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Penile Implants

Penile Implant Surgeon in Houston, TX

Men’s Health Specialist – Dr. Jonathan Clavell

Dr. Jonathan Clavell is a board-certified urologist and men’s health specialist in Houston, Texas. Dr. Clavell is an expert in both inflatable (commonly referred to as the pump) and mechanical implants (Semi-rigid). Dr. Clavell has emerged as one of the leaders in penile prosthesis surgery and implant revision surgery in the state of Texas and the United States. Performing more than 350 penile implants per year, Dr. Clavell is in the top 1% of penile implant surgeons and is considered one of the best penile implant specialists in the world. Dr. Clavell is the Center of Excellence for both Boston Scientific’s AMS 700 series and Coloplast Titan. He will discover the best penile implant option for you and your lifestyle. Call (713) 424-4030 to learn more and call to schedule your appointment with Dr. Clavell.

Dr Clavell AMS 700 inflatable Penile Prosthesis Center of Excellence
Dr Clavell Titan Touch Penile Prosthesis Center of Excellence
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What Is a Penile Implant?

A penile implant or penile prosthesis is a medical device designed to help gain and maintain an erection. It is placed into a man’s body and is designed to help him get an erection. This is a saline (liquid with water and salt) fluid-filled device that is placed inside the penis and help expand the penis to gain an erection. The penile implant consists of three components: Two cylinders or tubes that are placed inside the penis, a pump placed inside the scrotum, and a reservoir (or bag) that contains the fluid, which is transferred by the pump into the cylinders, causing the penis to expand and become rigid.

How Is the Penile Implant Placed?

There are different approaches to placing the penile implant, all of which have their advantages and disadvantages.

Penoscrotal

Advantages

  • Provides better exposure of the corporal bodies in case there is fibrosis (scar tissue).
  • Low risk of dorsal nerve injury.
  • Incision is not visible.
  • Allows fixation of the prosthetic pump inside the scrotum.
  • Gives the surgeon the ability to perform adjunct procedures (ventral phalloplasty, vasectomy, etc) if needed.
  • Allows for the “No-Touch Technique”.

Disadvantages

  • Possible complications associated with pump and tubing since the wound can be over these parts.
  • Possible difficulty to placing the reservoir or might require a counter incision.
  • Larger incision than infrapubic.

Infrapubic

Advantages

  • Reservoir is placed under direct vision.
  • Shorter surgical time.
  • Possible quicker recovery and shorter delay for patients to start cycling the implant.

Disadvantages

  • Higher risk of injury to dorsal nerve bundle.
  • Possible suboptimal pump placement.
  • Limited Exposure for complex revisions.
  • May be technically challenging for obese patients.

What Are the Benefits of a Penile Implant?

  • Reliable: For men who have erectile dysfunction, the penile implant provides a reliable option to gain an erection. Sometimes oral medications or penile injections cause undesirable side effects, are inconvenient, or simply do not work. The penile implant has no side effects when used and gives you a reliable erection that will assure you to have sexual intercourse.
  • Durable: Studies show that most penile implants last more than 10-15 years.1,2
  • Natural: The penile implant feels natural for both the patient and his partner.
  • Prevents Penile Shrinkage: The penile implant occupies the entire space within the penis, therefore preventing shrinkage.  Erectile dysfunction causes penile atrophy or shrinkage. The penile implant will occupy the space within the penis, and will give the resting penis a fuller, ‘longer’ looking shaft.
  • Convenient: There is nothing to carry with you, nothing to take by mouth or by needle, nothing to forget at home, and most importantly, it is ready when you are.
  • Corrects Curvature: Patients who have Peyronie’s Disease or penile curvature, are likely to have less curvature with the presence of a penile implant.  The penile implant is strong enough to overcome many curvatures. If you have severe curvature, Dr. Clavell will discuss with you if you need any additional procedure to make your penis look normal again.
  • Maintains Erection After Orgasm: With the penile implant, once you reach orgasm, the penis remains erect until it is no longer desired. The penis will remain erect as long as you want it erect. Premature ejaculation is no longer an issue. You may even have a second orgasm during the same sexual encounter.
  • High Satisfaction Rate: When compared to other treatment options, the penile implant provides the highest satisfaction rate, approximating 94-97%, and far outpacing satisfaction levels for oral medications (51.6%) and injection therapy (41%).

Penile Implant Options

How Do I Choose the Penile Implant that Is Right for Me?

Watch the videos below for an in-depth explanation from men’s sexual health expert, Dr. Jonathan Clavell regarding penile implants. In the first video, Dr. Clavell discusses the benefits of the AMS 700 and Coloplast Titan penile implants. In the second video, he explains the benefits and drawbacks of malleable penile implants.

