The insertion of a penile implant is a surgical solution often considered to treat severe erectile dysfunction. As a urological surgeon and andrologist, I have found that this procedure raises a question that is frequently asked by patients: does the insertion of a penile implant lead to a loss of volume in the penis? Is it possible to keep a good-sized penis? The aim of this article is to shed some light on the subject, explain the mechanisms involved and give you some advice on how to optimize the results of the operation.

Understanding severe erectile dysfunction and its impact on penis size

Patients who undergo penile implant surgery generally suffer from severe, often long-standing erectile dysfunction. This condition is associated with a progressive reduction in the ability of the cavernous tissues responsible for erection to expand. Over time, these tissues retract, which can lead to a visible loss of volume in the penis.

Several medical factors can aggravate this retraction:

• Cardiovascular disease: obstruction of the arteries supplying the penis reduces blood flow, which in turn reduces the size and quality of the erection.
• Diabetes complicated by neuropathy: This disorder can alter the trophicity of tissues, i.e. their ability to feed and maintain health, which also affects the size of the penis.

In short, when a patient undergoes penile implant surgery, the penis has often already lost volume due to the underlying disease and the prolonged absence of functional erections.

Penile implant surgery: a procedure that does not reduce the size of the penis

Contrary to popular belief, penile implant surgery does not result in any additional loss of volume. In fact, during the operation, the corpora cavernosa are measured at maximum extension, in order to select the optimal size of the cylinders to be implanted.

The aim is to place an implant that corresponds exactly to the measured length, or even slightly longer if the tissue is sufficiently supple. This precision is particularly possible with hydraulic implants, which offer greater adaptability.

In other words, the operation aims to restore the maximum possible length of the penis, taking into account the patient’s current anatomical situation. It therefore does not contribute to a further reduction in size, but rather seeks to preserve or optimize existing length.

The role of the glans in size perception

Another important aspect often overlooked is the loss of glans volume during arousal, which frequently accompanies severe erectile dysfunction. The glans, which normally swells and increases in volume with erection, may no longer dilate properly.

This lack of volumetric enlargement of the glans translates into a perceived loss of 1 to 2 centimetres in total length of the penis, which can reinforce the sensation of reduced size.

Why consult a specialist early for a penile implant?

One of the key messages I’d like to convey is the importance of early consultation with a urologist when conventional treatments for erectile dysfunction, whether oral tablets or intracavernosal injections, have lost their effectiveness.

If you find that these treatments no longer produce a functional erection, or produce an erection that is difficult to use, it’s vital to discuss the possibility of a penile implant as soon as possible.

The earlier the operation is performed, the less the penis will retract, and therefore the better the post-operative satisfaction. In fact, a less retracted penis offers greater potential for implantation and restoration of length.

The benefits of a suitable penile implant

The hydraulic penile implant is today’s benchmark technology. It enables patients to regain a firm, natural erection on command, thus improving the quality of their sexual life. By choosing an implant that matches the measured length of the corpora cavernosa, the chances of maintaining a satisfactory size are maximized.

Beyond functional restoration, preserving the size of the penis is a key factor in the psychological well-being and self-confidence of operated patients.

Tips for preparing for the operation

• Consult a specialized urologist: A complete work-up will enable you to assess the condition of the tissues and discuss treatment options.
• Act quickly: Don’t delay in considering implantation if medical treatments no longer work.
• Learn more about implant types: Hydraulic implants are often preferred for their performance and comfort.
• Follow post-operative advice: Rehabilitation and medical follow-up are essential to optimize results.

Conclusion: don’t let severe erectile dysfunction affect your quality of life

Penile implant surgery should not be dreaded because of an unfounded fear of size loss. On the contrary, this procedure represents an effective solution for restoring a functional erection and preserving the length of the penis, provided you act quickly.

If you feel that erectile dysfunction treatments are less effective, don’t hesitate to consult a urologist about this option. The earlier you have an implant, the better your chances of maintaining a good-sized penis and a fulfilling sex life.

I remain at your disposal for any questions or consultations you may have, as each patient deserves personalized care tailored to his or her needs.