It can feel incredibly discouraging when treatments for erectile dysfunction (ED) stop working. Many men start with medications like Viagra or Cialis, and for a while, those pills may provide the boost they need. But over time, especially after a procedure like a robotic prostatectomy or when dealing with conditions such as diabetes, these medications may no longer deliver results.
If you are in this situation, you are not alone. Many men face the frustration of failed treatments and begin searching for more lasting answers. While it is natural to hesitate when surgery is mentioned, penile implants offer a reliable and permanent solution for many men.
At Urology Specialists of Austin, our team regularly helps men navigate this journey. By understanding both non-surgical and surgical options, you can feel confident about the next step that might restore intimacy and quality of life.
When Other ED Treatments Don’t Work
For most men, the first stop on the road to treating ED is oral medication. These drugs improve blood flow and can be very effective, until they are not. Over time, health conditions or surgical changes can limit their effectiveness. Some men also stop taking these medications due to unpleasant side effects, like headaches or stomach upset.
Other approaches, such as low-intensity shockwave therapy, are sometimes marketed as regenerative solutions. While some patients may find benefit, success is often limited in men who have severe ED, especially following prostate surgery or advanced vascular disease. If the nerves or blood vessels critical to erections are no longer functional, these therapies are unlikely to restore natural function.
Non-Surgical Options
Before considering surgery, men may try other therapies that go beyond pills. Two of the most common are vacuum erection devices (VEDs) and penile injections.
The Vacuum Erection Device (VED)
Also known as a penis pump, the VED creates a vacuum that draws blood into the penis. A constriction ring at the base keeps the blood in place. While it is a safe, non-invasive option, it does take practice. Common frustrations include difficulty achieving a proper seal or discomfort with the constriction ring. With patience, the right equipment, and sometimes professional guidance, some men find this method effective.
Penile Injections (Trimix)
Trimix injections deliver medication directly into the erectile tissue before intercourse. Despite the intimidating idea of self-injection, this method has a very high success rate. Injections typically produce an erection lasting one to two hours.
The main challenges are storage and dosing. One of the medications in Trimix is unstable once thawed, so vials must be handled carefully and used within a set timeframe. Priapism—an erection that lasts too long—can also occur, making it important to follow instructions carefully.
Understanding Penile Implant Surgery
When other treatments prove too cumbersome or inconsistent, penile implants become an option worth serious consideration. Unlike external devices or temporary medications, a penile implant is a long-term, internal solution.
Penile implant surgery involves placing a medical device inside the penis to restore erectile function. The surgery has been performed safely for decades and continues to advance with new technology.
Types of Penile Implants
There are two main categories of penile implants:
| Implant Type | How It Works | Key Benefit | Consideration |
|---|---|---|---|
| 3-Piece Inflatable | Fluid moves from a reservoir to cylinders using a pump in the scrotum. | Provides the most natural-feeling erection and complete flaccidity. | Requires manual dexterity to operate. |
| 2-Piece Inflatable | Pump and reservoir are combined in the scrotum. | Fewer parts, simpler surgery. | Erections may be less firm than the 3-piece option. |
| Semi-Rigid Rods | Malleable rods placed in the penis, positioned manually. | Easiest to use with few mechanical concerns. | The penis remains semi-rigid, which some find less discreet. |
The three-piece inflatable implant is the most popular choice because it allows the penis to look and feel natural when both erect and flaccid. Other options remain valuable for men who prefer simpler operation or have specific health considerations.
What to Expect from the Procedure and Recovery
Penile implant surgery may sound intimidating, but many men are surprised by how straightforward the process is.
The Surgery
The procedure typically lasts about one to one and a half hours. Some men go home the same day, while others may stay overnight for additional monitoring and antibiotics. The incision is discreet, usually at the base of the penis or where the penis meets the scrotum.
The Recovery Period
Initial recovery involves soreness, swelling, and bruising that improve over the first week. Patience is key—most men wait about six weeks before activating their device for the first time.
Once healed, a urologist will teach you how to operate the implant. From then on, men enjoy reliable, on-demand erections without the need for pills or injections. Importantly, penile implants do not interfere with penile sensation, the ability to orgasm, or ejaculation.
Is Penile Implant Surgery Right for You?
One of the strongest arguments in favor of penile implants is patient satisfaction. Studies consistently show rates above 90%, both for men and their partners. That satisfaction comes from reliability: once implanted, the device works every time.
Men with diabetes or those recovering from prostate surgery often make excellent candidates. For diabetic patients, well-controlled blood sugar is important to reduce the risk of infection.
Another key point is insurance coverage. Medicare, Tricare, and many private plans often cover penile implants when other treatments have not worked. Unlike cosmetic procedures, this surgery is recognized as medically necessary to restore sexual function.
Frequently Asked Questions
Will I lose length with a penile implant?
Some men experience length changes due to the underlying ED, not the implant itself. Surgeons carefully size the implant to fit your anatomy, but it is important to have realistic expectations.
Can I still have an orgasm and ejaculate?
Yes. A penile implant does not affect nerves responsible for orgasm or the ability to ejaculate.
Is the implant noticeable?
No. The device is completely internal. Even a partner will not notice it unless specifically feeling for the pump inside the scrotum.
How long does a penile implant last?
Most modern implants last 10–15 years or more. If a mechanical issue arises, revision surgery can replace the device.
Moving Forward
Severe erectile dysfunction impacts not only physical health but also emotional well-being and relationships. For men who feel out of options, penile implant surgery offers a dependable way forward.
If you are weighing your choices, the best step is to talk with a urologist experienced in treating ED. At Urology Specialists of Austin, our team is dedicated to helping men find solutions that match their needs, whether through non-surgical methods or penile implant surgery. We provide guidance, support, and the expertise needed to make an informed decision.
Conclusion
Erectile dysfunction can be a long and frustrating journey. Pills may lose effectiveness, devices can feel awkward, and injections may not fit your lifestyle. But that does not mean you are out of options.
Penile implants provide a proven, long-term solution that restores spontaneity, intimacy, and confidence. With high satisfaction rates and strong insurance coverage, this procedure has helped countless men reclaim an important part of their lives.
If you are ready to explore your options, consider reaching out to Urology Specialists of Austin. Talking openly with a urologist about your experiences, concerns, and goals is the first step toward regaining control of your sexual health and overall well-being.