, while two-piece inflatable implants offer less adjustability; semi-rigid implants cannot be inflated or deflated, as they stay permanently firm and are bent into position.¹ ²

Most patients can resume cycling once they have fully healed from penile implant surgery, as modern implants are designed to withstand everyday physical activity.¹ However, patients should consult their surgeon for personalized advice based on their specific implant type and recovery progress.²

There is no standard “normal” length of time: how long an erection lasts during sexual activity varies widely from man to man and depends on individual factors including age, health status, and psychological factors. The duration of an erection is influenced by both physiological mechanisms controlling blood flow to the penis and psychological factors affecting sexual arousal.³

Several medication classes can cause erectile dysfunction, including antihypertensives (especially thiazide diuretics and beta-blockers), antidepressants, antipsychotics, antiandrogens, and certain recreational drugs.¹ These medications may affect erectile function through various mechanisms, but alternative treatments are often available.²

Erectile dysfunction (ED) can have physical causes (vascular, hormonal, neurologic), psychological causes (anxiety, depression), or most commonly, a combination of both.¹ While psychological ED may respond to counseling, physical ED often requires medical intervention, with both types benefiting from a comprehensive treatment approach.²

The 2025 EAU Guidelines on Sexual and Reproductive Health do not address erections under anesthesia; erections during general anesthesia are uncommon, but they can occasionally occur during surgery.¹ Penile implant procedures are performed under anesthesia specifically to ensure patient comfort and surgical safety during the implantation process.²

The 2025 EAU Guidelines do not specify an optimal age for penile implant surgery, as the decision is based on erectile dysfunction severity, failure of less invasive treatments, and patient preference rather than age. Penile implants are usually considered when other treatments have failed or are unsuitable, or when a definitive therapy is preferred, and have high satisfaction rates (92-100% in patients) with appropriate counseling; the guidelines do not report satisfaction separately by age.

The 2025 EAU Guidelines on Sexual and Reproductive Health do not give an average cost for penile implants. The total cost depends on the type of device, the surgeon, the hospital and your health system or insurance plan; the AUA guideline notes that cost concerns can be one reason a malleable implant is chosen.¹ ⁵

The fastest-acting ED treatments include avanafil (effective within 15-30 minutes), sildenafil and vardenafil (30-60 minutes), and intracavernosal injections (5-15 minutes), with penile implants providing immediate on-demand erections for men seeking a permanent solution.¹ ² ³

To stop an erection, some men try simple measures such as position changes, although the EAU Guidelines do not endorse cold applications or exercise; removing the constriction ring ends an erection created with a vacuum erection device, and in persistent cases medical interventions such as intracavernous injections of sympathomimetic agents are used.[1, 2] For men with recurrent unwanted erections, consulting a urologist about treatment options including medications or penile implants may be appropriate.[3]

Most penile implants last 10 to 15 years on average, although this depends on the implant type, patient health, and surgical factors. Over time, mechanical failure or complications may require revision or replacement.

Sildenafil is not typically needed or effective after penile implant surgery, as the implant itself provides the rigidity needed for sexual intercourse.

Most men report a perceived decrease in penile length after a penile implant, though objective studies show only a small reduction of less than 1 cm. Small gains in stretched length have been reported in one study of selected patients with a length-expanding implant.