Can you still orgasm after a penile implant?

What does an implant change about orgasm and ejaculation?

An implant restores rigidity of the shaft so that intercourse is possible. It is not designed to change orgasm or ejaculation, and the American guideline asks that this is explained clearly before surgery.

"The man and his partner (if present) should understand that although the penile implant will enhance shaft rigidity, it does not generally enhance glans rigidity or enhance or improve the processes of orgasm and ejaculation." Source 2, p. 32

The glans, or head of the penis, does not usually become rigid during an implant erection. This is part of the same counselling, so that the man and his partner know what the device does and does not do. When no semen is released at all, a condition called anejaculation, the sensation of orgasm is usually still normal.

Does an implant affect sex drive?

An implant has no direct effect on libido. The American guideline asks that the difference between penile rigidity and desire is explained before surgery, and that a man who is struggling with loss of libido has this addressed separately.

Low desire therefore needs its own assessment rather than an expectation that the implant will fix it. Counselling aimed at sexual and relationship concerns may also help both the man and his partner after implant surgery. Prolactin, a pituitary hormone, can lower libido, so it can be measured as a first screening test in men with reduced sexual desire.

What else can change orgasm?

Many men who consider an implant have erectile dysfunction after treatment for prostate cancer. The European guideline makes a strong recommendation that these men are told about sexual changes beyond erectile dysfunction, such as lower desire, a different orgasm, no ejaculation, curvature like Peyronie's disease and a change in penile size. An implant restores rigidity but does not reverse those other changes.

Anorgasmia, the perceived absence of orgasm, has other recognised causes. These include testosterone deficiency, an underactive thyroid, medicines such as antidepressants, antipsychotics and opioids, psychosexual causes and loss of penile sensation. Psychological factors are considered responsible for 90% of anorgasmia problems, and blood tests for testosterone, prolactin and thyroid hormone can help rule out physical causes.

Can sensation in the penis change after an implant?

Sensation is one of the topics covered in counselling before surgery, together with length, girth, infection risk, pain, the time before the device can be used and how easy it is to operate. After surgery, PDE5 inhibitor tablets and alprostadil have been used to improve sensation and warmth of the glans, although the data are not strong enough to guide practice.

Loss of sensation is more likely after a delayed replacement, which is needed when an infected device has been removed and the tissues have been left to heal before a new implant is placed.