Can you get an erection with a penile implant?

Yes, you can get an erection with a penile implant. Penile implants are medical devices surgically inserted into the penis to help men achieve an erection when other treatments for erectile dysfunction (ED) are ineffective or unsuitable[1]. They are a reliable and effective solution for men with severe ED who do not respond to other treatment options[2].

There are two main types of penile implants: inflatable implants and non-inflatable (malleable) implants[3]. Inflatable implants are commonly used and offer a more natural-feeling erection. The three-piece inflatable implant includes cylinders in the penis, a fluid reservoir placed in the lower abdomen, and a pump located in the scrotum[4]. When the user squeezes the pump, fluid is transferred into the cylinders, creating a firm erection. Pressing the deflation mechanism returns the penis to a flaccid state.

The two-piece inflatable implant functions similarly but combines the pump and fluid reservoir in one unit within the scrotum. This version may be chosen in patients where abdominal access is limited, although it may not provide the same level of rigidity as the three-piece version[5].

Non-inflatable (malleable or semi-rigid) implants consist of bendable rods inserted into the penis. These allow the penis to be positioned manually for sexual activity. Although always somewhat firm, they offer a simpler surgical technique and are easy to use, particularly for men with limited manual dexterity[6]. However, they may be less discreet due to the constant rigidity.

Both implant types enable penetration and satisfy the criteria for a functional erection. According to the 2023 EAU Guidelines, the satisfaction rates are very high, with 92–100% for patients and 91–95% for their partners[7]. Mechanical failure rates are less than 5% after 5 years of follow-up for modern inflatable devices[8].

There are two main surgical approaches for penile prosthesis implantation: peno-scrotal and infrapubic[9]. While any surgery carries risks—such as infection (2–3% in low-risk patients and high-volume centers, potentially reduced to 1–2% with antibiotic-impregnated or hydrophilic-coated prostheses)[10], mechanical failure, or erosion—these risks are relatively low with modern implants. Choosing the right type of implant depends on the patient’s anatomy, preferences, and medical history, all of which should be discussed thoroughly with a urologist.