Penile Prosthesis (Penile Implant): Brands, Techniques, Warranty and Success Rates
The penile prosthesis (penile implant) is the treatment with the highest success and satisfaction rates in erectile dysfunction that has not responded to medication, injections or other treatments. On this page I cover implant types, brands and warranty periods, surgical techniques and their technique-specific complications, real device survival and infection data from the literature, and all the questions my patients ask most often.
What is on this page?
- What a penile prosthesis is and who it suits
- Implant types and how they work (schematic)
- Penile prosthesis brands and their technical features
- Warranty periods (Turkish practice)
- Surgical techniques: penoscrotal, infrapubic, subcoronal
- Technique-specific complications
- Device survival and satisfaction rates from the literature
- Infection rates and prevention strategies
- A detailed 20-question FAQ
What Is a Penile Prosthesis?
A penile prosthesis is a device placed surgically inside the erectile bodies (corpora cavernosa) of a penis that can no longer achieve an erection. Because it does not depend on the vascular and nerve mechanism, it offers a definitive solution in situations where medication is insufficient, such as venous leak, advanced diabetes or erectile dysfunction after prostate cancer surgery. International guidelines regard it as the gold standard where other treatments have failed or are unsuitable.
What Are the Success and Satisfaction Rates?
Erectile problems can seriously affect a man’s quality of life as he grows older. Because of embarrassment, fear of judgement and the assumption that it is simply a normal part of ageing, the rate at which men seek medical help remains very low. Penile implant surgery has been performed for decades and works by producing rigidity mechanically. Placed in an operation lasting around an hour, these devices become safer with each generation. Complication rates have fallen to 2–3%, while patient and partner satisfaction has reached around 95%.
The literature supports this picture: in systematic reviews of studies using different surgical techniques, patient satisfaction is reported at above 80% (Palmisano et al.). In a manufacturer-run patient survey, 95% of 194 patients who received an AMS 700 reported satisfaction with intercourse. A large Rigicon series reported from Turkey recorded satisfaction of 92.4%.
How Does a Penile Prosthesis Work?
In the most commonly used three-piece (inflatable) implant, the system has three parts: the cylinders placed inside the penis, the fluid reservoir placed in the abdomen and the pump positioned in the scrotum. When the pump is squeezed several times, fluid passes from the reservoir into the cylinders and the penis becomes rigid; after intercourse the release button returns the fluid to the reservoir and the penis becomes flaccid again.
What Are the Types of Penile Prosthesis?
Malleable (Semi-Rigid) Implant
This was the first type of penile implant and is the simplest to use. Although rigidity is excellent, the fact that the penis remains permanently firm can create difficulties in social life.
Three-Piece Inflatable Implant
The three-piece implant gives results closest to a natural erection. The penis, normally soft, is made rigid before intercourse and returns to a flaccid state afterwards. One part of the implant is placed in the abdomen and another inside the penis, while the pump is positioned next to the testicle. Some patients find the pump difficult to operate at first, so it should be tried before surgery. If you come to the clinic you will have the opportunity to see and try the pump and the device.
Implants That Expand in Girth and Length
Recently introduced, this implant works on the same principle as the three-piece device and is also operated by a pump. Unlike the standard three-piece implant, it expands in both girth and length when inflated. It is therefore the most advantageous type in terms of concealment.
| Implant type | Advantage | Limitation | Who it suits |
|---|---|---|---|
| Malleable | Easiest to use, lowest probability of mechanical failure | Permanently rigid, harder to conceal | Patients with limited manual dexterity who want a practical solution |
| Three-piece inflatable | Closest to a natural erection, fully flaccid when deflated | Using the pump has to be learned | Most patients who prioritise naturalness |
| Girth + length expanding | Expands in both girth and length; best concealment | Newer generation; pump use required | Patients who prioritise appearance and comfort when flaccid |
Penile Prosthesis Brands and Features
Three manufacturers dominate penile implant production worldwide: Boston Scientific (AMS), Coloplast and Rigicon. Each brand differs in cylinder material, coating technology and pump design. The information below is based on manufacturers’ technical statements and the current product range in Turkey.