What are the different Pumps that Coloplast Titan and AMS 700 provide?

The pump is what men interact with to both inflate and deflate the cylinders of the penile implant. The Coloplast Titan and the AMS 700 series both have 2 different pumps in the market. In the following videos, Dr. Clavell presents the pumps for each company and if this can make an impact in your overall satisfaction.

Why Choose Dr. Clavell?

No-Touch Technique

The most common complication after penile implant surgery is infection. In the hands of an experienced surgeon, that complication rate is less than 2-3%. The most common source of infection is bacteria in the skin. For this reason, Dr. Clavell prevents contact with the skin by using the “No-touch Technique (NIT)”. Dr. Clavell has been able to reduce the risk of infection to less than 1%. By avoiding contact between the penile prosthesis and the skin, we reduce the incidence of contamination of the penile implant with the bacteria in the skin.

In order to prevent complications, Dr. Clavell believes the management before the surgery is just as important as the care after the surgery. Dr. Clavell will provide you with specific instructions on what to do and what to expect before and after the surgery to prevent infection and other complications, such as reservoir herniation and hematoma (postoperative bleeding) formation.

Learn More about Dr. Clavell’s Optimized No Touch Technique

High-Volume Practice

Dr. Clavell is a Center of Excellence, consultant, and trainer for both Boston Scientific and Coloplast, and an expert in the implantation and revision of both devices. Dr. Clavell is also involved in training surgeons both nationally and internationally in regards to penile implant surgery. He will discuss with you which implant is best suited specifically for you. Men from all over the world seek Dr. Clavell for surgery, wanting to make sure they have the best outcome possible.  With more than 300 implants per year, our Houston urology clinic is the highest volume practice in prosthetic penile implants in the state of Texas and one of the highest volume practices in the United States and the world!

Jonathan Clavell, M.D., F.A.C.S

Board-Certified Urologist

Jonathan Clavell, M.D., F.A.C.S., is a board-certified urologist and fellowship-trained Sexual Medicine specialist providing advanced men’s health care to patients throughout Houston and the Southwest. He treats a full range of urologic conditions, including erectile dysfunction, BPH, Peyronie’s disease, vasectomy procedures, and complex men’s health concerns.

Dr. Clavell uses advanced minimally invasive and surgical techniques to deliver personalized, patient-centered care. He is also a national and international educator, training surgeons in penile implant surgery, Peyronie’s disease treatment, and Rezūm therapy for BPH, making his practice a trusted destination for specialized urologic care.

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What Can I Expect After My Procedure?

After the procedure, you will wake up with the device partially inflated to both tamponade (stop) bleeding inside the penis and prevent penile shrinkage. You will also notice a special dressing that will keep the scrotum under compression and will prevent swelling or a hematoma (accumulation of blood). When possible, we prefer to keep patients admitted for observation to administer an additional dose of IV antibiotics to prevent infection. All patients are discharged the day after the surgery. Almost nobody needs to stay in the hospital.

You will be discharged with the compression dressings. You will remove these dressings 48-72 hours after your surgery. Subsequently, you may start showering but should avoid bathing (submerging in water) or swimming. Pain in your penis and scrotum is minimal and lasts for at least 1 to 2 weeks after surgery. You may return to work approximately 1 week after surgery, as long as it does not involve heavy lifting.

You will follow up with Dr. Clavell 4 to 6 weeks after surgery, when he will teach you how to cycle the device. You may start having sexual intercourse after your first follow-up appointment.

Learn More about What to Expect After Your Surgery

Frequently Asked Penile Implant Questions

What is a penile implant?

A penile implant (penile prosthesis) is a medical device placed entirely inside the body to treat erectile dysfunction that no longer responds to medication. The most common type is a three-piece inflatable implant which consists of two cylinders in the penis, a pump in the scrotum, and a fluid reservoir inside the abdomen— and it’s completely concealed, so no one can tell you have one.

With a three-piece inflatable implant, squeezing the pump in the scrotum moves saline from a small reservoir into two cylinders in the penis, creating a firm erection on demand. A deflation valve returns the fluid to the reservoir afterward, so the penis returns to a natural, flaccid state. You control when the erection happens and how long it lasts.

If you have erectile dysfunction that no longer responds to oral medications, you may be a candidate. Age and conditions such as diabetes, prior prostate cancer treatment, or Peyronie’s disease generally do not disqualify you — many men in these situations do very well with an implant.

