Taking out a penile implant is more than undoing the original surgery, because the body has adapted around the device. The effects most men notice are a shorter penis and weaker or absent natural erections, both from scarring inside the penis. How much is lost depends heavily on timing: whether a replacement goes in during the same operation or the penis is left empty for months.
How Much Length Can Be Lost
An implant sits inside the two erection chambers, that run the length of the penis. When the device comes out and the chambers stay empty, they shrink as they heal. The tissue heals by contracting and filling with scar, so the loss builds over weeks to months rather than appearing at once.
Men who waited for a later replacement lost on average about 3.7 cm (roughly 1.5 inches) of length inside the penis.1PubMed. The Impact of Immediate Salvage Surgery on Corporeal Length Preservation in Patients Presenting with Penile Implant Infections The bigger the penis was to start with, the more length was lost.2PubMed. The Impact of Immediate Salvage Surgery on Corporeal Length Preservation in Patients Presenting with Penile Implant Infections
The loss is measured inside the chambers, so the visible change may differ slightly. Once scar tissue sets in, the loss is largely permanent.
Putting a new implant in during the same surgery helps keep length.3PubMed Central. Narrative review of immediate salvage for penile prosthesis infection The new device keeps the chambers stretched open while they heal. Stretching or vacuum devices are sometimes used during a wait to slow shortening, but only when the surgeon says the healing tissue can tolerate them, and they can’t promise to restore length already lost.
It helps to ask the surgeon whether same-day replacement is possible for you, and what length-preserving steps they use if the chambers must stay empty. Ask them to record your stretched penile length before the operation. That gives you a baseline to compare against later and a realistic sense of what changed.
Erections After Removal
After an infected implant is removed, the spongy tissue that fills with blood during an erection often turns to scar.4PubMed Central. Pathophysiology and Grayscale Ultrasonography of Penile Corporal Fibrosis Scarred chambers can’t expand, and later surgery to place a new implant becomes harder.
Some function can remain. In one reported case, a man got an erection about 60–70% rigid with an injected drug after removal, enough for penetration.5PubMed. Erectile function significant enough for penetration during sexual intercourse after removal of inflatable penile prosthesis That is the exception, not the rule.
Removal doesn’t return you to how things were before the implant. The erection problem that led to the implant is still there, with scarring from the implant and any infection layered on top.
For men who stay without an implant, a few options exist. Pills such as sildenafil work by increasing blood flow into healthy erection tissue, so they often disappoint when that tissue is scarred and cannot expand. Injections into the side of the penis act directly on the tissue and may help some men, as in the reported case, but results vary and a urologist must supervise the first dose.
A vacuum pump draws blood into the penis and a ring at the base holds it there. That can give enough firmness for sex without surgery, though the penis may feel cooler and hinge at the base. Sensation and orgasm usually remain, because the nerves for feeling are separate from the erection chambers.
Replacing the Implant Right Away or Later
Same-day replacement means removing the infected device, washing out the area, and placing a new implant in the same operation.6PubMed Central. Narrative review of immediate salvage for penile prosthesis infection Men can resume sex sooner and keep penis length.7PubMed Central. Narrative review of immediate salvage for penile prosthesis infection About 80% of same-day replacements succeeded, compared with 71% when replacement waited, a difference too small to be sure of.8PubMed. Penile prosthetic infection: management by delayed and immediate salvage techniques Surgeons can also place the new device just outside the old scar capsule; in one series, only 1 of 18 such cases got reinfected.9PubMed. Salvage and Extracapsular Implantation for Penile Prosthesis Infection or Extrusion
Not everyone is a candidate. A severe infection that has spread beyond the implant, or a patient who is very ill, usually calls for removal alone, because putting new material into badly infected tissue invites reinfection. A device pushing through the skin has already breached the body’s barrier, so the surgeon may want the area to heal first. Poorly controlled diabetes raises infection risk, so blood sugar control matters when deciding on a replacement. The final decision is often made during surgery, when the surgeon sees how infected the tissue looks, so ask beforehand what the backup plan is.
