The definitive treatment for severe erectile dysfunction when tablets and injections have genuinely failed. Satisfaction rates are high, the result is reliable, and the decision cannot be undone.
A penile implant is a device placed inside the two erectile bodies of the penis. An inflatable version uses a small pump hidden in the scrotum to move fluid into cylinders, giving an erection that looks and feels close to natural and goes down afterwards. A malleable version is a pair of bendable rods that are simply positioned up for sex and down the rest of the time.
Satisfaction rates for implant surgery are among the highest in men's health, commonly reported above ninety per cent for both patients and partners. That reflects how reliable the result is once healing is complete, because unlike tablets or injections it works every time and needs no planning.
The point that must be understood before consenting is that the operation removes the natural erectile tissue's ability to work. If the device is ever removed and not replaced, natural erections do not return. That is why Dr. Ashutosh Shah offers this only after other options have been genuinely tried, and why counselling before surgery is unhurried.
This is not a first line treatment, and it should never be presented as one. These are the situations where it genuinely becomes the sensible choice.
Implants are almost always the endpoint of one of a small number of conditions that have damaged the erectile tissue or its nerve supply.
A full review of what has already been tried and why it failed. If tablets or injections have not had a fair trial at proper doses, you will be advised to do that first rather than proceed to surgery.
Bloods including HbA1c, penile Doppler where useful, cardiac fitness for anaesthesia and a genital examination. Diabetes is brought under control before booking, because infection risk depends heavily on it.
An unhurried discussion of inflatable versus malleable devices, cost, hand dexterity, what the result will look and feel like, and what cannot be reversed. Partners are welcome at this session.
Admission in the morning, spinal or general anaesthesia, and a procedure of sixty to ninety minutes under strict sterile protocol with antibiotic cover. You stay one night for observation and pain control.
A wound check within the first ten days, with reassurance about the swelling that always looks alarming around day three. Support garment use and activity limits are reinforced.
At four to six weeks you are taught to operate the device in person, and repeat sessions are given if needed. Sexual activity is cleared at this visit, with a final review at six months.
Most men stay one night. Swelling and soreness in the scrotum and lower shaft are expected for the first two weeks, and are worst around day three before improving steadily. Simple pain relief handles it in almost every case, and a supportive garment reduces the swelling considerably.
Desk based work is usually possible after seven to ten days. Cycling, heavy lifting and riding a two wheeler wait four to six weeks. An inflatable device is left deflated during early healing, then you are taught to operate the pump at the follow up visit, and it takes most men a few sessions of practice to become confident with it.
Sexual activity restarts at four to six weeks once healing is confirmed. The device continues to feel more natural over the following two to three months as swelling fully settles and you stop thinking about the mechanics.
Implant surgery is the most expensive treatment in this area, and the device itself accounts for most of the figure. A malleable device costs considerably less than a two piece inflatable, which in turn costs less than a three piece inflatable. Surgeon fees, theatre, anaesthesia, the hospital stay and follow up are quoted alongside the device so you see the complete picture. Where a curvature correction or scar tissue clearance is needed at the same sitting, that is added transparently. You receive a single written quotation after assessment, and it is not revised later.
There is no universally best device. The right choice depends on your hand strength, anatomy, previous surgery, cost considerations and what matters most to you.
Cylinders in the erectile bodies, a pump in the scrotum and a fluid reservoir in the abdomen. It gives the closest result to a natural erection, both when firm and when flaccid. It is the most expensive option and needs reasonable hand dexterity.
Ask about thisCylinders and a combined pump and reservoir unit, with no separate abdominal component. A sensible choice where previous abdominal or pelvic surgery makes reservoir placement difficult, and it costs less than the three piece device.
Ask about thisA pair of bendable rods positioned up for sex and down otherwise. Nothing can mechanically fail, it is the least expensive option, and it suits men with limited hand strength or dexterity. The penis remains permanently firm, which takes adjustment.
Ask about thisWhere significant curvature accompanies severe erectile dysfunction, the penis is straightened by modelling or a small incision at the same sitting as the implant. This avoids a second operation and treats both problems together.
Ask about thisFor men left with severe erectile dysfunction after radical prostate surgery, once at least a year of rehabilitation, tablets and injections has been given a fair trial. Tissue planes can be scarred, so surgical planning is more detailed in these cases.
Ask about thisFor mechanical failure of an older device, an implant placed too short or too long, or one that has eroded. These operations are technically harder than a first implant and are planned with imaging and considerable care.
Ask about thisHonest answers about this procedure in Surat.
Ask a QuestionAn inflatable device gives an erection close to natural in both appearance and rigidity, and most partners cannot tell during intercourse. The glans does not become firm with the device, which some men notice initially. A malleable device gives permanent firmness that is positioned up or down, which is effective but less natural in feel.
It can be removed surgically, but natural erections will not return afterwards, because the operation permanently alters the erectile tissue. Removal without replacement also leaves scarring that makes any future implant harder to place. This is why counselling before consent is deliberately slow and why the decision should never be rushed.
Modern devices are durable, and published figures commonly show the large majority still working well at ten years. Malleable devices have fewer moving parts and tend to last longest. Mechanical failure does eventually happen in some men, and replacement surgery is generally more straightforward than the original operation.
Not in normal circumstances. The pump sits inside the scrotum where it feels like a small firm structure, and the components are entirely internal with no external parts. In a changing room or through clothing nothing is visible. A partner will usually be aware, which is why involving them in the decision helps.
Infection is the complication that matters most in device surgery, and reported rates in modern practice are low, generally in the low single figures per cent. Risk rises with poorly controlled diabetes, so blood sugar is optimised before booking. Strict sterile protocol, antibiotic cover and careful technique are what keep that figure low.
Sensation of the skin and glans is preserved, because the nerves responsible run outside the tissue where the device sits. Orgasm and ejaculation continue as before, provided they were normal beforehand. What changes is how the erection is produced, not how sex feels or whether climax is possible.
In almost every case, yes. Injection therapy works for the majority of men whose tablets have failed, costs far less, and reverses nothing. An implant is reasonable when injections have genuinely failed at proper doses, cannot be tolerated, or when a man has used them successfully for years and now wants something simpler.
Four to six weeks, once healing has been confirmed at follow up and you have been taught to operate the device. Starting earlier risks disturbing the healing tissue around the cylinders. Most men then need a few weeks of practice before the device feels routine rather than deliberate.
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