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Istanbul Penile ImplantCentre · Prof. Dr. Bülent Alıcı

Risks and safety

Risks and Complications of Penile Implant Surgery

Penile implant surgery is a well-established operation with high reported satisfaction, and it carries real risks. Both statements are true, and you are entitled to see them together. This page lists the complications that are discussed at consent, what each one means in practice, and how it is managed if it happens.

Written by
Istanbul Penile Implant Centre editorial team
Medically reviewed by
Prof. Dr. Bülent AlıcıMD, Professor of Urology and Andrology
Published
Last updated

On numbers

This page describes recognised risks so that you can discuss them properly. It does not tell you how likely any of them is in your case. Individual risk depends on your health, your anatomy, whether this is a first implant or a revision, and other factors that can only be assessed in a consultation.

Complications

What can go wrong, and what is then done

Each entry states the complication and the usual management. Nothing here is intended to frighten you out of a decision, or to reassure you out of one.

Infection

What it means

The most significant specific risk of implant surgery. Because the device is a foreign body, an infection involving it usually cannot be cleared with antibiotics alone. Signs include increasing pain, spreading redness, fever, and discharge from the wound.

How it is managed

Prevention is the priority: antibiotics around the time of surgery, strict theatre technique, antibiotic-loaded or antibiotic-impregnated devices, treating urinary infection beforehand and optimising diabetes control. If a device does become infected, treatment usually means removing or replacing it, sometimes in a single salvage operation.

Bleeding and haematoma

What it means

Some bruising is expected. A haematoma is a larger collection of blood, most often in the scrotum, which can cause swelling and discomfort.

How it is managed

Most settle without intervention. A large or expanding collection may need drainage. Blood-thinning medication is reviewed before surgery.

Pain and swelling

What it means

Discomfort and swelling of the penis and scrotum are a normal part of the first one to two weeks. Pain that persists beyond the expected period, or that increases rather than settles, needs assessment.

How it is managed

Regular pain relief, support and rest during the early period. Persistent pain is investigated rather than simply endured — occasionally it relates to component size or position.

Erosion and extrusion

What it means

A component can, over time, press through the tissue containing it — for example a cylinder towards the urethra or the skin. It is uncommon and more likely where sensation is reduced or tissue quality is poor.

How it is managed

Requires surgical assessment. Treatment depends on which component is involved and usually means removing or repositioning it.

Mechanical failure

What it means

An inflatable implant is a mechanical device with tubing, seals and a pump. Fluid leaks, tubing problems and pump or valve faults can occur, usually presenting as difficulty inflating or holding rigidity. A malleable device has no moving parts and is not subject to this.

How it is managed

Assessment to identify the faulty component, then revision surgery to replace part or all of the device. Do not assume a change in function is normal — report it.

Reservoir and pump complications

What it means

The reservoir can become displaced or be uncomfortable, and rarely may need repositioning. The pump can sit too high or too low in the scrotum, which makes it harder to operate. Auto-inflation, where the device partially inflates on its own, can also occur.

How it is managed

Many issues are managed conservatively or with adjustment. Repositioning surgery is sometimes needed. Previous abdominal or pelvic surgery raises the importance of planning reservoir placement carefully.

Change in penile length or shape

What it means

An implant is sized to your anatomy and does not lengthen the penis. Some men perceive the penis as shorter than before, particularly where there was pre-existing shortening or scarring. Residual curvature can persist.

How it is managed

Realistic expectations set before surgery are the most important factor. Additional manoeuvres to address curvature can be performed at the time of implantation where appropriate.

Revision surgery

What it means

Some men will need a further operation at some point — to treat infection, correct a component problem, or replace a device that has reached the end of its working life.

How it is managed

Revision is an established procedure, but it is more complex than a first implant because of scarring. Long-term follow-up is part of implant care for this reason.

Anaesthetic risks

What it means

The general risks of general or spinal anaesthesia apply, including reactions to medication and cardiac and respiratory risks, which relate mainly to your general health rather than to this operation.

How it is managed

A pre-anaesthetic assessment identifies and addresses these risks. Your anaesthetist will discuss them with you individually.

