Contrary to what many men imagine, sexual life after a penile prosthesis may retain several familiar aspects, although there are changes that should be understood. Learn what erections are like after implantation and what special daily care may help maintain a good sex life.
Sex with a penile prosthesis is a very common concern among men who are candidates for this device, since this surgery brings significant changes to penile function, which may affect sexual life.
A penile prosthesis may offer an effective option for men with severe erectile dysfunction, potentially allowing penile rigidity adequate for sexual intercourse and contributing to sexual quality of life, depending on the evaluation and progression of each case.
But is the experience of having sexual intercourse after surgery the same as before? What really changes in sexual life after a surgical procedure like this? Below, understand how a gradual return to sexual activity may occur after penile implantation.
What changes in sex with a penile prosthesis?
The use of a penile prosthesis may modify some aspects of sexual life, although many men maintain satisfactory sexual relations after the adaptation period. The main difference is that the erection no longer depends exclusively on sexual stimulation to occur.
Patients with an implant can obtain an erection without the need for sexual arousal, since in these cases the erection occurs in a controlled way by the man himself: simply activate or inflate the prosthesis for the penis to become erect.
In addition, the prosthesis may allow penile rigidity to be maintained during sexual intercourse while the device remains activated. Even after ejaculation, the penis may remain erect until the man deactivates the prosthesis mechanism. This may influence the dynamics of sexual intercourse in some cases, depending on how the couple adapts to the device.
After all, what is eroticization?
Eroticization is the process by which a stimulus becomes sexually exciting or provocative for a person. It may involve a wide variety of stimuli, such as images, sounds, smells, touch, or specific situations that trigger sexual arousal.
For many people, the ability to become sexually aroused is closely linked to the ability to obtain an erection. However, in men with a penile prosthesis, the need to depend on eroticization to achieve an erection may no longer exist.
This means that the man does not need to depend exclusively on eroticization to obtain an erection. Instead, he gains greater control over erectile function and may activate the prosthesis to obtain the rigidity needed for sexual intercourse, regardless of the context or sexual stimulus.
How eroticization contributes to arousal
This ability may be positive for many men, especially for those who have difficulty becoming sexually aroused or maintaining an erection due to medical problems.
Thus, sexual intercourse may become more stable and consistent, allowing the man and his partner to experience sexuality with greater security and adaptation to their individual and relational needs.
Even so, it is important to highlight the role of eroticization during sexual intercourse, even in cases involving a penile prosthesis. When a man has a good level of sexual arousal, penile sensitivity may become more pronounced, regardless of whether there is a prosthesis or not.
Some men report positive changes in the subjective perception of sexual experience after the procedure, associated with greater confidence during sexual intercourse, which may positively affect self-esteem and overall sexual well-being.
It is important to remember: although a penile prosthesis may eliminate the need for eroticization to achieve an erection, it remains important to cultivate a healthy and satisfying sex life. This may involve exploring different forms of intimacy and sexual pleasure.
What is an erection like with a penile prosthesis?
An erection with a penile prosthesis is different from one that occurs naturally. Instead of depending on blood flow to fill the corpora cavernosa of the penis, as happens in a natural erection, the prosthesis uses its own mechanism to create the rigidity necessary for sexual intercourse.
Most penile prostheses consist of cylinders that the surgeon implants into the corpora cavernosa of the penis. When the man activates the mechanism, the prosthesis creates a firm erection that is sufficiently long-lasting for sexual activity.
Although the sensation of an erection with a penile prosthesis may differ from a natural erection, some men report favorable adaptation to the device, allowing them to maintain an active sex life.
Although the man controls the erection by activating the prosthesis, eroticization continues to play an important role in the experience of sexuality. When sexual arousal is present, there may be greater perception of sensitivity and involvement during sexual intercourse, even in men with a penile prosthesis.
Ejaculation with a penile prosthesis
Ejaculation after penile implantation occurs normally. The prosthesis does not interfere with this process, which is controlled by the autonomic nervous system and involves the release of semen through the urethra during sexual climax.
The prosthesis is intended to restore the ability to obtain and maintain an erection, but it does not determine the production or release of semen. Therefore, men who undergo penile prosthesis implant surgery generally continue to experience ejaculation as before.
However, men who did not have ejaculation before penile prosthesis surgery already (cases of anejaculation) will continue not to ejaculate. This is the case for men who have previously undergone prostate surgery or who have hormonal changes or neurological diseases.
It is important to note: ejaculation and orgasm are different processes. Orgasm corresponds to the pleasure response generated in the brain, while ejaculation is the release of semen through the urethra. In general, a penile prosthesis does not directly interfere with these processes, although each case should be evaluated individually.
What is it like to live with a penile implant?
Living with a penile implant may bring significant changes to a man’s life, especially for those who were facing persistent erectile dysfunction problems.
The prosthesis may provide greater mechanical control over penile rigidity. With the device, some men may no longer depend on previously used approaches to obtain sufficient rigidity for sexual intercourse, always according to medical evaluation.
It is important to remember that the penile prosthesis is intended to provide the rigidity needed for penetration when this had previously been compromised, allowing penile firmness to be maintained during sexual intercourse.
Choosing the right prosthesis
The most appropriate type of prosthesis for each patient should be defined based on penile anatomy, clinical conditions, and the man’s general health status.
