Penile Implant for Erectile Dysfunction Explained

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Penile Implant for Erectile Dysfunction: How It Works and Who It May Suit

Published: 15 October 2026

A penile implant for erectile dysfunction is a surgical device placed inside the penis to enable erections when other treatments have not worked [2]. It is typically considered after oral tablets, injections, and vacuum devices have been tried, and is most often offered to men with severe ED caused by physical conditions such as diabetes, prostate surgery, or Peyronie's disease [1][2]. This page explains how the procedure works, who it may suit, the risks and benefits, and how it compares with tablet treatments available through Cured Pharmacy's UK-registered prescriber service.

What is a penile implant for erectile dysfunction?

A penile implant (also called a penile prosthesis) is a medical device surgically inserted into the penis to help men achieve an erection [2]. There are two main types: inflatable implants, which use a pump placed in the scrotum to transfer fluid into cylinders in the penis, and malleable (semi-rigid) rods that can be bent into position manually [2]. Inflatable devices are more popular because they offer a more natural appearance when not in use, while malleable rods are simpler and may suit men with limited hand dexterity [2].

The procedure is performed under general or spinal anaesthetic by a urological surgeon, usually as a day case or with one overnight stay [2]. It is considered a permanent solution because the natural erectile tissue is replaced or altered during surgery, meaning it is not easily reversible [2]. For this reason, penile implants are typically reserved for men who have not responded to less invasive treatments such as oral tablets, vacuum erection devices, or alprostadil injections [1][2].

In the UK, penile implant surgery is available on the NHS in some areas for men with severe erectile dysfunction that has not improved with other treatments, though availability varies by clinical commissioning group [2]. Private treatment is also an option, with costs typically ranging from several thousand pounds. Because it is a surgical procedure, it requires careful assessment by a specialist urology team to ensure it is appropriate and safe [2].

How does a penile implant work?

An inflatable penile implant consists of two cylinders placed inside the erectile chambers of the penis, a small fluid reservoir implanted in the abdomen, and a pump placed in the scrotum [2]. When the man squeezes the pump, fluid moves from the reservoir into the cylinders, creating an erection firm enough for sexual intercourse [2]. After sex, a release valve on the pump allows the fluid to return to the reservoir, and the penis becomes soft again [2]. The entire system is hidden inside the body, so it is not visible when dressed or undressed.

Malleable (semi-rigid) implants are simpler: two bendable rods are placed inside the penis, which can be positioned upward for sex and bent downward at other times [2]. This type does not require a pump or reservoir, making the surgery slightly shorter and the device easier to use, but the penis remains semi-firm at all times, which some men find less discreet [2].

Both types of implant allow spontaneous sexual activity without the need to plan ahead or take a tablet beforehand [2]. Unlike oral ED medicines, which require sexual stimulation and adequate blood flow to work, a penile implant provides a mechanical erection regardless of nerve function or blood supply [2]. This makes it particularly useful for men whose ED is caused by nerve damage (for example, after radical prostatectomy for prostate cancer) or severe vascular disease [1][2].

Success rates and satisfaction

Clinical studies report high satisfaction rates among men who have penile implants, with many surveys showing that over 80–90% of men and their partners are satisfied with the results [8]. The device typically allows reliable erections sufficient for penetrative sex, and because it is always available, it can restore confidence and spontaneity [8]. Mechanical failure can occur over time—inflatable devices may develop leaks or pump problems—but modern implants are designed to last many years, and revision surgery is possible if needed [2][8].

Who may be suitable for a penile implant for erectile dysfunction?

Penile implants are usually considered for men with severe, persistent erectile dysfunction that has not improved with oral tablets (such as sildenafil or tadalafil), vacuum devices, or alprostadil injections [1][2]. Common underlying causes in these men include diabetes with nerve or blood vessel damage, previous pelvic surgery (especially radical prostatectomy for prostate cancer), Peyronie's disease with severe curvature, or significant vascular disease [1][2]. The treatment is also an option for men who cannot take PDE5 inhibitor tablets due to contraindications, such as those taking nitrates for angina [1][2].

Candidates must be in good enough general health to undergo surgery and anaesthesia, and they should have realistic expectations about the outcome [2]. A thorough assessment by a urologist will include a review of medical history, current medications, and any previous treatments tried [2]. Psychological factors are also considered: while an implant can restore the physical ability to have an erection, it does not address relationship issues, low libido, or performance anxiety, so counselling or psychosexual therapy may be recommended alongside or instead of surgery [1][2].

Men with active urinary tract infections, uncontrolled diabetes, or certain bleeding disorders may need to delay surgery until these conditions are managed [2]. The decision to proceed with an implant is made jointly between the patient and the specialist team, ensuring that all less invasive options have been explored first and that the benefits outweigh the risks [2].

Risks and side effects of penile implant surgery

As with any surgery, penile implant procedures carry risks [2]. Infection is the most serious complication and occurs in around 1–3% of cases; if an infection develops around the implant, the device usually needs to be removed and replaced after the infection has cleared [2]. Mechanical failure of the device—such as a leak in the inflatable system or a broken pump—can happen over time and may require revision surgery to repair or replace components [2]. Some men experience a slight reduction in penile length or changes in sensation after surgery, though these are usually minor [2].

