Can You Have an Orgasm After a Penile Implant?

Penile implants (also called penile prostheses) are surgical devices implanted within the penis to enable men with erectile dysfunction to achieve erections suitable for sexual intercourse.¹ According to the 2025 EAU Guidelines, these implants represent a third-line treatment option for erectile dysfunction when other treatments have failed or are not suitable for the patient.² The ability to experience orgasm remains intact after implantation because the surgery does not interfere with the sensory nerves responsible for sexual pleasure or the mechanisms of orgasm. The EAU Guidelines identify two main types of penile implants currently available: inflatable devices (two-piece and three-piece) and semi-rigid devices (malleable, mechanical, and soft flexible).³ Three-piece inflatable implants are often preferred by patients because they provide the most natural-feeling erections, though no prospective randomized controlled trials have compared satisfaction rates between different types.⁴ Semi-rigid implants result in a permanently firm penis that can be manually positioned and offer advantages of simpler implantation technique and easier use, though they may have disadvantages of less natural appearance and reduced concealability.⁵ Patient satisfaction rates with penile implants are exceptionally high, ranging from 92-100% for patients and 91-95% for partners, making them one of the most satisfying treatment options for erectile dysfunction when appropriate counseling is provided.⁶ This high satisfaction rate suggests that sexual function, including the ability to achieve orgasm, remains fulfilling for most recipients. The EAU Guidelines also note that focused psychosexual counseling may further improve sexuality and sexual well-being in both patients and their partners after penile implant surgery.⁷ Regarding complications, the two main issues with penile implants are mechanical failure and infection. Technical improvements have reduced mechanical failure rates to less than 5% after 5 years of follow-up for the most commonly used three-piece prostheses.⁸ A meta-analysis showed implant durability or survival rates of 93.3% at 1 year, 91.0% at 3 years, 87.2% at 5 years, 76.8% at 10 years, 63.7% at 15 years, and 52.9% at 20 years.⁹ Careful surgical techniques with appropriate antibiotic prophylaxis have reduced infection rates to 2-3% with primary implantation in low-risk patients and highvolume centers.¹⁰ It’s important to note that while penile implants restore erectile function, they do not address other aspects of sexual health that might affect orgasm, such as reduced libido or ejaculatory disorders. The EAU Guidelines emphasize the importance of comprehensive counseling before implantation to ensure patients have realistic expectations about outcomes.¹¹ Additionally, patients should understand that implants do not change penile size beyond what was achievable before surgery, which may be relevant for satisfaction with sexual function.¹² In conclusion, penile implants are highly effective at restoring erectile function without compromising the ability to experience orgasm. The high satisfaction rates reported in the EAU Guidelines suggest that most men can enjoy fulfilling sexual experiences, including orgasm, following penile implant surgery. For optimal outcomes, patients should receive thorough pre-operative counseling and follow post-operative care instructions carefully.¹³