Dr. Clavell offers both leading three-piece inflatable systems — the Coloplast Titan (including the latest Titan Prime model)  and the Boston Scientific AMS 700 (including the LGX, which expands in length and girth, and the CX) — plus malleable (bendable) options such as the Genesis, AMS Tactra, and Rigi10. The implant is sized to your anatomy during surgery, which is part of why a high-volume specialist matters.

In General…. No. you should NOT lose length with the penile implant if being implanted by a high volume surgeon. The implant DOES NOT get your penis smaller, erectile dysfunction and Peyronie’s disease do. Even though are some studies that mention that the penis is smaller after a penile implant, most high volume surgeons have certain tricks they can recommend prior to surgery and do during your surgery to maximize your size. Moreover… Have you heard the term.. if you don’t use it you lose it?…. Well… in a sense…. that is kind of true. If you’ve had ED for a long time…. That is…. If you have problems with getting blood flow into your penis, the penis will not stretch as it used to and this may cause your penis to decrease in size. If you wonder.. well, doc, when I was young I didn’t have sex every day and my penis didn’t get smaller. That might be true.. but… EVERY NIGHT you had multiple erections while you slept. This is why it is important to have those erections at night or in the morning.. If you have night-time erections: CELEBRATE THOSE! ED CAAN cause your penis to get smaller which may limit the size of the penile implant. Will the size be similar to what your penis was 10-15 years ago, we do not know…. But, One thing we as penile implant surgeons can assure is that…As surgeons, we try to put in the biggest implant your penis will tolerate.

Now, some might wonder… what can I do if I’ve lost some size already? One thing you could do is use a vacuum erection device. Use it regularly to stretch your penis and sometimes, you can recuperate some of your lost size.

In General…. No. you should NOT lose length with the penile implant if being implanted by a high volume surgeon. The implant DOES NOT get your penis smaller, erectile dysfunction and Peyronie’s disease do. Even though are some studies that mention that the penis is smaller after a penile implant, most high volume surgeons have certain tricks they can recommend prior to surgery and do during your surgery to maximize your size. Moreover… Have you heard the term.. if you don’t use it you lose it?…. Well… in a sense…. that is kind of true. If you’ve had ED for a long time…. That is…. If you have problems with getting blood flow into your penis, the penis will not stretch as it used to and this may cause your penis to decrease in size. If you wonder.. well, doc, when I was young I didn’t have sex every day and my penis didn’t get smaller. That might be true.. but… EVERY NIGHT you had multiple erections while you slept. This is why it is important to have those erections at night or in the morning.. If you have night-time erections: CELEBRATE THOSE! ED CAAN cause your penis to get smaller which may limit the size of the penile implant. Will the size be similar to what your penis was 10-15 years ago, we do not know…. But, One thing we as penile implant surgeons can assure is that…As surgeons, we try to put in the biggest implant your penis will tolerate.

Now, some might wonder… what can I do if I’ve lost some size already? One thing you could do is use a vacuum erection device. Use it regularly to stretch your penis and sometimes, you can recuperate some of your lost size.

Even though you might think the implant will “Explode”, it won’t. This is not a balloon that will continue to stretch. This is a well-designed medical device that when it reaches a certain pressure, it cannot expand beyond that. This will not pop. There is no such thing as “overinflating” the implant. So rest assured, inflate that implant to the max, because it will not break by you inflating it. Another thing to remember is that the implant will only be able to expand to what your penis allows it to. If you’ve always had a “thin” penis, don’t expect to have 6 inches of circumferential girth after the implant. This is like if you put a balloon to expand inside an American Football. Doesn’t matter how bing The balloon is.. it will only expand to what that football allows it to expand, it won’t expand beyond that.

Even though you might think the implant will “Explode”, it won’t. This is not a balloon that will continue to stretch. This is a well-designed medical device that when it reaches a certain pressure, it cannot expand beyond that. This will not pop. There is no such thing as “overinflating” the implant. So rest assured, inflate that implant to the max, because it will not break by you inflating it. Another thing to remember is that the implant will only be able to expand to what your penis allows it to. If you’ve always had a “thin” penis, don’t expect to have 6 inches of circumferential girth after the implant. This is like if you put a balloon to expand inside an American Football. Doesn’t matter how bing The balloon is.. it will only expand to what that football allows it to expand, it won’t expand beyond that.

