How you prepare

Initially, you'll talk to your doctor or a urologist about penile implants. During your visit, your doctor will likely:

• Review your medical history. Be prepared to answer questions about current and past medical conditions, especially your experience with ED. Talk about any medications you're taking or have taken recently, as well as any surgeries you've had.

• Do a physical exam. To make sure penile implants are the best options for you, your doctor will do a physical exam, including a complete urologic exam. Your doctor will confirm the presence and nature of ED, and make sure that your ED can't be treated in another way.

  He or she will also try to determine whether there's any reason that penile implant surgery is likely to cause complications. Your doctor will also examine your ability to use your hands, since some penile implants require greater manual dexterity than others.

• Discuss your expectations. Make sure you understand what the procedure involves and the type of penile implant that suits you best. It's also important to know that the procedure is considered permanent and irreversible.

  Your doctor will also explain the benefits and risks, including potential complications. Ideally, you'll include your partner in the discussion with your doctor.

Types of penile implants

There are two main types of penile implants:

• Inflatable implants. Inflatable devices, the most common type of penile implant used, can be inflated to create an erection and deflated at other times. Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis.

  To achieve an erection, you pump the fluid from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. The two-piece model works in a similar way, but the fluid reservoir is part of the pump implanted in the scrotum.

• Semirigid rods. Semirigid devices are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment.

  A positionable penile implant is a semirigid device with a central series of segments held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.

Other special designs can fit a shortened penis, or one that's larger than average. Some inflatable penile implants are also available with antibiotic coatings, which might help reduce the risk of infection.

Comparing implant types

When choosing which type of penile implant is right for you, consider your personal preference and your medical history. Your doctor might suggest one type of design over another based on your age, risk of infection, and health conditions, injuries or medical treatments you've had in the past.

Before penile implant surgery you might also need to:

• Avoid certain medications. Your doctor might recommend that you temporarily stop taking aspirin and anti-inflammatory drugs, which can increase your risk of bleeding.
• Arrange for a ride home. Ask your doctor when you'll be able to go home after surgery. Penile implant surgery typically involves an overnight stay.
• Limit food and liquids. Don't eat or drink anything after midnight before your surgery, or follow specific instructions from your doctor.