“When can I have sex with it?”
“How long does it last?”
“What happens if I use it too much?”
“What happens if I don’t use it enough?”
“How often should I see my doctor?”
Penile implants are a game-changer for men with erectile dysfunction, and these are common questions that come up. Curiosity is a good thing, and implants perform best when you understand the basics. To keep your game fresh, it helps to pay attention to proper use, catch problems early, and keep your tune-ups in check.
Time to Activate
If you think you’ll be able to jump back into your nighttime extracurriculars right after surgery, your expectations will need an adjustment. After surgery, the soft tissues and incision areas need time to heal. Usually, about four to six weeks after surgery, you’ll be allowed to “activate.” Activation refers to the first intentional inflation of the prosthesis after the surgical site has healed and swelling has resolved.
The initial activation often happens in the surgeon’s office, allowing the patient (and partner) to learn proper pump technique and ensure the device works as intended. During the activation session, the surgeon demonstrates how to operate the pump-deflation mechanism and addresses any questions you may have to make sure you’re comfortable with the process. This education is pretty important, since proper technique can prevent mechanical issues and early mishaps that could stress the device or tissue.
Once you’ve been cleared for activation, it’s important to cycle the device regularly. Cycling refers to inflating and deflating the implant to keep the internal components moving. Regular cycling also helps maintain the health and elasticity of penile tissue.
Resuming sexual activity is an exciting milestone, and as soon as your healthcare provider has cleared you, game on. The timeline varies based on individual healing and comfort levels, but it’s usually around the same time as activation. A month or more may seem like a long time to wait, but be patient – jumping the gun could increase the risk of infection, wound dehiscence (rupture), or cylinder migration.
Whatever you come to them with, your provider has likely heard it before, so communicate openly about any concerns or questions during this period.
Know the Limits
You’ve gotten through surgery, you’ve been cleared for resuming activity, and now the fun begins. Is it possible to have too much fun with a prosthesis?
Not really…. If you’re using it properly. An inflatable penile prosthesis (IPP) is designed to withstand sexual activity without damage, and the concept of “overuse” is more about misuse than frequency. Behaviors such as forcing the cylinders against resistance during inflation, bending the device at extreme angles, or using it before complete healing can lead to mechanical issues or injury to the penis.
Underuse also occurs, and yes, it can be problematic in more ways than one, but we’ll focus on just one. If the inflatable cylinders remain deflated for extended periods, especially in the early months post-surgery, the surrounding tissue may contract, making future inflation more challenging. We often recommend scheduled early cycling, inflating and deflating the device regularly after activation. This keeps the cylinders flexible and maintains a healthy range of motion.
After the healing period, occasional use is fine – most patients don’t need to inflate daily once comfortable with the device and satisfied with their sexual routine.
Maintaining
IPPs don’t require routine tune-ups like a car, but some practical steps help keep the device working well:
- Proper use: Learn pump mechanics and avoid unnecessary stress on the device.
- Early cycling: Being consistent helps the device settle and prevents corporal contraction (the tightening of smooth muscle cells in the penis).
- Monitoring: Watch for signs of complications, such as pain, swelling, or malfunction.
Regular follow-up appointments with your healthcare provider can also minimize long-term complications and ensure the implant functions reliably.
Even after healing, IPPs can encounter issues. And while many implants function well for years, revision surgery could become necessary. Potential complications and reasons for revision include:
- Infection: Persistent redness, swelling, drainage, or fever signals urgent evaluation. Although rare, infections can occur and may require device removal.
- Mechanical problems: Cylinder leaks or pump malfunction may require replacement, and sometimes parts just wear out over time.
- Erosion or migration: The implant may shift or move through surrounding tissue, but proper sizing and avoiding early trauma usually prevent this; treatment usually involves explantation (surgical removal of the implant).
- Fibrosis: A lack of early cycling can lead to scarring that limits the expansion of the cylinder.
The Weeks and Years Post-Op
Routine follow-ups help catch potential issues early, ensuring the IPP continues to function optimally. Follow-up schedules vary, but a typical timeline includes:
- 1 Week Post-Op: Initial check-up to assess the surgical site.
- 4-6 Weeks Post-Op: Activation session and functional assessment.
- 3-6 Months Post-Op: Evaluate implant function and patient satisfaction.
- Annually: Long-term follow-up to monitor implant condition and address any concerns.
These visits are also a chance to review technique, ask questions about changes in your sexual routine, and talk through any new symptoms. Even years after surgery, most patients benefit from maintaining contact with their provider to ensure a smooth operation.
Managing chronic health conditions such as diabetes, high blood pressure, or cardiovascular disease also plays a significant role in long-term implant success. Good control of these conditions supports proper blood flow and healing, reducing the chance of complications. Lifestyle factors, such as maintaining a healthy weight, staying physically active, and not smoking, further support overall penile and vascular health.
It’s worth noting that most inflatable penile implants last well over a decade, with high satisfaction rates among patients and their partners. Knowing that your device has a strong track record of durability can provide peace of mind as you return to normal life.
If you’re considering a penile implant or want long-term guidance with your device, consult with an experienced specialist. Dr. Kapadia has been designated as a Coloplast Titan and Boston Scientific AMS 700 Center of Excellence surgeon for penile implants – one of the few surgeons in the nation to achieve this dual designation. His expertise ensures patients receive the highest level of care from surgery through long-term follow-up.