The inflatable penile implant contains a reservoir that holds the fluid that will be inflating your penis to give you an erection. This reservoir is placed either in your pelvis or underneath your abdominal muscles. In most occasions, the reservoir is not palpable even if you have a flat stomach. You might feel it initially after it’s placed but you will likely stop feeling it a couple of weeks after surgery. The fluid inside that reservoir is SALINE, the same thing we give you through an IV for hydration. IF that fluid leaks out, your body will absorb it and you won’t even notice it. So.. there is no need to worry, I am certain that your surgeon will do everything possible to get that reservoir in a space that you will not be able to feel it.

The nerves that give the sensation to your penis lie on the top part of your penis. I tend to make my incision below your penis and will be NO-WHERE near those nerves. Even surgeons who place the implant from above, via an infrapubic approach, are able to spare those nerves without injury. The only thing that the implant will do is help your penis get hard. It should not affect sensation, it will not get blood flow to the head of your penis, it should not affect your orgasm.

This is a great question. To be honest, Firmness is determined by your grip strength. If you have a strong grip, you will be able to get it as strong as a rock. If that is too hard for your partner, you can always tailor it to 80 or 90%…. So basically… whatever feels comfortable for both you and your partner. Remember… with the implant… YOU have COMPLETE control of your erection. From Flaccid, to a fully rigid erection.

The penile implants are made out of silicone and Bioflex which is an chemically inert substance.. Which means.. that your body will not reject it. You will not become allergic to it, you will not need medications to prevent rejection. It will not cause cancer in the future. Inflatable implants have been present for over 50 years, and have been proven to be safe. This is an implant, not a transplant. So no need to worry, no need for anti-rejection medications…. your body will not REJECT the implant.

The implant is entirely internal, so it isn’t visible and partners typically cannot tell it’s there. Inflated, it produces a firm, natural-feeling erection; deflated, the penis looks and feels normal. Sensation, orgasm, and ejaculation are generally preserved, because the implant only restores rigidity.

Penile implant surgery is safe and well-established, with an overall complication rate under 2–3%. Infection is the most important risk to prevent; using the No-Touch Technique together with antibiotic-coated devices, Dr. Clavell has reduced infection risk to under 0.5%.

Most patients go home the same day. Compression dressings come off in 48–72 hours, and men with desk jobs often return to work in about a week. Discomfort is usually mild and lasts two to three weeks, and sexual activity typically resumes after your follow-up, around 4–6 weeks.

Modern inflatable implants are highly durable. The Coloplast Titan, for example, has a mechanical reliability of about 97.5% at five years and includes a 10-year replacement policy. Most men keep the same implant for many years, and if a device ever fails mechanically it can be replaced.

Cost depends on the device, facility, and your insurance. Penile implants for erectile dysfunction are frequently covered by Medicare and many commercial plans when ED hasn’t responded to other treatments. Our team verifies your benefits and reviews any out-of-pocket cost with you before surgery, so there are no surprises.

Dr. Jonathan Clavell is one of the top penile implant surgeons in the United States and ranks among the top 1% nationally by surgical volume. A board-certified urologist and fellowship-trained specialist in Sexual Medicine and Prosthetic Urology, he performs more than 350 penile implant surgeries each year and holds Center of Excellence recognition for both the Coloplast Titan and AMS 700 implant systems.

Dr. Clavell is particularly known for complex penile implant surgery, revision surgery, and treating complications from previous penile implant procedures. He regularly manages challenging cases involving infection, device malfunction or malposition, severe corporal fibrosis and scarring, penile curvature, loss of length, Peyronie’s disease, and complex anatomy requiring advanced penile reconstruction.

His combination of high surgical volume, specialized fellowship training, and expertise in complex penile implant revisions and complications attracts patients to Houston from across the United States and internationally for first-time implants, difficult revisions, and second opinions.

Yes. Dr. Jonathan Clavell is nationally recognized for complex penile implant revision surgery and the treatment of complications from procedures performed elsewhere. As a high-volume penile prosthetic surgeon, he routinely treats challenging cases involving implant infection, device malfunction or malposition, severe scarring and corporal fibrosis, penile curvature, loss of length, Peyronie’s disease, and complex anatomy after one or multiple previous surgeries. Patients travel to Houston from across the United States and internationally for penile implant revisions, complex reconstruction, and second opinions.

Schedule a Penile Implant Consultation in Houston, TX

Dr. Clavell is a board-certified urologist with fellowship training in sexual dysfunctions, penile implants, reconstructive surgery for Peyronie’s disease, and BPH management. He will take the time to discuss your symptoms and help determine if a penile implant is right for you. For more information, please contact our urology clinic at (713) 424-4030 and schedule a consultation today!

For more immediate answers, check out Dr. Clavell’s 10 most common questions regarding penile implants.