Penile Surgery
Penile Implant Surgery in Abu Dhabi
Dr. Alejandro Molina, Consultant Urologist & Andrologist in Abu Dhabi, treats severe and refractory erectile dysfunction — including after radical prostatectomy, and where Peyronie’s disease is also present — with penile implant surgery (penile prosthesis). The inflatable penile implant is the option most commonly selected, with the malleable alternative considered individually.
Where this fits
When Is a Penile Implant Considered?
This reflects how erectile dysfunction is generally approached, not a rigid sequence every patient must follow — some steps may be skipped or reordered depending on individual circumstances.
01
Erectile dysfunction
Confirmed and assessed for underlying cause.
02
Oral medication
PDE5 inhibitors are typically tried first.
03
Other non-surgical options
Vacuum devices, shockwave therapy or injections.
04
Persistent / refractory ED
Considered when the above have not given reliable results.
05
Implant assessment
Candidacy and device type discussed individually.
Our approach
Penile Implant Surgery Is the End of an Assessment Pathway — Not the Beginning
A penile implant is a surgical decision, and surgical decisions deserve more than a single conversation about a device. Before it is discussed as a realistic option, assessment covers:
Cause and severity
Confirming that erectile dysfunction is genuinely severe or refractory — not assumed from symptoms alone.
Previous treatments
Reviewing what has already been tried — oral medication, vacuum devices, injectable therapy — and why it did or didn't work.
Wider clinical context
Vascular, hormonal and anatomical factors that may be contributing are assessed, not overlooked in favour of a quick surgical fix.
Realistic expectations
What an implant can and cannot restore — for rigidity, sensation, orgasm and perceived length — discussed before any surgical decision, not after.
Device selection
Inflatable or malleable, chosen according to anatomy, health and personal preference, not offered as a single default recommendation.
This is what separates a specialist ED pathway from a generic implant provider — the device is the last step of an assessment, not the first conversation.
What is a penile implant?
A Device Placed Within the Penis to Restore Rigidity
A penile prosthesis is a surgically implanted device, placed within the erectile chambers of the penis, designed to allow a man to achieve a rigid erection when desired.
Candidacy — reviewed individually, never assumed
Often considered once
- Erectile dysfunction is severe or refractory
- Oral medication, vacuum devices or injectable therapy have not provided reliable results
- The underlying cause has already been appropriately assessed
Addressed or reassessed first
- Active infection at the time of assessment
- Reversible or unaddressed causes of erectile dysfunction not yet fully explored
- Expectations that don't align with what the surgery is designed to do
- Certain anatomical or medical factors identified at assessment
Primary option
The Inflatable Penile Implant
Most patients who go on to have implant surgery choose an inflatable device — the option covered in most depth here.
- Cylinders
- Pump
- Reservoir
Components
Two or three pieces: cylinders placed within the erectile chambers, a fluid reservoir, and a pump — most often placed in the scrotum.
Inflation
Pressing the pump moves fluid from the reservoir into the cylinders, producing rigidity when desired.
Deflation
A release mechanism returns the fluid to the reservoir, allowing a return to a flaccid state.
Flaccid-state appearance
When deflated, the flaccid appearance is close to natural for most men, and the device is not generally noticeable in clothing.
Patient operation
The patient operates the pump himself, achieving and releasing rigidity when he chooses.
Why it's the option most commonly selected
Its inflate/deflate mechanism most closely mirrors the natural cycle of rigidity and flaccidity.
How it works
01
Resting / flaccid
The default state — no fluid in the cylinders.
02
Pump activation
The patient presses the pump, moving fluid from the reservoir.
03
Rigidity for intercourse
Fluid fills the cylinders, producing rigidity on demand.
Secondary option
Malleable Penile Implant
A simpler, semi-rigid device with no pump — the rods are manually positioned. It is not considered inferior or obsolete: it remains a useful option in selected circumstances, including where simplicity, manual dexterity, anatomy or a previous surgery make a mechanically simpler device more appropriate. Which device suits you is discussed individually, not assumed in advance.
