Selecting a surgeon for penile implant surgery is a crucial decision that can significantly impact your outcome. The medical literature consistently shows that higher-volume implanters have fewer complications, underscoring the importance of experience and a subspecialist focus.

Unparalleled Focus on Male Sexual Health

Dr Ross is one of few urologists in Australia to dedicate his entire practice to male sexual health and penile implants. By concentrating exclusively on this area, he ensures every aspect of your care is guided by deep expertise and meticulous attention to detail. This dedicated approach allows him to stay at the forefront of advancements in penile implant surgery, providing you with the highest level of care.

Global Training and Experience

To offer the best possible care, Dr Ross trained with world-leading experts, including Dr Paul Perito in Miami - the highest volume penile implant surgeon globally - and pioneers in the UK, Belgium, and Spain. These international experiences, combined with a high surgical case volume, allows Dr. Ross to deliver care that prioritises safety, precision, and superior outcomes.

Minimally Invasive Techniques for Faster Recovery

Drawing from best practices learnt internationally, Dr Ross uses a refined technique designed to ensure a faster recovery - most patients to resume intercourse in as little as 3 weeks. This means less downtime, quicker healing, and a faster return to daily life and intimacy.

Personalised and Compassionate Care

Beyond technical expertise, Dr. Ross is committed to understanding your unique needs and goals. Every patient receives a personalised treatment plan tailored to their circumstances, delivered with compassion and discretion.

Choosing the right penile implant surgeon is about more than just credentials - it’s about finding a specialist with the experience, focus, and dedication to ensure the best possible outcome for you.

Penile implants are a great solution for men who need them. Most of these men wish they had done it sooner, thus avoiding bouncing back and forward between treatments that demonstrate little or no efficacy.

Penile implant surgery is not a last-ditch effort. The main consideration of whether to have a penile implant is this: Does the penis get hard and stay hard enough for penetrative intercourse? What do you currently need to do to ensure this happens?

Getting the stars to align often takes the spontaneity and enjoyment out of intimacy. This is common problem many men face, whether they care to admit it or not. For these men, penile implants offer a reliable solution that ensure you have a penetrating penis, whenever you want, for as long as you want, 100% of time. 

Proactive consideration of a penile implant also prevents the loss of penile size caused by atrophy from years of inadequate erection. The penis is a unique organ that oxygenates itself during tumescence, as such, men can lose between .5 and 5cm’s in 14 months from the onset of impotence. Penile implant surgery stops this atrophy as the device acts as an internal tissue expander. 

This being said, Dr Ross firmly believes that there is nothing better than having sex with your own penis with natural erections and penile implant surgery is reserved for people who need it. Knowledge is power when it comes to successful treatment of erectile dysfunction – knowing what treatment will work and what will not is key. As such, for men with erectile dysfunction, Dr. Ross will usually perform a quick study of the penile vascular system, called a penile duplex ultrasound. With this study, we can immediately start and expedite the algorithm to restore sexual health and function in a targeted way. It highlights which men do not need a penile implant and have the ability to restore or regenerate their natural function VS those who should consider a penile implant earlier to prevent the complications and architectural changes in the penis associated with delayed treatment.

While most ED cases are labelled broadly as vasculogenic, neurogenic or psychogenic, this overlooks a critical point of differentiation. Vasculogenic is divided into arteriogenic and veno-occlusive dysfunction. Medications, injections, and the newer regenerative options only work for arteriogenic ED. For those with veno-occlusive dysfunction or “venous leak”, these treatments rapidly lose effectiveness because the problem is not inflow.

Contrary to now disproven techniques, venous leak cannot be corrected by tying off superficial veins (venous ligation surgery). The “leak” that is picked up on ultrasound is the cumulative effect of thousands of deeper microscopic channels that are not closing effectively during erection because the erectile tissue is not expanding as it should. Veno-occlusive dysfunction is more accurately a structural problem within the erectile tissue, which results in reduced flexibility and expansion. While this can coexist with arteriogenic ED (where blood inflow is a problem), men with veno-occlusive dysfunction typically don’t have a problem getting blood out to the penis, the problem is keeping it there. This is why medications and injections can temporarily hold things at bay, but the problem ultimately progresses despite this. Once medications stop working for this type of ED, the only option is high-dose injection therapy (usually with a cock-ring) or penile implant surgery.

Yes! Many patients believe they are not candidates for penile implant surgery because they consider themselves a “high risk” for any surgery.  Thankfully, this 15-30 minute procedure can be performed with any form of anaesthesia available:  local with IV sedation, spinal or general. With Dr Ross, patients on anticoagulant therapy can also safely undergo penile implant procedure without stopping their therapy.  This is especially important in patients who have undergone cardiac stent placement.  Considering the age range of our patients who have undergone a penile prosthesis (21 to 95) and their co-morbidities (transplant, diabetics, dialysis, etc.) few patients are considered unsafe for this minimally invasive procedure.

In Dr Ross’ experience, he has not encountered a hobby, sport, or occupation that prevents implant patients from continuing their participation. Whether you’re passionate about high-intensity activities like cycling, swimming or martial arts, or enjoy pursuits such as yoga or weightlifting, or work in physically demanding environments, a penile prosthesis does not get in the way, nor is it at risk of injury. The implant does not set off security alarms at airports or guarded buildings. Once healed, my patients proceed with a normal active lifestyle if so desired.

