With an inflatable penile implant, a man can achieve an erection safely through an internal fluid-and-pressure mechanism.

An inflatable penile implant is an effective device for treating severe erectile dysfunction. It allows the patient to inflate and deflate the penis through a pump implanted in the scrotum, with the aim of simulating an erection as naturally as possible.

Doctors recommend this model for men who have not achieved satisfactory results with other erectile dysfunction treatments or who have experienced significant side effects.

In this article, you will better understand the inflatable penile implant, how it works, and how specialists perform the surgery.

What is an inflatable penile implant?

The inflatable penile implant — also known as a hydraulic penile implant — is a type of penile prosthesis and a surgical treatment for erectile dysfunction.

This model consists of cylinders, saline solution, and an activation pump.

When inflated, the penis achieves an erection with sufficient rigidity for penetration. After sexual intercourse, the implant can simply be deflated so that the penis returns to an almost flaccid state.

Who is an inflatable penile implant recommended for?

Doctors recommend the inflatable or hydraulic implant for men with severe erectile dysfunction. These patients generally do not respond satisfactorily to conservative treatment with oral medications or intracavernosal injections.

In addition, men who experience relevant side effects from medications or injections may also be candidates for this surgical intervention.

Specialists may also recommend the implant in selected cases of penile deformities after medical evaluation, a situation that may occur in Peyronie’s disease.

Although age does not determine the indication for an inflatable penile implant, doctors should consider it as part of the overall clinical assessment.

Younger men tend to live with the implant for a longer period and, for this reason, are more likely to require future surgery to replace the device. In fact, an article in the scientific journal Urology, published in 2022, showed that the survival rate of the inflatable prosthesis after 20 years decreases almost by half.

On the other hand, older men may have motor limitations in their hands, which can make it difficult to handle the prosthesis pump and compromise the achievement of an adequate erection.

Types of inflatable penile implant

There are inflatable penile implant models made up of two or three pieces.

• Two-piece inflatable implant: a pair of cylinders with an integrated reservoir, implanted in the penis + a pump positioned in the scrotum;

• Three-piece inflatable implant: a pair of cylinders implanted in the penis + an activation pump housed in the scrotum + a separate reservoir positioned in the abdominal region.

In addition, inflatable penile implant models differ according to the type of cylinder expansion:

• Standard: the cylinders have greater length and diameter, providing greater rigidity and axial resistance;
• Narrow: the cylinders have a smaller diameter and are indicated for men with longer and thinner penises. However, they offer less rigidity when compared with the Standard model.

Components of the inflatable penile implant

The inflatable penile implant is composed of the following components:

Cylinders

The cylinders are two tubes implanted inside the penile shaft, which receive the saline solution from the reservoir of the inflatable penile implant.

Proper sizing of the penile cylinders is essential to ensure the rigidity required for sexual intercourse.

Pump

The pump is a control mechanism positioned in the scrotum and responsible for transferring the saline solution from the reservoir to the penile cylinders and vice versa. This is the component the man activates to achieve an erection.

Reservoir

The reservoir is located in the lower portion of the abdominal region and stores the saline solution. When the patient activates the pump, the system transfers this fluid to the cylinders, promoting penile rigidity. This component is not palpable or externally visible.

Use of extenders

Penile implant extenders are pieces that attach to the cylinders with the aim of increasing their length when the implanted prosthesis is shorter than the length of the penis.

However, the use of extenders must be carefully considered, as it can compromise the rigidity and stability of the prosthesis.

After all, this situation increases the risk of the penis bending during penetration, which can impair the functionality of the implant.

Benefits of an inflatable penile implant

Satisfaction with an inflatable penile implant is high, with positive effects on male sexual health:

Penile rigidity

The implant allows the recovery of sexual function. By providing a new erectile mechanism, the prosthesis ensures sufficient rigidity for penetration.

Controlled erection

The man controls the erection and can maintain sexual intercourse even after orgasm, without needing to wait for the refractory period. However, erotic stimulation remains a fundamental factor for a better sexual experience.

Discretion and natural appearance

The inflatable prosthesis is more discreet when compared with the malleable model. Because it allows the penis to remain partially flaccid, the patient can conceal it comfortably under underwear, maintaining an appearance more similar to that of a natural penis.

Improved sexual quality of life

The prosthesis may allow a safe and spontaneous return to sexual activity, as it represents a definitive functional solution. This predictability helps reduce performance anxiety and frustration associated with recurrent episodes of erectile failure.

Improved self-esteem

Resuming sexual life has a positive impact on the patient’s psychological well-being, self-esteem, and self-confidence, as well as on partner satisfaction.

How is inflatable penile implant surgery performed?

Surgery to place a penile implant usually lasts about one and a half hours. This time may vary according to the complexity of the case and the surgeon’s experience. Doctors perform the procedure under sedation or general anesthesia.

Through an incision made below the glans, the surgeon introduces the cylinders inside the corpora cavernosa of the penis, preserving these structures as much as possible. It is worth adding that this stage is performed with the penis in an induced erection.

Next, the surgeon tests the implant’s function by inflating and deflating the prosthesis several times. It is essential to verify that there are no mechanical restrictions that could compromise the rigidity achieved.

In cases where there is penile curvature caused by fibrosis, penile reconstruction is performed beforehand, with alignment and optimization of the length and girth of the penis. Without this step, the stability and functional performance of the prosthesis may be compromised.

Postoperative period and recovery

After penile implant surgery, the patient may feel pain, usually controlled with analgesic medication.

The man should remain at rest and keep a surgical dressing in place for a few days.

In addition, postoperative medical follow-up is essential, with reassessment appointments to monitor recovery progress.

The recovery period may extend up to 60 days. The patient may resume light activities after about 7 days, while more intense activities are usually released after 21 days. Sexual activity should only be resumed after medical authorization.

How the hydraulic penile implant works

Once each component is properly implanted, the surgeon should instruct the patient on the correct way to activate the prosthesis.

Then, to achieve an erection at the desired time, the patient simply activates the pump, which transfers fluid from the reservoir to the cylinders, resulting in penile rigidity.

For the penis to return to a flaccid state, it is necessary to perform a downward bending movement in the case of the two-piece prosthesis or press the pump again in the three-piece model, allowing the fluid to return to the reservoir.

Frequently asked questions (FAQ )

What is the price of an inflatable penile implant?

The average price of an inflatable penile implant ranges from €5,000 to €9,000, including VAT, without considering hospitalization costs and medical fees.

What is the warranty for a penile implant?

Penile implant warranties are no longer lifetime warranties. Currently, the warranty ranges from 7 to 10 years in Portugal, depending on the manufacturer and prosthesis model.

Is the inflatable penile implant covered by the Portuguese National Health Service (SNS)?

No. The model usually made available by the SNS is the malleable penile implant, reserved for cases of severe erectile dysfunction that are refractory to conventional treatments.

An inflatable penile implant may be an effective treatment for your case

The inflatable penile implant is recommended in situations where other erectile dysfunction treatments have not produced the expected results.

With proper clinical evaluation and medical follow-up, this treatment may allow the recovery of your erectile function and the return to your sexual life with confidence.

Therefore, if you would like more information or want to clarify your doubts confidentially, we can help you.

Dr. Paulo Egydio is a urologist with 25 years of experience in penile implant surgery and is available in Portugal. Schedule your appointment.