The surgical pathway
Assessment, Surgery, Recovery
Assessment
Confirming that erectile dysfunction is severe or refractory, reviewing previous treatments tried, and evaluating overall health and expectations before surgery is considered.
Surgery
Performed under appropriate anaesthesia. The chosen device — inflatable or malleable — is placed within the erectile chambers of the penis.
Recovery
A structured recovery period follows, with activity gradually resumed and device use introduced under guidance, timelines discussed individually at consultation.
After implantation
Sexual Function After Surgery
What it changes
- Provides mechanical rigidity suitable for intercourse
- Not generally noticeable in clothing once deflated
What it doesn't change
- Sensation — generally preserved if present beforehand, not automatically changed by the device
- Orgasm — depends on the same nerve and hormonal pathways as before surgery
- Penile length — does not inherently increase
- Ejaculation — depends on your underlying prostate/reproductive status
A penile implant is designed to allow a man to achieve a rigid erection when desired. It does not change sensation, orgasm or ejaculation, which are governed by separate mechanisms. As with any surgery, individual results vary, and expectations are discussed in detail during assessment — the aim is a realistic understanding of what the device can and cannot do before proceeding.
Day to day, an inflatable device is activated by a pump mechanism, most often placed in the scrotum, that a man operates himself when he wants rigidity; a malleable device is simply positioned by hand. Some men also perceive a reduction in length compared to their erections before erectile dysfunction developed — this is generally related to the underlying condition itself, including tissue changes that occur with longstanding untreated ED, rather than something the implant surgery removes. This is part of the realistic-expectations conversation at assessment, not a surprise left for after surgery.
The aim is a realistic understanding of what the device can and cannot do — before proceeding, not after.
A specific clinical pathway
Penile Implant After Radical Prostatectomy
01
Radical prostatectomy
Nerve-sparing performed where oncologically appropriate.
02
Recovery / rehabilitation
PDE5 inhibitors, vacuum therapy and/or injections.
03
Persistent ED
When function hasn't recovered sufficiently over time.
04
Implant assessment
Discussed in selected patients, individually.
Erectile dysfunction can persist after radical prostatectomy, even when surgery goes well and, where oncologically appropriate, nerve-sparing was performed. Nerve-sparing reduces the risk of permanent erectile dysfunction, but does not guarantee recovery — baseline erectile function before surgery, age, and individual nerve healing all affect the outcome.
Rehabilitation after prostatectomy typically starts with the same treatment ladder used for erectile dysfunction from any cause — PDE5 inhibitors, vacuum erection devices, and intracavernosal injection therapy — often introduced early to support recovery while nerve function is still resolving.
Where erectile function has not recovered sufficiently over this period, and other treatments have not given reliable results, a penile implant is one option discussed in selected patients — assessed with the same principles used for any candidate, applied to your specific situation.
Learn more about laparoscopic radical prostatectomyRead: Penile Implant After Radical Prostatectomy
A specific clinical pathway
Peyronie's Disease and Penile Implant
Peyronie’s deformity
Severe ED
Implant assessment
in selected cases
Severe Peyronie’s disease — where curvature, deformity or shortening significantly affects sexual function — can coexist with erectile dysfunction that does not respond reliably to other treatment. In selected patients, a penile implant can address the erectile component, and depending on the surgical technique used, some of the curvature, in a single procedure. This is assessed individually and is not the default approach to Peyronie’s disease alone.
Explore Peyronie’s DiseaseWhat to expect
Recovery, Phase by Phase
Initial healing
Restricted activity while early healing takes place after surgery.
Gradual return to activity
Normal daily activity is resumed gradually, following guidance specific to your surgery.
Device-use introduction
Once healing is sufficient, use of the device is introduced under guidance.
Follow-up
Progress and any concerns are reviewed as part of your individual recovery plan.
Realistic expectations
Risks and Complications
- Infection
- Mechanical wear or device malfunction over time, in some cases requiring revision surgery
- Changes in sensation
- Bleeding or bruising
- Risks associated with anaesthesia and surgery generally
FAQs