The discreet nature of the device also ensures it remains unnoticed, even during intimate moments. With proper care and guidance, most men find they can return to their usual routines shortly after recovery, experiencing minimal disruption and maximum benefits. For those who need it, getting a penile implant is a transformative procedure not only restores sexual function but empowers patients to live life fully - physically, emotionally, and socially.

When inflated, an inflatable penile prosthesis provides rigidity comparable to a natural erection, giving you a penetrating penis on demand and restoring confidence and spontaneity in intimacy. Importantly, the prosthesis does not alter the sensation on the skin of the penis, a man's ability to reach orgasm, or ejaculation.

However, it’s worth noting that once a penile prosthesis is placed, the natural erection reflex—characterised by the sensation of blood rushing to the penis—may be diminished. Additionally, while the prosthesis ensures reliable rigidity of the erectile bodies (corpora cavernosa), it does not cause swelling (tumescence) of the penile head (glans). 

To address this, Dr Ross uses an erectile tissue-sparing surgical approach. This technique aims to preserve the natural erection reflex, allowing many men to retain the familiar sensation of penile engorgement even after the implant. The erectile bodies are not cored out, we want to keep and maintain the health of this tissue. Depending on their baseline function, many of my patients say they can almost get hard without activating the device. Thus, the implant enhances your natural erectile function by providing dependable rigidity, while maintaining as much of the penis’s natural responsiveness as possible. In this way, men can continue to effectively use medications like Viagra and Cialis, even after penile implant surgery, to enhance the engorgement of the tissue around the implant with good effect.

Unlike a car that needs servicing, there is no reason to replace a penile implant or change the fluid unless it breaks or if a problem arises. With a correctly selected penile implant in the hands of a specialist, 80% of implants remain perfectly functional beyond 15 years. A recent study assessing the minimally invasive infrapubic approach, found that device survival was 92.5% at 7 years (the end of their follow-up period) and likely to continue at this rate (Di Pierri, 2024).

Based on long-term data, there is a difference in the overall longevity between different companies that make penile implants. This difference may be more or less relevant depending on your goals and each implant has their advantages in meeting the specific needs of any patient. Dr Ross will address this issue with you confidentially during your consultation to ensure you are matched with the best implant for your needs. Irrespective of the company, he generally says that 1 to 2% of all inflatable penile implants will fail per year, with a mechanical malfunction occurring in 5-10% of cases in the first 10 years. Failure is usually due to fluid leakage or a breakdown in device function, necessitating implant replacement surgery. Infections also require removal of the implant, followed by immediate replacement with a placeholder malleable implant (to prevent shortening) or after a healing period. The risk of post-operative infection is well below 1% for initial implant surgeries.

The most common complaint Dr Ross sees from patients seeking second opinions or revisions, beyond device failure, is related to pump placement. Sometimes the pump can ride up and be difficult to use. Other times the tubing is too long for the anatomy and coils uncomfortably in the scrotum. Counterintuitively, long scrotal tubing can also make the pump difficult to access, sometimes deflecting too far back into the perineum. Dr Ross places the pump in the midline between the testicles, toward the back of the scrotum and right at the bottom (the dependent position). Tubing length is tailored to your anatomy. The reason the scrotum pump is placed here

1. It’s easy to use

2. It can be accessed easily with either hand

3. It’s not or less visible from the outside. Other common complaints are undersized cylinders.

Any patient seeking re-operation for a failed penile implant should research with their surgeon which implant will be used to replace the implant and why. If seeking a revision for a functioning implant, patients must clearly identify their perceived implant inadequacies and set realistic expectations. Better is the enemy of good and revision surgery does come with risks. Setting proper goals and expectations is key.

There is a lot of confusing information about this on the internet. Let’s clear it up. Firstly, be careful of any treatment that offers you a longer penis. If it sounds too good to be true, it probably is!

Studies have repeatedly shown that your stretched flaccid penile length equates to your erect penile length, both with and without a penile implant. So, what you bring on the day to your procedure, is what you will take home when it comes to penis size. For this reason, Dr Ross will talk to you about what you can do in the lead up to surgery to get the best possible outcome on the day.

Oversizing the cylinders does not increase the length of your penis but it does lead to higher risk of cylinder complications. Equally, length growing cylinders do not perform the same way once inside the fixed structure that is your corpora cavernosa.

Once the right penile implant is in place, if used frequently both with my post-implant rehabilitation regime and sex, the penis will begin to grow in both length and girth. This increase is not immediate but modest changes do occur over time.

Prevention of length loss in the first place is critical. Think back to a time when had regular morning erections. During sleep men without erectile dysfunction have 5-10 erections every night. These cyclical erections ensured that your erectile tissue remained healthy and oxygenated. When you remove this, the erectile tissue becomes less oxygenated, resulting in decreased elasticity and increased scarring (fibrosis), which ultimately manifests as loss in length and girth. Since the implant is matched to the size of your corpora on the day of surgery, restored erections with the implant may appear smaller compared to your recollection of previous normal erections you’ve experienced throughout your life. 

For this reason, a proactive and targeted approach based on the underlying cause of erectile dysfunction is critical to prevent dissatisfaction down the track. 

The take home messages here are:

1. Erectile dysfunction leads to penile atrophy.

2. The penile implant does not make the penis shorter.

3. The only treatment for erectile dysfunction that stops all atrophy is the penile implant.