Private Penile Implant Surgery for Erectile Dysfunction

1. Assessment. The urologist confirms ED, reviews treatments tried and examines penile length, curvature, scarring and skin health.
2. Device selection. You compare inflatable and malleable options based on hand function, anatomy, prior abdominal surgery, concealment and priorities.
3. Infection prevention. Diabetes control, urine testing, skin preparation and antibiotics may be required.
4. Anaesthesia. Surgery is usually performed under general or spinal anaesthesia with sedation.
5. Placement. Through a penoscrotal or infrapubic incision, the surgeon places cylinders inside the erectile bodies. Inflatable systems also require a pump and, for three-piece models, a reservoir.
6. Closure and recovery. A catheter or drain may be used briefly. Some patients go home the same day; others stay overnight.
7. Activation. Inflatable devices remain partly inflated while tissues heal, then the clinic teaches cycling at a later visit.

Operating time is often roughly one to two hours but can be longer for revision, scarring, Peyronie’s correction or combined surgery.

Recovery varies with the implant type, surgical approach, previous pelvic surgery or radiation, Peyronie’s disease, diabetes, revision surgery, and your surgeon’s protocol. Protect the incision and device early, and do not operate an inflatable implant until the surgical team teaches you how.

Week 1

What it may feel like: Penile and scrotal swelling, bruising, aching, and tenderness are common. The pump may feel high, firm, or difficult to locate while swelling is present. Fatigue, nausea, constipation, and temporary urinary discomfort can occur after anaesthesia, pain medicine, or catheter use.

Goals: Protect the incision, control pain and swelling, urinate safely, prevent infection and blood clots, and maintain light movement.

Activities:

• Wear supportive underwear or a scrotal support as directed.
• Position the penis and device exactly as instructed; protocols differ.
• Take short, frequent walks and change position regularly.
• Keep the incision and dressings clean and dry.
• Use prescribed pain medicine, antibiotics, and bowel medication exactly as directed.
• Do not squeeze the pump, cycle the device, lift heavily, drive, exercise, or have sex.
• If the implant is left partly inflated, do not try to deflate it yourself unless specifically instructed.

Weeks 2–4

The early-healing phase: Bruising and swelling should gradually improve, although the scrotum, pump, or incision may remain tender.

Goals: Support wound healing, return to light daily activity, and monitor device position and infection warning signs.

Activities:

• Increase walking gradually while avoiding strenuous activity.
• Many people return to desk-based work when comfortable and no longer using impairing pain medicine. Physical work usually requires more time.
• Attend the first postoperative visit for wound, swelling, and device-position checks.
• Continue to avoid cycling, running, heavy lifting, soaking the incision, and sexual activity.
• Do not repeatedly handle the pump in an attempt to “get used to it” before clearance.

Weeks 4–8

Activation and training: Once the incision and deeper tissues have healed sufficiently, the urologist may activate an inflatable prosthesis and teach inflation and deflation. Timing varies, especially after revision surgery, Peyronie’s correction, infection treatment, or difficult placement.

Goals: Learn safe device use, restore confidence, and resume activity gradually.

Activities:

• Practise cycling only as prescribed. Early inflation can feel tight or uncomfortable.
• Learn how the pump and release mechanism feel when the device is working normally.
• Return gradually to exercise, lifting, and driving after clearance.
• Resume sexual activity only when the incision is healed, pain is controlled, and the surgeon approves—often around four to eight weeks.
• Use lubricant and choose positions that avoid excessive pressure until comfort improves.

Months 2–3

The confidence-building phase: Swelling and tenderness usually continue to settle. Operating the device should become easier with practice.

Goals: Use the implant reliably, return to normal routines, and identify persistent concerns.

Activities:

• Continue any prescribed cycling schedule.
• Progress exercise and higher-demand work gradually.
• Report persistent pain, difficult pump access, buckling, incomplete inflation, inability to deflate, or dissatisfaction with rigidity or concealment.
• Keep follow-up appointments even when the device appears to work normally.

Longer-term care

A penile implant does not require routine daily maintenance beyond correct use, but it is a mechanical device and may eventually need revision or replacement. Keep the implant identification and warranty information. Tell future clinicians about the prosthesis before pelvic procedures, catheterization, or imaging questions.

