In this content, we clarify the main questions about prices, as well as possible coverage by health insurance providers and the Portuguese National Health Service (SNS).

Clinical assessment is required before therapeutic indication

A penile implant may be considered a surgical option for patients with severe Peyronie’s disease associated with erectile dysfunction, following an individual clinical assessment.

When penile curvature compromises sexual life, when the penis does not have enough rigidity for penetration, or when the patient does not respond to oral and injectable pharmacological treatments, the implant may be the indicated therapeutic option.

For this purpose, a medical consultation with a urologist is required. During the consultation, the patient’s needs, expectations, clinical history and objectives are assessed in order to consider the therapeutic options suitable for each case.

Once the surgical indication has been considered, it is necessary to assess each patient’s penile anatomy in detail in order to select a prosthesis with a length and diameter compatible with the individual clinical characteristics, aiming to support the best possible rigidity and functionality in each case.

In addition, the support of the sexual partner is a relevant factor for adherence to and continuity of treatment.

Types of penile prosthesis and their impact on the final penile prosthesis cost

When considering only the penile implant itself, its price is mainly influenced by the model chosen. For this reason, it is important to understand the differences between them.

There are two types of penile implants most frequently used: the malleable implant and the inflatable implant.

Malleable penile prosthesis

The malleable penile prosthesis consists of two metal rods covered with silicone. After placement in the penis, it keeps the organ in a semi-rigid position and may allow some degree of discretion in daily life, depending on each patient’s characteristics.

For sexual activity, the patient manually positions the penis according to the guidance received and the characteristics of the implanted device.

The malleable model may be considered for different patient profiles, including situations in which penile anatomy, age, manual dexterity or other clinical conditions influence the choice of device.

The cost of a malleable penile prosthesis is around €2,000, although it may vary depending on the manufacturer, the quality of the materials used and the need to import the device.

Inflatable penile prosthesis

The inflatable penile prosthesis has three components: cylinders inserted into the penis, a saline reservoir placed in the abdominal cavity and an activation pump positioned in the scrotum.

When the pump is activated, the saline solution moves from the reservoir into the cylinders, producing an erection of the penis. For this reason, it is essential that the patient has good manual dexterity to operate the device correctly.

After the system is deflated, the penis tends to return to a state close to flaccidity, which may provide greater discretion in daily life, depending on the case.

Compared with the malleable prosthesis, this model has a higher risk of mechanical failure and requires more surgical reinterventions, as it has a more complex operating mechanism. For this reason, doctors do not usually recommend it for young men.

The cost of an inflatable penile prosthesis tends to be higher and may reach approximately €7,000 or more, depending on the manufacturer’s specifications, the selected model and the purchasing conditions.

Penile prosthesis surgery: total procedure cost

When discussing penile implant surgery, it is also necessary to include the care-related and technical costs of the surgical procedure.

Therefore, the total cost of the procedure should be calculated globally, taking the following components into account:

• Penile prosthesis cost: €2,000 to €7,000;
• Professional costs, including medical fees: defined after individual clinical assessment, in accordance with the Code of Ethics of the Portuguese Medical Association;
• Anaesthesia costs: to be defined;
• Hospital and admission costs: approximately €1,800.

Approximate values, subject to variation.

When there is coverage for the penile prosthesis by a health subsystem or by the SNS, the amount payable by the patient may be reduced, according to the applicable rules and the assessment of each situation.

On the other hand, when the patient assumes all expenses in full, the final cost of the procedure becomes higher.

In addition, exchange rates also influence the cost, as many devices are imported.

Coverage by the Portuguese National Health Service (SNS), private insurers and health subsystems

Coverage for penile implant surgery by private insurers or health subsystems is not uniform in Portugal and depends on the specific conditions of the insurance policy or the subsystem’s regulations.

It is essential for the patient to check their plan in advance, particularly whether there is coverage for the device, the surgical act, hospital admission or only some of these components.

The SNS is the public option for the treatment of severe erectile dysfunction, including penile implant surgery. Access criteria, waiting times and the type of device made available may vary.

As a rule, surgery is not covered by the SNS when the indication is exclusively Peyronie’s disease, that is, in the absence of associated severe erectile dysfunction. Each situation should therefore be confirmed with the competent services.

Possibility of penile prosthesis surgery through the Portuguese National Health Service (SNS)

Penile implant surgery may be performed through the SNS in clinically justified situations, generally in cases of severe erectile dysfunction that is refractory to treatment. The indication always depends on assessment by a urologist and on the criteria applicable in the health service.

It is important to note that, within the SNS, the option usually made available is the malleable penile prosthesis.

Urological assessment and definition of penile prosthesis cost

In addition to knowing the approximate prices of a penile prosthesis, it is important to understand that the choice of model should be made together with the urologist after an individual clinical assessment.

If you suffer from erectile dysfunction and have not obtained a response to conventional treatments, seek medical assessment with a urologist to understand the therapeutic options suitable for your case.