Procedure of Penile Implant Surgery

Introduction

Penile implant surgery is a medical procedure used to treat men suffering from erectile dysfunction (ED) that hasn’t responded to other treatments such as oral medications, vacuum devices, or injections. The surgery involves placing a device inside the penis that enables it to become erect and sustain an erection for sexual intercourse. This solution offers long-term, reliable results and is particularly effective for men with severe or permanent erectile dysfunction, often related to diabetes, prostate surgery, Peyronie’s disease, or spinal cord injuries. The procedure of penile implant surgery can help patients make informed decisions, manage expectations, and prepare for recovery.

Penile Implant Surgery Procedure

1. Preoperative Preparation :- Before the surgery, a complete medical evaluation is done to assess the patient’s overall health. Blood tests, urinalysis, and possibly imaging tests are conducted. This step ensures the patient is fit for anesthesia and surgery. The urologist will also discuss the type of implant suitable for the patient, the risks, benefits, and what to expect during recovery. The patient may need to stop certain medications and fast for several hours before the surgery.

2. Anesthesia Administration :- The surgery is usually performed under general anesthesia or spinal anesthesia with sedation. General anesthesia keeps the patient asleep throughout the procedure, while spinal anesthesia numbs the lower part of the body. The choice depends on the patient’s health, preference, and the surgeon’s recommendation.

3. Sterilization and Surgical Preparation :- The penis and surrounding area are thoroughly cleaned with antiseptic solution, and sterile drapes are applied. Sterilization prevents infections. Surgical site preparation is crucial since the penis is a sensitive and infection-prone area.

4. Making the Incision :- A small incision is made in one of the following locations just below the head of the penis. At the base of the penis. In the lower abdomen (less common). The choice of incision depends on the type of implant, the patient’s anatomy, and surgeon preference. This incision provides access to the erectile chambers of the penis (corpora cavernosa), where the implant will be placed.

5. Dilation of Corpora Cavernosa :- Surgeons use dilators to gently stretch and open the two erectile chambers. This step creates the space inside the penis to accommodate the implant cylinders. It is done carefully to avoid damaging nearby tissues.

6. Placement of Implant Components :- The specific components inserted depend on the type of implant inflatable implants have cylinders, a pump (placed in the scrotum), and a fluid reservoir (placed in the abdomen). Malleable (semi-rigid) implants involve inserting bendable rods into the penis. For inflatable implants, the surgeon inserts the cylinders into the penis, positions the pump in the scrotum, and connects it to the fluid-filled reservoir placed in the abdomen. These parts are connected using tubing. For malleable implants, two rods are inserted into the penis that can be bent up for intercourse and down for concealment.
   

7. Testing the Device :- Once in place, the surgeon inflates the device (if inflatable) to test functionality. This ensures the implant is working properly and the erection looks natural. Any adjustments can be made before closing the incision.

8. Closing the Incision :- After confirming correct placement and function, the incision is closed with dissolvable stitches. Care is taken to avoid scarring and preserve the natural appearance. A dressing is applied over the surgical area, and a catheter may be placed temporarily.

9. Post-Surgical Bandaging and Recovery Room :- The penis is typically positioned upright and bandaged to reduce swelling. The patient is moved to a recovery area for monitoring. Keeping the penis upright helps prevent curvature or damage during the healing process. Patients are monitored for any immediate complications like bleeding, pain, or reaction to anesthesia.

10. Hospital Stay and Discharge :- Most patients go home the same day or after an overnight stay, depending on the case. The urologist will provide postoperative instructions, pain management strategies, and antibiotics to prevent infection. The patient will be advised on activity restrictions, including avoiding sexual activity and heavy lifting for several weeks.

11. Follow-Up Visits :- The surgeon schedules follow-ups to check the healing process and teach the patient how to use the device (for inflatable implants). Initial activation of the implant is typically done after 4–6 weeks. Follow-ups ensure there are no signs of infection, implant malfunction, or tissue erosion.

Conclusion

Penile implant surgery is a highly effective and permanent solution for erectile dysfunction when other treatments have failed. The procedure, though delicate, is standardized and safe when performed by an experienced urologist. There are two main types of implants malleable and inflatable each with its own surgical technique and recovery protocol. Understanding the detailed steps of the procedure helps men prepare physically and mentally for surgery and increases confidence in the decision-making process. With proper care and follow-up, patients can achieve satisfying sexual function and improved quality of life.