Pain and swelling are common in the first few weeks after the operation, and most men are advised to avoid sexual activity for four to six weeks to allow healing [2]. Rarely, the implant can erode through the skin or urethra, or scar tissue may form around the device, causing discomfort [2]. There is also a small risk of anaesthetic complications, bleeding, or blood clots, as with any surgical procedure [2].

Despite these risks, serious complications are uncommon when the surgery is performed by an experienced urological surgeon in a specialist centre [2]. Patients are given detailed information about what to expect, how to use the device, and warning signs of infection (such as fever, increasing pain, redness, or discharge), and they are encouraged to contact their surgical team promptly if any concerns arise [2].

Long-term outlook

Most modern penile implants are designed to last 10–15 years or longer, though individual results vary [8]. Regular follow-up with the urology team is important to monitor the device and address any issues early [2]. If a mechanical problem occurs, revision surgery can often replace or repair the faulty component, and many men go on to have successful long-term use [8]. Overall, penile implants offer a permanent solution for men with severe ED, but the commitment to surgery and the potential for complications mean it is reserved for those who have not benefited from simpler treatments [1][2].

How penile implants compare with oral ED tablets

Oral tablets such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra) are usually the first-line treatment for erectile dysfunction because they are non-invasive, effective for many men, and have a well-established safety profile [1][2]. These medicines work by increasing blood flow to the penis in response to sexual stimulation, and they are taken on demand (or daily, in the case of low-dose tadalafil) [3][4][5][6]. For men whose ED is caused by reduced blood flow or mild nerve issues, tablets can be very effective, with success rates of around 60–70% or higher in clinical trials [9].

However, tablets do not work for everyone [1][2]. Men with severe nerve damage (for example, after radical prostatectomy), very poor blood supply to the penis, or certain hormonal imbalances may find that oral medicines provide little or no benefit [1][2]. In these cases, second-line treatments such as alprostadil injections or vacuum devices may be tried [2][7]. If these also fail, or if a man cannot tolerate them, a penile implant becomes a realistic option [2].

The key difference is that tablets require some degree of natural erectile function to work—they enhance an erection but do not create one mechanically [3][4]. A penile implant, by contrast, provides a reliable erection regardless of blood flow or nerve function, making it suitable for men with the most severe ED [2]. Tablets are reversible (you can stop taking them at any time), while an implant is a permanent surgical change [2]. Cost is another factor: tablets are relatively inexpensive (sildenafil from Cured Pharmacy starts at £0.45 per tablet, or £0.36 with first-order code Ednew), whereas implant surgery costs several thousand pounds privately or may involve a wait on the NHS [2].

When to consider each option

Most men with ED should try oral tablets first, as they are safe, effective, and easy to use [1][2]. If tablets do not work, or cause unacceptable side effects, the next step is usually a discussion with a GP or specialist about alprostadil injections, vacuum devices, or referral to a psychosexual therapist if psychological factors are significant [1][2]. A penile implant is typically considered only after these options have been explored and found unsuitable [2]. The choice depends on the cause and severity of ED, overall health, personal preferences, and the impact on quality of life [1][2].

Accessing treatment and support for erectile dysfunction

If you are experiencing erectile dysfunction, the first step is to see your GP [1]. ED can be an early warning sign of cardiovascular disease or diabetes, so a medical assessment is important even if you are considering treatment [1][2]. Your GP can check for underlying causes, review your current medications (some can contribute to ED), and discuss lifestyle changes such as losing weight, stopping smoking, reducing alcohol, and increasing physical activity [1][2].

For men who are suitable for oral tablets, Cured Pharmacy offers a convenient online consultation service reviewed by UK-registered prescribers [12]. You can request sildenafil from £0.45 per tablet (£0.36 with code Ednew on your first order), tadalafil from £7.95 (£6.36 with Ednew), vardenafil from £16.95 (£13.56 with Ednew), or avanafil (Spedra) from £20.95 (£16.76 with Ednew) [12]. The prescriber will check your medical history, current medicines, and any contraindications before approving treatment, ensuring it is safe and appropriate for you [12].

If oral tablets are not effective or suitable, ask your GP about referral to a specialist urology or sexual health service [1][2]. These teams can offer alprostadil injections, vacuum erection devices, or assess you for a penile implant if appropriate [2][7]. Psychosexual counselling is also available through the NHS or privately, and can be very helpful if anxiety, stress, or relationship issues are contributing to ED [1][2]. Remember, erectile dysfunction is common, affecting around half of men aged 40–70 to some degree, and effective treatments are available [10].

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 15 October 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 15 October 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 15 October 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 15 October 2026]
5. European Association of Urology. (n.d.). EAU Guidelines on Sexual and Reproductive Health. https://uroweb.org/guidelines/sexual-and-reproductive-health [accessed 15 October 2026]
6. Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338(20), 1397–1404. https://pubmed.ncbi.nlm.nih.gov/9580646/ [accessed 15 October 2026]
7. Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology, 151(1), 54–61. https://pubmed.ncbi.nlm.nih.gov/8254833/ [accessed 15 October 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.