Below, learn about the two most common types of penile prosthesis and how each may adapt to the patient’s needs.
Malleable penile prosthesis
The malleable prosthesis consists of a device formed by metallic rods coated with silicone, which are quite flexible and inserted by the surgeon into the corpora cavernosa. These rods keep the penis in a semi-rigid state.
The man may position the penis upward during sexual intercourse and place it downward or to the side when it is not in use. Therefore, adaptation to the malleable penile prosthesis may be simple in some cases, although the experience varies from patient to patient and also depends on the couple’s sexual dynamics.
Inflatable penile prosthesis
The inflatable model is composed of inflatable cylinders inserted into the corpora cavernosa of the penis, a pump implanted in the scrotum, and a saline solution reservoir.
For an erection to occur, the man must activate the pump, which will inflate the device. After sexual intercourse, simply press the prosthesis deactivation mechanism for the penis to return to the flaccid state.
When should a man use a penile prosthesis?
Penile prosthesis implants are indicated for men who face erectile function challenges and who have not achieved satisfactory results with clinical treatments.
Situations in which the use of a penile prosthesis may be considered include:
- Loss of rigidity: men who have lost the ability to obtain or maintain an erection firm enough for sexual activity may benefit from penile prosthesis placement.
- Difficulty with penetration: men who have difficulty or are unable to achieve penetration during sexual intercourse due to erectile dysfunction or penile curvature may be candidates for evaluation of penile prosthesis as a therapeutic option.
- Failure of other treatments: when other therapeutic options for erectile dysfunction do not produce satisfactory results or cause unwanted side effects, the doctor may consider penile prosthesis placement.
How is penile prosthesis implantation performed?
Penile prosthesis implantation is performed surgically, after a urologist confirms the diagnosis of erectile dysfunction with detailed examinations.
The surgical procedure may vary according to penile anatomy, the severity of erectile dysfunction, and the type of prosthesis chosen. In general, the surgery follows these steps:
- Preparation: before surgery, the patient’s genital area is prepared with appropriate asepsis. Local anesthesia is also administered to ensure comfort during the procedure.
- Access to the area: the surgeon makes an incision through the chosen access route, usually subcoronal, located just below the glans, to access the penis and the corpora cavernosa.
- Tissue preparation: the tissues around the corpora cavernosa are expanded to create space for placement of the penile prosthesis cylinders.
- Implantation: the prosthesis is introduced into the corpora cavernosa, preserving the tissues as much as possible, and carefully positioned in the appropriate location.
- System positioning: in cases of inflatable prostheses, the pump is placed in the scrotum and the reservoir inside the abdomen (for three-piece models), allowing the device to function properly.
- Finalization: after prosthesis placement, the incisions are carefully closed with absorbable surgical sutures. A dressing is applied to the operated area to protect the surgical wound and support appropriate healing.
Recovery after surgery
Recovery from surgery generally takes about 60 days, although it may vary according to each patient’s progress.
During the first five days, the recently operated man should maintain close follow-up with the surgeon. During this period, some rest is recommended. It is also necessary to change the dressing according to the guidance received, and showering may be done normally.
Throughout the first month after surgery, if recovery progresses positively, the patient may gradually resume some daily activities, such as working, driving, or performing physical activities, always according to medical guidance.
Recovery time before having sexual intercourse with a penile prosthesis ranges from 45 to 60 days.
Complete healing may take up to one year. Scar evolution varies according to the individual healing response and the characteristics of the procedure.
What are the best positions for enjoying sex with a penile prosthesis?
After the recovery period and according to medical guidance, the couple may gradually resume sexual activity, adapting positions according to the comfort and confidence of both.
If the couple experiences any initial difficulty, positions in which the man has greater control over movement, such as those in which he is on top, may be more comfortable until greater confidence is gained.
In addition, regardless of the type of prosthesis the patient has received, the couple should consider some precautions during sexual intercourse:
- Correctly activate the prosthesis erection mechanism before sexual intercourse, ensuring that rigidity is adequate for penetration;
- Avoid abrupt movements or excessive pressure on the penis;
- Use water-based lubricants to reduce the risk of irritation or allergies, both during penetration and masturbation.
Recommendations for sexual life with a penile prosthesis
A penile prosthesis may positively affect aspects of quality of life in some cases. Below are some recommendations that may help in daily life.
Maintain open dialogue with your partner
Do not be afraid to have conversations about sex with a penile prosthesis before, during, and after sexual intercourse. It is important that both people feel comfortable with the situation.
During the first times after penile prosthesis placement, partners may feel a greater need to communicate about what has changed. Over time, the couple will adapt to the functioning of the device and discover how best to experience sexual life.
Talk to your doctor
After recovery, it is important to maintain regular follow-up with the urologist and follow all medical recommendations in order to support appropriate adaptation to the device and the gradual return to sexual activity.
The urologist may clarify doubts about resuming sexual activity and guide the patient throughout the adaptation process, helping the man gain more confidence in using the prosthesis.
Men with erectile dysfunction may benefit from specialized medical evaluation to clarify whether a penile prosthesis is an appropriate therapeutic option for their case.
For an individualized evaluation of the clinical case, contact the clinic to schedule a specialized consultation with Dr. Paulo Egydio, a urologist dedicated to penile prosthesis placement. Contact us.
