Penile Implants - What is a penile implant?

There are several types of implants. In each case, the implant goes into the “erection bodies” of the penis and converts the non-functioning penis into a functioning penis.

One-piece

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In this case, flexible (a good analogy is a goose-neck lamp) or semirigid cylinders are placed into the erection bodies. The penis is rigid enough for sex but soft (“flaccid”) enough that it can be concealed in the clothes.

• Benefits: least expensive type of implant, fewer mechanical parts to fail
• Downsides: least natural erection, no antibiotic coating. Worst rigidity, worst flaccidity
• Good for: men with poor hand function (e.g. multiple sclerosis), men with “buried penis” who need a prosthetic to hold on a condom-style catheter

Two-piece

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In this case, the cylinders are filled with fluid and there is a pump in the scrotum (totally concealed, like a 3rd small testicle). The man uses the pump to get an erection, and “bends” the penis to move the fluid out and become flaccid again.

• Benefits: excellent rigidity, no need to place any parts in the pelvis/abdomen.
• Downsides: no antibiotic coating, not as good flaccidity. Not good for very thin men, not good for larger penises (because of poor flaccidity)
• Good for: men who have extremely complex pelvic issues that make placement of a “three-piece” (see below) undesirable, e.g. men who have had certain pelvic crush injuries or those with complex vascular reconstruction. Very few men are in this category.

Three-piece

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These are by far the most commonly used devices. There are fluid-filled cylinders, a pump in the scrotum (that has parts for both pumping up and deflating the cylinders), and a reservoir in the pelvis/abdomen that holds the fluid when the penis is flaccid.

• Benefits: excellent rigidity and flaccidity, total control over the erection, antibiotic coatings available
• Downsides: need for placement of reservoir
• Good for most men with erectile problems, including those from prostate cancer, diabetes, vascular disease, spinal cord injury, pelvic trauma, transplant patients and others

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