| Brand / Series | Type | Notable technical feature | Infection-prevention coating |
|---|---|---|---|
| Boston Scientific AMS 700 (CX / CXR / LGX) | Three-piece | Parylene-coated cylinders (wear resistance); the LGX model expands in length; MS (Momentary Squeeze) pump | InhibiZone (antibiotic) — impregnated at the factory |
| Coloplast Titan / Titan Touch | Three-piece | Bioflex cylinder material (durability and expansion); lock-out valve in the reservoir (prevents auto-inflation); one-touch release | Hydrophilic coating — soaked in antibiotic solution during surgery |
| Rigicon Infla10 (X / AX / Pulse) | Three-piece | Pulse pump for easy inflation and deflation; wide range of lengths and diameters | Hydrophilic coating |
| Coloplast Genesis · Boston Tactra · Rigicon Rigi10 | Malleable | Simple construction; the Tactra model uses a nitinol core for bending and position retention | Varies by model |
How is the brand chosen? There is no single answer to “the best brand”. The choice is determined by penile anatomy and dimensions, the availability of space in the abdomen for the reservoir (previous hernia repair, kidney transplant, radical prostatectomy), manual dexterity, infection risks such as diabetes, and which system the surgeon is most experienced with. The decision on brand is therefore made together at the consultation.
Warranty Periods
Because a penile prosthesis is a mechanical device, the manufacturer’s warranty is an important consideration in the decision to have surgery. Current practice in Turkey is as follows:
| Brand | Warranty (product replacement) | Scope |
|---|---|---|
| Boston Scientific AMS 700 (MS pump models) | 5 years | Replacement of the device in case of mechanical failure |
| Coloplast (Titan, Genesis) | 10 years — for products implanted on or after 1 April 2022 | The device or a component; certain exclusions apply |
| Rigicon (Infla10 family, Rigi10) | Lifetime product replacement warranty | Defects in material and workmanship; specific to the first patient, non-transferable |
Three critical warnings about warranties: (1) The warranty covers the device only; it does not cover surgery, hospital or anaesthesia costs. (2) Conditions may be updated over time by the manufacturer and distributor — you should therefore be given a written warranty document and the device serial number. (3) The warranty is generally specific to the first patient and non-transferable. Ask about these three points before surgery.
Surgical Techniques
Three basic incision approaches are used for implantation. None is definitively superior to the others; the choice is made according to the patient’s anatomy, previous surgery and the surgeon’s experience.
1. Penoscrotal Technique (most commonly used)
The incision is made where the penis meets the scrotum. It provides wide surgical exposure; placing the pump in the scrotum is straightforward, and it is preferred in complex cases (fibrosis, revision surgery). The reservoir is generally placed blindly, outside direct vision.
2. Infrapubic Technique
The incision is made just above the base of the penis. The operating time is shorter; in one comparative study the mean time was 128 minutes with the penoscrotal approach versus 91 minutes with the infrapubic approach. The reservoir can be placed under direct vision; on the other hand the pump is positioned blindly, and there is theoretical proximity to the dorsal nerve.
3. Subcoronal Technique
The incision is made along the circumcision line and the skin of the penis is retracted to provide exposure of the entire penile shaft. It is advantageous in cases requiring simultaneous correction of curvature. In uncircumcised patients it generally requires circumcision.
Technique-Specific Complications
| Technique | Strength | Technique-specific risks | Note from the literature |
|---|---|---|---|
| Penoscrotal | Widest exposure; easy pump placement; preferred in revisions | Bladder or vascular injury from blind reservoir placement (rare); urethral injury; scrotal incision | The most commonly used approach; regarded as standard in complex cases |
| Infrapubic | Shorter operating time; reservoir placed under vision; tendency to earlier return to sexual activity | Theoretical risk of reduced sensation due to proximity to the dorsal nerve; blind pump positioning | Loss of glans sensation has not been reported in reviews; the risk is regarded as theoretical |
| Subcoronal | Exposure of the whole shaft; suitable for simultaneous curvature correction | Requirement for circumcision in uncircumcised patients; problems related to skin perfusion | Less widespread; used in selected cases |
So which is better? In a systematic review of 22 studies, no significant difference was found between the penoscrotal and infrapubic approaches in implant size, penile length achieved, patient satisfaction, infection rate or risk of urethral injury. Satisfaction exceeded 80% in both groups. The conclusion is that it is not the technique but the surgeon’s experience with that technique that is decisive.
