There are several treatment options for erectile dysfunction. Surgical treatment could be an option if medications and pump devices have not worked. The most common surgical treatment is a penile implant.
Most doctors will begin treatment for erectile dysfunction (ED) with medications. If these do not work, a doctor may recommend other therapies, such as ED injections or penis pumps.
If these therapies do not provide a satisfactory outcome, a doctor may begin to discuss surgical options.
The
Vascular reconstruction surgery is another surgical option, but surgeons rarely perform it.
This article discusses surgical treatments for ED, the risks, benefits, outcomes, and more.
ED treatment aims to provide a person with an erection sufficient for sexual intercourse.
Surgical intervention for ED can have good outcomes. According to the American Urological Association, penile implants have the highest rates of success and satisfaction among ED treatment options.
However, medications are usually the first-line treatment for ED. They also have good results for many people. A doctor may recommend surgery for cases of ED that do not respond to medications.
Surgery is a last resort, however, and a person should consider it carefully.
Two types of surgery are available: penile implants and vascular reconstruction.
Penile implants are the main surgical procedure for ED. Doctors usually only recommend vascular reconstruction in specific cases of trauma to the penis or pelvis.
A healthcare professional might recommend any of the following lifestyle strategies in addition to medication or surgical intervention:
- quitting smoking
- limiting or stopping alcohol use
- increasing physical activity
- maintaining a moderate body weight
- stopping recreational substance use
This section explains the types, benefits, and risks of penile implants.
Types
Penile implant surgery is an irreversible procedure. It involves a surgeon placing a rod, usually silicone rubber, into a person’s penis to create a rigid state.
There are two types of implants. One is a malleable, semi-rigid device, and one is inflatable. Additionally, there are two styles of inflatable devices.
Malleable implants
Malleable implants are simple to implant and operate. They are single pieces of silicone rubber that a person can mold with the hands to make the penis more or less erect.
Malleable implants are only semi-erect devices, so the penis will not be fully erect or flaccid. These devices
Malleable implants are usually the best option for people who want an implant that is simple to use.
Inflatable devices
Two-piece inflatable devices are a pair of cylinders attached to a scrotal pump.
Surgeons place the two cylinders inside the penis and position the pump within the scrotal sac. This makes it discreet yet easily accessible for a person to use.
A person can inflate this device for intercourse and then partially deflate it to allow some appearance of a flaccid penis.
Three-piece inflatable devices comprise two cylinders that surgeons place inside the penis, a scrotal pump, and a reservoir for saline that fits inside the body.
Because they provide the best rigidity for an erection, three-piece inflatable devices make up about
Benefits
People usually tolerate prostheses well. They also have a high satisfaction rate, greater than
They allow for unplanned, repeated erections, so people can use them whenever they desire. Additionally, they can last for 10–15 years on average.
Risks
Infection remains the most significant risk of penile implant surgery.
However, infection rates are still low. Infection rates are
Another risk is that a person may not be satisfied with the physical results. Many people dislike their penis length after surgery, but counseling and mental preparation can help a person come to terms with the changes.
Learning to operate the device also takes time, so a person must practice patience.
Vascular reconstruction aims to restore blood flow to the penis by reconstructing any damaged blood vessels.
Doctors usually only recommend it for young males with damage to the arteries from injury or congenital abnormalities.
Some conditions, such as high blood pressure or diabetes, can cause ED due to insufficient blood flow to the penis. Doctors
This section discusses the types, benefits, and risks of vascular reconstruction.
Types
Vascular reconstruction can involve the arteries, called arterial reconstruction, or the veins, called venous reconstruction.
Surgeons may opt for venous reconstruction if any of the veins that carry blood to the penis are damaged.
Surgeons may opt for arterial reconstruction in older adults with arterial occlusive diseases, where the arteries narrow.
However, doctors mainly only recommend these surgeries in
Benefits
The long-term results of this type of surgery vary considerably. It is a high risk procedure.
However, it can work for otherwise healthy young males with damaged blood vessels. Additionally, if it works, it avoids the need for medications, injections, devices, or prostheses.
Risks
The most significant risk with this surgery is an overflow of blood to the blood vessels of the penis, called glans hyperemia. Sometimes, this can cause ulcers.
Other potential complications from surgery include:
- infection
- hematoma
- blood clots
Surgery is generally an outpatient procedure, so a person can go home to recover.
Some pain may occur. Doctors may prescribe pain medication or over-the-counter pain relievers to use after surgery.
Postoperative symptoms, such as bruising, swelling, and localized discomfort, may last for several weeks. A person should limit physical activity for 1 month following the surgery.
It may take around 4–6 weeks for a person to recover after surgery. If there is swelling or pain, the person may need to wait longer before having sex.
According to a 2020 research review, more than
However, it is a costly procedure. It is generally only available after all other treatment options have proved to be unsuccessful.
Individuals and their partners generally report satisfaction with the results of surgery. It may take some time to learn to use the device.
When considering any surgery, reaching out for support and information can be helpful.
A few organizations that provide help, support, and information include:
This section answers some frequently asked questions about erectile dysfunction surgery.
How much does erectile dysfunction surgery cost?
Many insurance plans have coverage for ED surgery, as well as Medicare.
Insurance providers will want to know that the person has tried all other treatment options first and had no success.
They may also ask for documentation from the doctor that:
- ED is due to physical, and not psychological, reasons
- ED has been present for a certain amount of time
- the person has tried all nonsurgical options
Without insurance coverage, surgery costs vary from $17,000–$25,000. This factors in the cost of the surgeon, surgery center, anesthesiologist, and other fees.
With private health insurance, these prices should be significantly lower.
Medicare does cover penis implants under Part B, which covers outpatient procedures. The deductible for 2023 is $226. The individual is responsible for 20% of all approved charges for the procedure. A Medicare supplement policy (Medigap) will usually cover this amount.
Is erectile dysfunction surgery painful?
Surgeons will perform the surgery while the patient is under general anesthesia. This means the patient will be unconscious and not feel any pain during surgery.
However, a person should expect some pain after the procedure. Some doctors will prescribe pain medication to ease the discomfort. After 1–2 weeks, over-the-counter pain medication may suffice.
Discomfort and pain should decrease within a few weeks.
When a person has tried medication and other treatments for ED, a doctor might recommend surgery for a penile implant.
In rare cases, doctors may recommend another surgery, called vascular reconstruction. This is mainly reserved for rare cases of healthy young males who have experienced physical trauma.
There are two types of penile implants. One is malleable but relatively rigid and does not allow the penis to become fully erect or flaccid.
The other, more popular type is an inflatable device. It allows the penis to inflate and deflate to an erect or flaccid state.
Penis implant surgery is an outpatient procedure. Private insurance and Medicare usually cover it. A person should expect some pain for a few weeks.
A person may be able to resume sexual activity 8 weeks after ED surgery. However, people should avoid sex and speak with a doctor if they experience pain or discomfort after 8 weeks.