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Male Sexuality and Cancer: Erection Problems

Penile Implant

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A penile implant is also called an inflatable penile prosthesis (IPP). It is a pump system, which is implanted into the penis. Surgery is needed to put the pump system in. IPPs are inflated so they’re erect for sex, and deflated so they’re soft the rest of the time.

There are two companies that manufacture these implants. They come in self-contained, 2-piece or 3-piece versions. The more complex the implant, the firmer and larger the erection when it’s inflated, and the softer and more natural the penis is when it isn’t inflated. However, the more parts the implant has, the more likely it is to break down.

All inflatable penile prostheses are similar. They all have 2 cylinders and a pump system that are put in the penis and the surrounding area. To get an erection, a man presses on a small pump that moves fluid into the cylinders in the penis. The penis doesn’t deflate after orgasm until a release valve is pushed. You can’t tell if someone has a penile prosthesis, unless you see the small scar on the bottom of the penis.

Picture of a penile implant

How does the prosthesis work?

The prosthesis has 2 cylinders, which are put in the penis. When they’re empty, the penis looks and feels soft and hangs down. When they’re filled with fluid (saline or saltwater that stays in the pump system), the penis gets bigger and hard. There are different kinds of pump systems, but they all work the same way—fluid is pumped into the device to make the penis hard. The inflatable prosthesis makes an erection that’s just like a natural erection.

Many men say the erection is shorter than what’s normal for them. This doesn’t usually matter to the person’s partner and it doesn’t usually affect a partner’s orgasm with intercourse. If this is a concern for you and your partner, try different sex positions. For heterosexual couples, try with the woman on top as it increases friction against the clitoris and makes it easier to have an orgasm. For same sex couples, it’s safe to try different positions to stimulate the partner’s prostate.

When the prosthesis isn’t inflated, the soft penis is a little fuller than normal, but it looks the same. A prosthesis doesn’t change how the skin of the penis feels or a man's ability to have an orgasm. A man still ejaculates and passes urine the same way. Once a prosthesis is put in, a man will never be able to get an erection without inflating it. If the implant is removed, the man won’t ever be able to have natural erections.

Who can get penile prostheses?

Penile prostheses are used for health issues that affect erection problems when there are no other treatment options. Once a prosthesis has been put in, a man can’t have an erection without it. This means it won’t work for men with stress-related erection problems. It’s best to get counselling for these types of problems or just give it time.

If a man has had a radical prostatectomy for prostate cancer, he needs to wait at least 2 years before having surgery to get an IPP. This is to see if the ability to have an erection will recover.

What are the side effects of the implant?

  • Implants work well 90 to 95% of the time. About 10% of men have mechanical problems with the IPP (e.g., part of the device springs a tiny leak). These problems can often be fixed.
  • Rarely (2% of the time), men get an infection in the first few days after surgery. If this happens, the IPP has to be removed until it heals.
  • It’s best to choose a surgeon who has lots of experience putting in penile prostheses.

Tips for Using an IPP

  • It’s important to have support from your partner if you choose this option. It’s also a good idea to have foreplay with your partner before and after you use the IPP.
  • Tell your partner you have an IPP. Don’t try to hide it.
  • Don’t use the IPP until you’re healed from your surgery. Your surgeon will tell you when it’s okay to have sex.
  • Think about getting your partner to inflate the IPP as part of foreplay. Before penetration, warm the penis with a warm washcloth or hand massage with a lubricant.
  • Talk about and make sure your partner understands that you‘re still attracted to them, even though you need the device to get an erection.​

Related Video


Information about the Inflatable Penile Prosthesis

Col Hallas of American Medical Systems gives an overview of penile implant devices and talks about how they work.

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