How Long Does an Implant Last? (Device Survival)
This is the question patients ask most. In a systematic review and meta-analysis of 12 studies covering 20,161 patients, device survival of inflatable penile prostheses was reported as follows:
These data carry an important message: an implant is not a device that lasts forever; but for the great majority of patients it is a reliable solution lasting more than ten years. In the event of mechanical failure the device can generally be replaced through the same incision, and if it is within warranty the new device is provided by the manufacturer.
How Is the Operation Performed?
The implant is placed surgically. Spinal or general anaesthesia is used depending on the patient. Patients usually come to hospital fasting on the morning of the procedure and stay one day. Antibiotics are given during the stay to prevent implant infection. The operation takes about one hour. The hospital stay is kept as short as possible to reduce infection risk.
Complications in penile implant surgery have decreased substantially. In centres that specialise in implant surgery and with experienced surgeons, problems are minimal. Nevertheless, anaesthesia-related problems can occur as in any operation, and infection, mechanical failure and pain are the most common complications. Managing these requires experience and teamwork.
What Is the Infection Risk?
Exaggerated figures circulate online on this subject. The current reality is this: the infection rate for first-time (primary) implants in the literature is 1–3%. In centres heavily involved in implant surgery this falls below 1%.
| Situation | Reported infection rate | Source / context |
|---|---|---|
| First (primary) implant surgery | 1–3% | Current reviews and society publications |
| Coated implant + no-touch technique | 0.46% | Eid et al., large series |
| Hydrophilic-coated vs uncoated implant | 1.06% vs 2.07% | Comparison of 2,357 coated and 482 uncoated implants |
| Revision (second) surgery | 7–18% | This is the genuinely high-risk group |
In other words, what should be avoided is not the first operation but unnecessary revisions. That in turn is minimised by correct brand selection, correct sizing and experienced surgery.
Steps to Prevent Infection
- Coating technology: Antibiotic-impregnated (InhibiZone) or hydrophilic-coated implants reduce infection rates by more than half.
- Diabetes control: Uncontrolled diabetes is among the most important risk factors; blood sugar and HbA1c should be optimised before surgery.
- Urine culture: Urinary infection is screened for and treated before surgery.
- Skin preparation and no-touch technique: Chlorhexidine skin preparation and placing the implant without contact with the skin markedly reduce risk.
- Short stay: Keeping the hospital stay short reduces exposure to hospital-acquired organisms.
- When does it appear? About 90% of infections occur within the first year; after that the risk falls markedly.
After Surgery: Using the Implant
Once tissue healing is complete, the implant is generally first used within 4–6 weeks. Inflating and deflating the pump is taught at the clinic; it may take a little time to get used to in the first weeks, but it soon becomes automatic.
What Changes and What Does Not
- Unchanged: Sensation in the skin of the penis, sexual arousal, orgasm and ejaculation are preserved. Semen production and urination are unchanged.
- Changed: Rigidity is now produced by the implant rather than by the blood vessels; an erection is available whenever wanted and without a time limit.
- Perception of length: After implantation the penis is felt at its best erect length, so some patients may feel it has “become shorter”. Realistic counselling before surgery is important for this reason.
- It is not reversible: Because the erectile tissue is dilated to accommodate the implant, a return to natural erections is not expected if the device is removed.
Who Is a Penile Prosthesis Suitable For?
A penile prosthesis is generally a last-line treatment and is considered in the following situations:
- No response to oral medication, intracavernosal injection or a vacuum device,
- Advanced vascular disease and long-standing uncontrolled diabetes,
- Significant venous leak,
- Permanent loss of erections after prostate cancer surgery,
- Peyronie’s disease with significant curvature together with erectile dysfunction (the curvature can also be corrected during implantation).