Loss of other treatment options

What it means

Preparing the erectile bodies for an implant alters them permanently. After implant surgery, tablets, injections and vacuum devices are generally no longer effective.

How it is managed

This is why an implant is normally considered once other treatments have been tried or ruled out, and why the decision is not rushed.

Prevention

How risk is reduced in practice

None of these eliminates risk. Together they are what modern implant surgery does to keep it as low as it can reasonably be.

  • Screening for and treating urinary or other infection before surgery is scheduled.
  • Optimising blood glucose control in patients with diabetes before the operation.
  • Intravenous antibiotics given before the incision, per protocol.
  • Antibiotic-loaded or antibiotic-impregnated device surfaces where appropriate.
  • A no-touch or minimal-touch surgical technique in a fully equipped operating theatre.
  • The same surgeon performing the operation and the postoperative reviews.
  • Written discharge instructions, including the specific signs that require urgent contact.
  • A defined route back to the surgical team after you return home.

The one that is easy to miss

Implantation closes other doors

This is the risk least often mentioned in marketing material, and the one most worth understanding before you consent.

Placing cylinders inside the corpora cavernosa alters the erectile tissue. If the device is later removed and not replaced, natural erections — including any residual response to tablets or injections — are unlikely to return. In that sense the decision is not reversible, even though the device itself can be removed.

This is why an implant is normally offered after other treatments have been tried, and why an honest surgeon will sometimes advise you to wait. If you have not exhausted non-surgical options, that conversation should happen before a date is booked. The assessment pathway is described on the page about how the operation works.

Questions about safety and complications

What happens if an infection occurs?

Because an implant is a foreign body, an established infection involving the device usually cannot be cleared with antibiotics alone. Treatment typically means removing the device, and in some cases a salvage procedure that removes and replaces it in the same operation. This is why prevention matters so much: antibiotics around surgery, strict theatre technique, antibiotic-loaded or impregnated devices, treating urinary infection first and controlling diabetes. Increasing pain, spreading redness, fever or wound discharge needs urgent contact.

Can the device break?

Yes. Inflatable implants contain tubing, seals and a pump, and mechanical problems such as fluid leaks or pump faults can occur. This usually shows itself as difficulty inflating the device or as the erection not holding. Malleable devices have no moving parts and are not subject to mechanical failure in the same way. Any change in how the device works should be reported rather than tolerated.

Is revision surgery possible?

Yes, and it is performed for several reasons: infection, mechanical failure, a component that is uncomfortable or badly positioned, or a device that has reached the end of its working life. Revision requires assessment of the existing device and the surrounding tissue before it can be planned. If you already have an implant elsewhere and are considering revision, tell us which device was used and, if possible, send the original operation note.

Can an implant be removed if I change my mind?

A device can be removed surgically, but the erectile bodies are permanently altered by implantation, and after removal erections are generally not possible even with medication. An implant should therefore be treated as a one-way decision, which is why it is normally considered only after other treatments have been tried or ruled out.

Medical references

We do not publish complication rates, device survival figures or satisfaction percentages on this website without a citation to the study they come from. Where you see a figure quoted elsewhere without a source, treat it with caution.

Guidelines and professional bodies

Device manufacturer documentation

Citations to be supplied

  • [MEDICAL REFERENCE — long-term device survival study][JOURNAL, YEAR] — Cite a peer-reviewed source before publishing any statement about how long a device lasts.
  • [MEDICAL REFERENCE — infection rate study][JOURNAL, YEAR] — Cite a peer-reviewed source before publishing any infection-rate figure.
  • [MEDICAL REFERENCE — patient satisfaction study][JOURNAL, YEAR] — Cite a peer-reviewed source before publishing any satisfaction figure.

External links open in a new tab and are provided for reference only. We are not affiliated with, and do not speak for, the organisations listed.

Discuss the risks in your specific case

Risk is individual. Diabetes, previous pelvic surgery, radiotherapy and a previous implant all change the picture. Send your history and you will get a considered answer rather than a generic reassurance.

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