Contact the implanting surgeon if function changes, the pump or cylinders shift, pain develops after a symptom-free period, or skin becomes thin over part of the device.

Helpful recovery tips

• Prepare for swelling: Early appearance is not the final result.
• Use support correctly: Supportive underwear may reduce pulling and discomfort.
• Prevent constipation: Hydration, fibre, walking, and prescribed bowel medication can help.
• Control blood sugar: Good diabetes management supports healing and lowers infection risk.
• Plan for privacy: Arrange enough help for safe recovery without feeling required to disclose unnecessary details.
• Learn directly from the care team: Device videos and online advice cannot replace hands-on teaching for your exact model.

Red flags—contact the care team urgently

• Fever, chills, spreading redness, foul drainage, or an opening incision.
• Increasing rather than improving pain, swelling, warmth, or tenderness.
• Difficulty urinating or inability to urinate.
• Skin darkening, blistering, thinning, or an exposed part of the device.
• A pump, cylinder, or reservoir that appears to have changed position.
• Inability to inflate or deflate the device after you have been trained.
• A sudden loss of rigidity, fluid movement, or new mechanical change.
• New severe penile curvature, numbness, or worsening pain.
• Chest pain, shortness of breath, fainting, or a painful swollen calf.

Potentially, when the implant is medically necessary for erectile dysfunction. The Schedule of Benefits in some provinces includes a fee code for “penile prosthesis for impotence,” which supports coverage of the surgical service in eligible cases. That does not guarantee that every patient, hospital, device or upgrade is fully funded.

Coverage may depend on medical necessity, failure or unsuitability of less-invasive treatments, referral to a participating urologist, hospital resources and device funding. Ask the urologist’s office to confirm all of the following before surgery:

• Is the surgeon’s service insured by OHIP?
• Is the hospital or facility fee covered?
• Is the recommended malleable or inflatable prosthesis fully funded?
• Is there a patient-paid device difference or upgrade?
• Are follow-up, activation and future revision covered?

Cosmetic penis enlargement is different and is not ordinarily covered by OHIP. See our separate guide to penis enlargement surgery in Canada.

Choosing a surgeon is an important decision because prosthetic surgery has a meaningful learning curve, infection can require device removal, and revision surgery is more complex than a first implant. Look beyond availability and advertising. The surgeon should confirm that an implant is appropriate, compare alternatives, and set realistic expectations for rigidity, concealment, sensation, orgasm, length, and future revision.

Implant-specific experience and volume

Ask how many primary and revision penile implants the surgeon performs each year—not simply how many urology operations. Discuss experience with:

• Three-piece and two-piece inflatable prostheses.
• Malleable implants.
• Implants after radical prostatectomy, pelvic radiation, or abdominal surgery.
• Peyronie’s disease with modelling, plication, or grafting when required.
• Significant corporal fibrosis after priapism, infection, or prior implant removal.
• Revision for infection, erosion, mechanical failure, sizing problems, or device movement.

Higher volume alone does not guarantee a good result, but procedure-specific experience can help a surgeon anticipate difficult anatomy, device selection, and complication management.

Credentials and subspecialty training

• Verify current licensure and restrictions through the relevant provincial medical college.
• Look for an FRCSC-certified urologist with focused experience or training in andrology, sexual medicine, reconstructive urology, or prosthetic urology.
• Ask who performs each part of the operation and who provides postoperative care.
• Confirm that the surgeon is trained on the specific device brands being offered.

Diagnosis and treatment reasoning

A careful assessment should review the cause and duration of ED, treatments tried, urinary symptoms, erections, penile length and curvature, skin health, hand function, and expectations. Ask:

• Is my ED unlikely to improve further without surgery?
• Have medicines, vacuum devices, and injections been used appropriately or ruled out for a clear reason?
• Could low testosterone, medication, cardiovascular disease, psychological factors, or another condition still be treated?
• How do prior prostate surgery, radiation, Peyronie’s disease, diabetes, or scarring affect my options?
• Is an implant the best next step, or should I continue non-surgical treatment?

Device selection

The surgeon should explain why a particular device fits your anatomy, health, and priorities.