Key points
- The penile prosthesis has the highest success and satisfaction rates in erectile dysfunction (satisfaction ~95%; above 80% in the literature).
- Complication rates are around 2–3%.
- Infection: 1–3% at first surgery, below 1% in experienced hands; 7–18% in revision surgery.
- Three main brands: Boston Scientific AMS 700, Coloplast Titan, Rigicon Infla10.
- Warranty (Turkey): 5 years for AMS 700 MS pump models, 10 years for Coloplast, lifetime for Rigicon.
- Device survival: year 1 93.3% · year 5 87.2% · year 10 76.8% · year 15 63.7% · year 20 52.9%.
- Techniques: penoscrotal (most common), infrapubic (shorter time), subcoronal (full exposure).
- No significant difference between techniques in satisfaction or infection; the surgeon’s experience is decisive.
- Sensation, orgasm, ejaculation and urination are preserved; the procedure is not reversible.
Frequently Asked Questions About Penile Prosthesis
What is a penile prosthesis?
A penile prosthesis is a device placed surgically inside the erectile bodies of a penis that can no longer achieve an erection. It produces an erection without depending on medication or on the vascular mechanism.
What are the success and satisfaction rates?
The penile prosthesis has the highest success rate of any treatment for erectile dysfunction. Complication rates have fallen to 2–3% while patient and partner satisfaction has reached around 95%. Systematic reviews report satisfaction above 80%.
Which brands are available?
Among three-piece inflatable implants, the Boston Scientific AMS 700, Coloplast Titan and Rigicon Infla10 series are the most widely used. Among malleable implants, Coloplast Genesis, Boston Scientific Tactra and Rigicon Rigi10 are preferred. Brand selection is made according to anatomy, expectations and the surgeon’s experience.
How long is the warranty?
In Turkish practice, AMS 700 models with the MS pump carry a 5-year warranty, Coloplast Titan and Genesis implants 10 years (for implants placed on or after 1 April 2022), and the Rigicon Infla10 family a lifetime product replacement warranty. The warranty covers only the device, not the cost of surgery; a written document should be requested before the operation.
How long does an implant last?
In a meta-analysis of 20,161 patients, device survival was 93.3% at 1 year, 87.2% at 5 years, 76.8% at 10 years, 63.7% at 15 years and 52.9% at 20 years. More than three quarters of patients therefore use their implant without problems for over ten years.
What is the infection risk?
The infection rate for first-time implants is 1–3%, falling below 1% with experienced implant surgeons. A large series using coated implants together with the no-touch technique reported 0.46%. The situation in which risk rises markedly is revision surgery, where the rate is 7–18%.
Which surgical techniques are used?
There are three basic approaches: penoscrotal (at the junction of penis and scrotum), infrapubic (above the base of the penis) and subcoronal (through the circumcision line). The penoscrotal technique is the most commonly used and provides the widest exposure.
Which technique is better?
Systematic reviews have found no significant difference between the penoscrotal and infrapubic approaches in satisfaction, infection rate, penile length achieved or risk of urethral injury. Operating time is shorter with the infrapubic approach. What is decisive is not the technique but the surgeon’s experience with it.
How long does the operation take and how long is the hospital stay?
The operation takes about one hour and is performed under spinal or general anaesthesia. Patients generally stay one night in hospital. The stay is kept as short as possible to reduce infection risk.
Are sensation and orgasm lost?
No. The implant only replaces the mechanism that produces rigidity. Sensation in the skin of the penis, sexual arousal, orgasm and ejaculation are preserved. Semen production is also unchanged.
Does the penis become shorter?
The implant holds the penis at its best erect length, so some patients may feel it is shorter. This is usually a difference in perception rather than a genuine loss. In men with long-standing untreated erectile dysfunction, tissue shortening may already have developed. Models that expand in length may offer an advantage.
When can I have intercourse afterwards?
Once tissue healing is complete, the implant is generally first used within four to six weeks. The exact timing is determined at follow-up.
What are the risks of the operation?
The most common problems are infection, mechanical failure and pain. Less commonly, cylinder erosion, pump migration and auto-inflation may occur. In experienced centres and with coated implants these rates are quite low.
