Erectile dysfunction (ED) is a common condition. For men who do not respond to oral medications or other less invasive therapies, a penile implant offers a definitive treatment solution. This prosthetic device is surgically placed to restore the ability to achieve a functional erection for sexual activity. The non-inflatable penile implant, also referred to as a malleable or semi-rigid rod, is one of the two primary types of prostheses available. This option uses a simpler mechanical approach compared to its fluid-filled counterpart.
How the Malleable Implant Works
The non-inflatable implant is characterized by its simple, single-piece construction, which contributes to its reliability and ease of use. It consists of a pair of rods that are designed to be firm yet flexible, providing constant structural support to the penis. The core of each rod is typically constructed from braided stainless steel or silver wires, encased in a durable, biocompatible silicone sheath.
The internal metal core provides the necessary rigidity for penetration while allowing the device to be manually manipulated. The implant does not rely on a pump, reservoir, or hydraulic fluid to achieve firmness. The malleability of the rods allows them to be bent into position for intercourse or downward against the body for concealment. This mechanism means the penis is always in a semi-rigid state, controlled entirely by physical positioning. The design minimizes mechanical failure points since there are no moving parts.
The Surgical Process and Initial Recovery
The implantation procedure is typically performed under general or spinal anesthesia and takes less than one hour. The surgeon makes a small incision, most commonly in the penoscrotal junction (where the penis meets the scrotum) or occasionally above the pubic bone. Through this single incision, the surgeon accesses the corpora cavernosa, the two chambers of spongy tissue in the penis.
Specialized instruments are used to dilate the chambers to the appropriate length and diameter. The two malleable rods are carefully measured and trimmed to fit precisely within the corpora cavernosa. This maximizes the length and girth restoration possible with the device. Once the rods are secured, the incision is closed, and a compressive dressing is often applied to manage swelling.
Following the procedure, patients are advised to keep the penis elevated toward the abdomen for several days to promote healing. Initial recovery involves managing pain, which is controlled with prescribed medication during the first few days. Significant swelling and bruising in the penis and scrotum are expected and will gradually subside over the next two to four weeks. Patients usually receive antibiotics to minimize infection risk. Surgeons recommend abstaining from strenuous activity for two to four weeks and waiting four to six weeks before engaging in sexual intercourse.
Choosing Between Non Inflatable and Inflatable Implants
The choice between a non-inflatable penile implant (NIPPI) and a three-piece inflatable penile prosthesis (IPP) involves trade-offs in function, complexity, and aesthetics. The malleable implant’s simplicity translates to a lower risk of mechanical failure compared to the IPP, which involves interconnected cylinders, a pump, and a fluid reservoir. The NIPPI surgery is also less complex and often shorter, which is favorable for patients with certain underlying medical conditions.
The non-inflatable device is a strong option for men with limited manual dexterity, such as those with severe arthritis or a history of stroke, as it only requires manual bending. These devices are generally less expensive than the more complex inflatable systems. However, the constant semi-rigid state of the NIPPI is its primary drawback, as the penis cannot achieve a truly flaccid state, making concealment more difficult.
In contrast, the IPP allows the penis to be fully flaccid when deflated, offering superior concealment and a more natural-feeling erection when inflated. While the IPP may offer greater girth and rigidity control, it is a more intricate device. This means the lifetime risk of a component malfunction is higher than with the NIPPI. Patients weigh the desire for a more natural, on-demand erection against the simplicity, durability, and lower cost of the non-inflatable implant.
Living With the Implant
Long-term patient satisfaction rates with non-inflatable penile implants are very high, often reported to be 90% or greater for both the patient and their partner. The device requires minimal maintenance, involving the simple manual manipulation of the rods into the desired position for intercourse. For everyday activities, the rods are bent downward against the thigh for comfortable and discreet concealment.
The expected longevity of a non-inflatable implant is substantial, with many devices functioning effectively for 10 to 15 years or more before replacement is considered. Due to their simple design, they have a lower risk of mechanical wear and tear than multi-component inflatable models. Although rare, long-term complications can include infection requiring device removal, or issues like device migration or erosion through the skin.