Ask about:

• Three-piece inflatable, two-piece inflatable, and malleable options.
• Brand and model choices and the surgeon’s experience with each.
• Pump operation, hand strength, concealment, rigidity, and flaccid feel.
• Reservoir placement after abdominal, bladder, hernia, or prostate surgery.
• Device coatings, warranty, expected longevity, and revision process.
• The plan if severe scar tissue or unsuitable anatomy is found during surgery.

Surgical approach and sizing

Ask the surgeon to explain:

• Penoscrotal versus infrapubic incision and why that approach suits you.
• How cylinder length and diameter are selected.
• How the team protects the urethra and checks device function.
• Whether the penis will be left partly inflated after surgery.
• Whether a catheter, drain, overnight stay, or extra procedure is expected.
• How Peyronie’s curvature or fibrosis will be managed.

Outcomes and safety

Request recent procedure-specific information, where available, about:

• Infection and device-removal rates.
• Erosion, urethral injury, and wound complications.
• Mechanical failure and revision rates.
• Unplanned return to the operating room or hospital.
• Persistent pain or difficulty using the pump.
• Patient-reported satisfaction and common reasons for dissatisfaction.
• Typical return-to-work and sexual-activity timelines.

A trustworthy surgeon should explain that the implant creates rigidity but does not restore natural erections, increase desire, or guarantee greater penile length.

Infection-prevention plan

Ask how the program reduces infection risk, including:

• Preoperative urine testing and treatment of infection.
• Diabetes or blood-sugar targets.
• Nicotine cessation.
• Skin preparation and perioperative antibiotics.
• Antibiotic-coated or hydrophilic devices.
• Operative handling protocols.
• The plan if infection is suspected after surgery.

Facility accreditation and emergency planning

Confirm that the procedure is performed in an appropriately accredited hospital or surgical centre. Ask about:

• Anaesthesia credentials and monitoring.
• Infection prevention and sterilization.
• Emergency equipment and trained recovery staff.
• Hospital-transfer arrangements.
• Overnight care when same-day discharge is not safe.

Rehabilitation and after-care

Look for a written plan covering:

• Incision and scrotal care.
• Support garments and penile positioning.
• Pain, antibiotic, and bowel medication.
• Work, driving, lifting, exercise, and sexual restrictions.
• Device activation and hands-on training.
• After-hours concerns and emergency contact.
• In-person and virtual follow-up for out-of-province patients.

Transparent pricing

Request an itemized quote showing:

• Surgeon and assistant fees.
• Facility and operating-room fees.
• Anaesthesia.
• Exact implant brand and model.
• Catheter, dressings, medication, and supplies.
• Activation, training, and follow-up visits.
• Additional charges for Peyronie’s treatment, scar-tissue work, removal of an old implant, overnight care, or complications.
• Device warranty and responsibility for future revision costs.

Questions to ask at your consultation

Candidacy and alternatives

• Why do you think an implant is appropriate for me now?
• Which non-surgical treatments remain reasonable?
• How likely is natural erection recovery in my situation?
• How do my prostate surgery, radiation, Peyronie’s disease, diabetes, or urinary symptoms affect the decision?

Surgeon and device

• How many primary and revision implants do you perform each year?
• How many patients have anatomy and medical history similar to mine?
• Which device and surgical approach do you recommend, and why?
• What is the backup plan if you find severe scarring or difficult reservoir placement?

Safety and outcomes

• What are your infection, erosion, mechanical revision, and device-removal rates?
• How do you reduce infection risk?
• What should I realistically expect for rigidity, concealment, length, sensation, and orgasm?
• How often do patients need another operation?

Recovery and follow-up

• When will the device be activated?
• Who teaches me to inflate and deflate it?
• When can I drive, work, exercise, and resume sex?
• Who should I call after hours?
• How will follow-up work if I live out of province?

Costs and coverage

• What exactly is included in the quote?
• Is the exact device included?
• What could add cost?
• How are infection, removal, mechanical failure, or revision billed?
• What documentation will I receive for insurance, warranty, or future care?

Signals of a high-quality implant program

• Performs penile prosthesis surgery regularly, including revisions.
• Explains candidacy and alternatives without pressure.
• Offers device choice based on anatomy and priorities—not only availability.
• Shares procedure-specific risks and realistic expectations.
• Uses an accredited facility with a clear emergency pathway.
• Provides hands-on activation training and accessible follow-up.
• Gives itemized pricing and clear warranty and complication policies.