What happens if the implant becomes infected?
Because the implant is a foreign body, an infection generally cannot be resolved with antibiotics alone and the device may need to be removed. About 90% of infections appear within the first year. Coated implants, urine culture and blood sugar control markedly reduce the risk.
Can patients with diabetes have an implant?
Yes, men with diabetes are among the groups that benefit most. However, the infection risk is somewhat higher, so blood sugar and HbA1c should be brought under control before surgery and a coated implant is recommended.
Can I have an MRI scan?
Current penile prostheses are generally classified as MR conditional. Nevertheless, the brand and model must always be reported to the radiology team before an MRI. This is why the implant card given after surgery should be kept.
Will it set off airport detectors?
Inflatable implants are made of silicone and polymer materials and generally do not affect metal detectors. The device may be visible on body scanners. Carrying your implant card easily resolves any questions.
Does it affect urination or fertility?
No. The implant is not placed in the urinary channel and urination is unaffected. Because ejaculation and semen production continue, reproductive capacity is not changed by the implant.
Can it be reversed?
The implant can be removed surgically; however, because the erectile tissue is dilated to accommodate it, a return to natural erections is not expected after removal. It is therefore important that other treatments have been tried before this decision.
Can an implant be used in Peyronie’s disease?
Yes. If there is significant curvature together with erectile dysfunction, the curvature can largely be corrected by modelling during the implant operation, solving both problems in a single procedure.
How much does it cost?
Cost varies with the implant type, the brand chosen and the clinical situation, and under Turkish healthcare regulations fixed prices cannot be published. For current information you may contact the clinic.
Before choosing an implant type and brand, the best approach is to see the device and try the pump. Get in touch for an assessment or an appointment.
Scientific References
- European Association of Urology (EAU). Guidelines on Sexual and Reproductive Health — Erectile Dysfunction. 2024.
- Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis. Urology. 2022. (12 studies, 20,161 patients)
- Eid JF, Wilson SK, Cleves M, Salem EA. Coated implants and no-touch surgical technique decreases risk of infection in inflatable penile prosthesis implantation to 0.46%. Urology. 2012;79(6):1310–1315.
- Serefoglu EC, Mandava SH, Gokce A, Chouhan JD, Wilson SK, Hellstrom WJG. Long-term revision rate due to infection in hydrophilic-coated inflatable penile prostheses: 11-year follow-up. J Sex Med. 2012;9(8):2182–2186.
- Carvajal A, Benavides J, García-Perdomo HA, Henry GD. Risk factors associated with penile prosthesis infection: systematic review and meta-analysis. Int J Impot Res. 2020;32(6):587–597.
- Palmisano F, Boeri L, Cristini C, et al. Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner? Sex Med Rev. 2018;6(4):631–639.
- Grande P, Antonini G, Cristini C, et al. Penoscrotal versus minimally invasive infrapubic approach for inflatable penile prosthesis placement: a single-center matched-pair analysis. World J Urol. 2018;36(7):1167–1174.
- Chung E. Penile prosthesis implant: scientific advances and technological innovations over the last four decades. Transl Androl Urol. 2017;6(1):37–45.
- Carson CC 3rd, Mulcahy JJ, Harsch MR. Long-term infection outcomes after original antibiotic impregnated inflatable penile prosthesis implants. J Urol. 2011;185(2):614–618.
- Bernal RM, Henry GD. Contemporary patient satisfaction rates for three-piece inflatable penile prostheses. Adv Urol. 2012;2012:707321.
- Coloplast — Global Men’s Health Products Replacement Policy (2022). Manufacturer document.
- Rigicon — Infla10 Product Replacement Lifetime Warranty. Manufacturer statement.
- Boston Scientific — AMS 700 product information and Turkish distributor warranty conditions.
This content is for general information only and does not replace examination by a specialist. Brands, warranty conditions and technical specifications may be changed over time by manufacturers and distributors; a current warranty document should be requested before surgery. Implant type, surgical technique and outcomes vary with the patient’s anatomy, comorbidities and expectations. For diagnosis and treatment, please consult a specialist physician.
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