Penile Prosthesis Placement
(Semirigid & Inflatable Coloplast Titan)
A comprehensive patient guide to surgical implants for erectile dysfunction. We offer both semirigid (malleable) rods and multi-component inflatable prostheses — and we use the Coloplast Titan for inflatable implants due to its durability, rigidity, and natural feel.
Educational content only; not medical advice.
Who Should Consider a Penile Implant?
Penile prosthesis (implant) surgery is a definitive solution for erectile dysfunction (ED) when oral medications, vacuum devices, shockwave therapy, or injections are no longer effective or acceptable. It restores reliable, on-demand rigidity for intercourse while preserving sensation and orgasm in most men.
Ideal Candidates
- ED from diabetes, vascular disease, Peyronie’s disease with ED, post-prostatectomy ED, or medication-refractory ED
- Desire a dependable, spontaneous erection without planning around pills or injections
- Realistic expectations about length, girth, and postoperative “cycling” (for inflatable devices)
Note: Implants do not increase penile length beyond what healthy erectile tissue allowed prior to ED; they restore rigidity using cylinders sized to your corporal bodies at surgery.
Implant Options We Offer
Semirigid (Malleable) Rods
- Two bendable rods placed inside the penis
- Always firm; bend up for intercourse, down for concealment
- Mechanically simple, very low risk of mechanical failure
- Excellent choice for patients who want no pump to operate or have limited hand dexterity
Multi-Component Inflatable — Coloplast Titan
- Two inflatable cylinders + concealed scrotal pump + abdominal reservoir
- Natural look and feel; flaccid when deflated, rigid when inflated
- Strong axial rigidity for penetration; excellent concealment when deflated
- We use the Coloplast Titan for its durability, hydrophilic coating, and rigidity profile
We do not use Boston Scientific/AMS inflatable systems in our practice.
Semirigid vs Inflatable — Quick Comparison
| Feature | Semirigid (Malleable) | Inflatable (Coloplast Titan) |
|---|---|---|
| Appearance/Feel | Always firm; bends down for concealment | Flaccid when deflated; natural-feeling erection when inflated |
| Ease of Use | Simplest (no pump); ideal for limited dexterity | One-hand pump to inflate/deflate; brief learning curve |
| Mechanical Reliability | Very few parts to fail | Modern systems are highly reliable; parts are replaceable if needed |
| Concealment Comfort | Good, but penis remains firm | Excellent — soft/flat when deflated |
| Rigidity for Intercourse | Dependable; may be slightly less natural feel | Outstanding axial rigidity and glans support feel with Titan |
| Surgery Complexity | Simpler, shorter surgery | More components; still typically outpatient |
How Surgery Works — Step by Step
- Pre-op visit & sizing plan: We review your history, goals, and anatomy; choose semirigid vs inflatable. Men with curvature may have adjunct straightening maneuvers during inflatable placement.
- Anesthesia & setting: Procedure is performed under general or regional anesthesia in our state-of-the-art Ambulatory Surgery Centers (ASC) for comfort and safety.
- Antibiotic protocol: Targeted IV antibiotics + device coatings reduce infection risk.
- Placement: Cylinders are inserted into the corpora cavernosa (the erectile bodies). For Titan, a reservoir is placed in the lower abdomen and a pump is positioned in the scrotum through the same small incision.
- Testing & closure: We test function, achieve hemostasis, and close with absorbable sutures. A compressive dressing supports healing.
- Discharge: Most patients go home the same day with detailed instructions and pain control plan.
Surgical time: ~45–60 minutes for semirigid; ~60–90 minutes for inflatable (individual factors vary).
Recovery, “Cycling,” and When You Can Resume Sex
Week-by-Week Recovery
- Week 1: Rest, scrotal support, ice as directed. Short walks. Expect swelling/bruising.
- Week 2–3: Light activity; most return to desk work. Pain improves.
- Week 4–6: For inflatable, begin daily “cycling” (inflate/deflate) to optimize comfort and length preservation per instructions.
- Week 6–8: Typically cleared for intercourse if incisions healed and tenderness resolved.
What to Expect Long-Term
- Sensation and orgasm generally unchanged; ejaculation depends on prior prostate/duct status
- High satisfaction for patient and partner once device use is learned
- Device lifespan commonly 10+ years; parts can be revised if needed
Risks, Safety, and How We Minimize Complications
Modern penile implants are safe and dependable. As with any surgery, risks exist. We use evidence-based protocols to reduce them.
Potential Risks
- Infection (uncommon with modern protocols)
- Bleeding or hematoma
- Device malfunction over time (repairable)
- Discomfort from pump early on (improves as swelling subsides)
- Perceived change in length (due to long-standing ED fibrosis)
Our Prevention Measures
- Targeted antibiotics + device antimicrobial coatings
- Experienced high-volume surgeons and meticulous technique
- Careful cylinder sizing and corporal dilation
- Post-op support, swelling control, and guided cycling
We counsel honestly about expectations: implants restore rigidity reliably but cannot “add” length beyond your corporal capacity. Cycling helps maximize comfort and functional length.
Why We Use the Coloplast Titan for Inflatable Implants
- Rigidity & durability: Cylinder materials provide strong axial rigidity for penetration with a natural feel.
- Hydrophilic coating: Aids antibiotic adherence during surgery as part of infection-prevention strategy.
- Concealment: Deflates to a soft, low-profile state for daily comfort and discretion.
- Component design: Proven pump ergonomics and replaceable parts facilitate longevity and serviceability.
We exclusively place the Coloplast Titan for multi-component inflatable systems in our practice.
Preparing for Surgery
Before Your Procedure
- Complete pre-op labs and medical clearance if needed
- Hold blood thinners as directed
- Antibacterial wash the night before and morning of surgery
- Arrange a ride home (same-day discharge)
Aftercare Essentials
- Supportive underwear and scrotal support
- Ice and elevation routine for swelling control
- Pain plan with scheduled OTC/ Rx as directed
- Follow-up visits to begin cycling (inflatable) and ensure healing
Frequently Asked Questions
Will an implant affect my sensation or orgasm?
Sensation and orgasm are typically unchanged because nerves responsible for pleasure are not removed. If you’ve had prostate surgery, ejaculation may be absent; orgasm is often still achievable.
Can anyone tell I have an implant?
With inflatable devices, the penis looks and feels soft at rest. The small pump is concealed in the scrotum.
How long will it last?
Many devices last 10 years or more. If a part wears out, it can be repaired or replaced.
What if I have Peyronie’s disease?
Inflatable implants often straighten curvature; adjunct techniques (modeling, plication, or grafting) may be used during the same surgery if needed.
Is an implant covered by insurance?
Many insurance plans, including Medicare, cover penile prostheses for medically refractory ED. Our team will verify your specific benefits.
Why Choose Advanced Urology
- High-volume implant surgeons with refined technique and outcomes
- State-of-the-art ASCs for comfort, efficiency, and safety
- Comprehensive ED program — we offer every major therapy and tailor the best option to you
- Patient-first coaching on expectations, cycling, and partner communication