Penile implant surgery places a prosthesis inside the two erectile bodies of the penis so that a man with severe erectile dysfunction can create dependable rigidity. It is usually performed under general or spinal anaesthesia. Through a small penile or scrotal incision, the surgeon measures the erectile bodies, places correctly sized cylinders, and—if an inflatable device is used—positions the pump in the scrotum and the reservoir in a deeper pelvic or abdominal space. The wound is then closed. A catheter, compressive dressing or drain may be used for a short period depending on the case and surgeon.

Before the operation

Before surgery, the indication and implant type are confirmed and expectations are reviewed. Your team checks medicines, allergies, diabetes control, infection risk, previous pelvic or penile surgery and any urinary symptoms. Blood thinners and diabetes medicines may need a specific perioperative plan. Active infection should be treated before implantation.

Penile implant surgery: step-by-step

1. Anaesthesia and preparation

You are given general or spinal anaesthesia. The genital area is prepared using a strict sterile technique. Antibiotics are given according to the surgical protocol and local antimicrobial policy.

2. Surgical incision

A common approach uses a small incision where the penis meets the scrotum (penoscrotal). Some surgeons use an infrapubic approach above the base of the penis. Malleable and inflatable devices can be placed through appropriately chosen approaches.

3. Opening and measuring the erectile bodies

The surgeon opens the tunica albuginea, the strong covering of each corpus cavernosum, and gently creates space for the prosthetic cylinders. The corporal length is measured carefully. The objective is the best safe fit, not deliberate oversizing.

4. Placing the cylinders and other components

Paired cylinders are inserted into the corpora. With a malleable implant, these rods are the main components. With a three-piece inflatable implant, a pump is placed in the scrotum and a fluid reservoir is placed in a suitable pelvic or abdominal position. Previous pelvic surgery may alter reservoir planning.

5. Testing and wound closure

The device is tested before closure. The surgeon checks symmetry, cylinder position, haemostasis and, when relevant, curvature. The implant may be left partly inflated for a short period to reduce bleeding and swelling. The incision is closed in layers.

How long does the operation and hospital stay take?

Operating time varies with implant type and complexity. Primary uncomplicated cases are generally shorter than revision surgery, severe fibrosis or combined Peyronie’s correction. Many patients go home the same day or after an overnight stay, depending on anaesthesia, medical health, pain control and local practice.

Will there be a catheter, drain or dressing?

Benefits and important risks

The main benefit is predictable rigidity without needing a tablet, injection or external erection device each time. Important risks include infection, bleeding or haematoma, pain, wound problems, erosion, device malposition, mechanical failure, altered perceived length and the possibility of revision surgery. Injury to the urethra or surrounding structures is uncommon but can change the operation if it occurs.

One technical point patients often misunderstand

The implant does not replace the penis. The cylinders are placed inside the two corpora cavernosa—the erectile bodies that normally fill with blood. The skin, glans, urethra and most sensory structures remain in place. With an inflatable system, a scrotal pump and a fluid reservoir are added. Cylinder length is selected from measurements made during surgery; deliberately oversizing the device to chase extra length can increase pain, deformity or erosion rather than create a larger healthy penis.

What is checked before the incision is closed

Before closure, the surgeon checks cylinder position, symmetry and device function. With an inflatable implant, the system is cycled to confirm that the cylinders fill and empty appropriately and that tubing lies without obvious kinking. The wound is inspected for bleeding, and local protocols determine whether a drain, compression dressing or temporary partial inflation is used. These details vary between surgeons and device types; variation does not automatically mean one technique is safer than another.

Why previous surgery can change the operation

Prior prostate surgery, pelvic surgery, urinary diversion, transplant surgery, previous implant infection, Peyronie’s disease or severe corporal fibrosis can change where components are placed and how difficult corporal dilation is. In complex cases, the safest incision, reservoir position and implant type may therefore differ from the standard plan. This is one reason an accurate surgical history is more important than choosing a device from an online comparison alone.

Why infection prevention affects every step

Prosthetic surgery is unusually sensitive to infection because bacteria can adhere to foreign material. Preparation therefore includes screening for active infection, careful skin preparation, peri-operative antibiotic strategy and disciplined implant handling. Diabetes control and general surgical fitness matter, but a single laboratory number should not be interpreted in isolation. The important principle for patients is that an elective implant should not be placed through active infection or an unhealthy operative field simply to avoid rescheduling.

Before surgery: what your surgeon needs to know

• All medicines and supplements, especially blood thinners, diabetes medicines and drugs that affect infection or bleeding risk.
• Previous abdominal, pelvic, urethral or penile operations and any implanted devices.
• Any current urinary infection, skin infection, fever, dental infection or open wound.
• The type of implant planned and whether previous corporal fibrosis or Peyronie’s disease is expected to make placement more complex.
• Who will accompany you home and what postoperative contact plan you have if pain, fever, urinary difficulty or wound changes develop.

FAQs

Related reading

• Who Should Consider a Penile Implant?
• Penile Implant Surgery Recovery: Week-by-Week Guide
• Penile Implant Infection: How Common Is It?
• When Can You Have Sex After Penile Implant Surgery?
• Urologist in Latur

References

• European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Management of Erectile Dysfunction. 2026 https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/management-of-erectile-dysfunction
• Cocci A, Capogrosso P, Minhas S, et al. Penile prosthesis implantation: a systematic review of intraoperative and postoperative complications. Int J Impot Res. 2026;38(2):93-122. doi:10.1038/s41443-025-01108-4.
• Miller LE, Khera M, Bhattacharyya S, Patel M, Nitschelm K, Burnett AL. Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis. Urology. 2022;166:6-10. doi:10.1016/j.urology.2022.03.026.
• Pozo C, Ralph D, Lee WG. An update on penile prostheses: a narrative review. Asian J Androl. 2026;28(1):9-15. doi:10.4103/aja202557.