On the waiting route, the device comes out, the infection is treated, and the chambers stay empty for months before a new implant is considered. Scar tissue builds during that time, which makes later placement harder and the operation more demanding. The surgeon may need a shorter or narrower device to fit the scarred chambers, which can mean a different result than before. The tradeoff is that waiting gives the infection time to clear fully, which can matter for men who aren’t good candidates for same-day replacement.
Why Implants Get Removed
The most common reasons are infection, a device that stops working, and being unhappy with the result.10PubMed Central. A novel approach for removal of an inflatable penile prosthesis reservoir using laparoscopic instruments Others include the device wearing through tissue (erosion), fluid buildup, scarring that bends the penis, and lasting pain.11Mark P. Solomon MD. Penile Implant Removal, Revision, Explant Some men had implants removed for persistent pain even after their wounds healed, and bacteria were found on those devices.12PubMed Central. CONSERVATIVE THERAPY IS AN EFFECTIVE OPTION IN PATIENTS WITH LOCALIZED INFECTION AFTER PENILE IMPLANT SURGERY Unexplained pain can therefore be one possible sign of hidden infection worth checking. Report fever, redness, swelling, or pus near the incision, pain that worsens instead of fading, or a device that feels stuck to the skin or shows through.
The reason for removal shapes what you lose. Removal for infection tends to cause the most scarring and length loss, because the infection damages the tissue around the device. A device that simply broke can often be removed cleanly and swapped for a new one in the same operation, usually with less damage. If you are unhappy with the result, ask first whether adjustments or other fixes could help short of removal, since the length and erection loss may be permanent.
Hidden Bacteria on Implants
Bacteria can coat an implant in a slimy protective layer. This film was found on 11–100% of infected implants and even 3–70% of ones that seemed uninfected.13PubMed Central. A scoping review of penile implant biofilms—what do we know and what remains unknown? Problems needing repeat surgery showed up anywhere from 2 weeks to over 2 years after placement.14PubMed Central. A scoping review of penile implant biofilms—what do we know and what remains unknown?
Standard lab cultures found bacteria on only 29% of removed devices, while genetic testing found them on 56%.15PubMed. Microorganism Profiles of Penile Prosthesis Removed for Infection, Erosion, and Mechanical Malfunction Based on Next-Generation Sequencing A negative culture, then, doesn’t rule out bacteria.
Bacteria can sit quietly on the device from the time of surgery. Antibiotics alone rarely clear bacteria living in a bacterial film on a device, which is why removal is often needed.
Ask whether tissue samples and the removed device will be sent for testing, and what type of testing the lab uses, since the more sensitive genetic methods find bacteria that routine cultures miss. The results can guide which antibiotics you take afterward. If pain or symptoms return after a replacement, mention it early, since bacteria left behind can cause trouble again.
Surgical Risks and Recovery
Injury to the urine tube happens in roughly 1 to 2 of every 100 implant surgeries.16PubMed Central. Penile implant surgery-managing complications Tearing through the chamber wall happens in about 1 in 100.17PubMed Central. Penile implant surgery-managing complications Scarred tissue after infection makes these risks a real concern during removal.
Many men go home within a day or two of the operation, though your surgeon will say what applies to your case. Swelling and bruising of the penis and scrotum fade over a few weeks. Sex is usually off-limits for about six weeks after any replacement, so plan intimacy around that period. Follow-up visits check that the wound is healing and that no infection is developing, so keep them even if you feel fine. A counselor or sex therapist can help with the grief or anxiety that may follow removal, either for you alone or as a couple.
Costs and Consent
The middle hospital cost of a removal in the US was about $10,900.18PubMed. Trends in penile prosthesis implantation and analysis of predictive factors for removal Removal for infection cost about $11,250, versus $8,600 for mechanical problems.19PubMed. Trends in penile prosthesis implantation and analysis of predictive factors for removal
Ask your insurer whether it covers both removal and a replacement, since coverage for each may be decided separately. Request the device model and records from the original surgeon, because the new surgeon needs to know what is inside you.
In lawsuits over implants, nearly a third involved informed consent and a third infection.20PubMed. Penile prostheses and the litigious patient: a legal database review Before agreeing to surgery, ask the surgeon to explain in plain terms how much length you may lose and how likely a new implant is to work. Ask what happens if more infection turns up than expected during surgery, and whether you are consenting to a same-day replacement or removal only.