Penile Implants vs ICI vs PDE5

Melissa Hadley Barrett

"There is more than one way to skin a cat and to get an erection."

It's True.

Yes, you heard correctly. There is more than one way to get an erection. Here, we are going to talk about penile implants, intracavernosal injections(ICI), and PDE 5 medications; all of which have their place at the table. It depends on personal preference and what works best in your circumstance.

Vacuum pump devices are also an option and we have discussed these in previous blogs (check our post on Vacurect pumps here). In this blog, I will not discuss them. However, if you have a pump and also would like to try ICI, they can be good to use before the injection to increase the size of the target.

Penile implants have been in use for over 40 years, and are a long-term option for a man suffering from ED. Considered highly effective and incredibly reliable the penile implant has helped many men return to an active and satisfying sex life. The 3-piece device is implanted into the penis, contained entirely within the body, and offers concealed support for an erection whenever and as long as desired, giving back the spontaneity to have sex when the mood strikes. Patients report 97% satisfaction rates with a penile implant.  For more information, you can listen to these episodes from The Penis Project Podcast:


What we Do

ICI Injections aka Penis Injections

Let’s talk about ICI injections. Believe it or not, I have thousands of penis owner patients who use a needle in the shaft of their penis on a regular basis in order to get an erection.

When I mention this as an option, most men initially screw up their faces and make a comment along the lines of "There is no way I am doing that”. Then, after a little convincing that they will not know until they try it (just once), they are a convert and eagerly book to come back and learn how to do it themselves.

I’m not going to pretend that this is an ideal way to achieve an erection. However, for many men and their partners, it is better than not having one at all. You will not believe me until you try it, but there really is no pain involved. I know what you are thinking, “How would she know she doesn’t even have a penis?” and you would be correct, I don’t, but I do have firsthand experience as I have given A LOT of these injections over the years!

And I can only think of two instances where the man complained of pain.

Most men are shocked at the lack of feeling in their old friends. I have literally hundreds of patients who use injections successfully who are both coupled and single.

For more information about ICI (penis injections), check out our full discussion here. 

We have a few episodes sharing stories about penis injections. Check the episodes below:

PDE 5 Medications aka Penis Pills

I am only going to mention PDE 5 medication briefly here as we have a different blog discussing all of it.

Check all about Penis Pills here.

Basically, there are four medications in this group Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Spedra). 

They all have slightly different action times and side effects and each induvial responds differently to different medications so I encourage you to try them all and see what works best for you. The other important point to note about PDE 5 medication is you need to have your neural pathways (nerves) functioning at least a bit for them to work. So if your nerves have been damaged in any way, these medications will not work for you so an implant or injections are going to be your best options.



In summary, all these options have pros and cons and it really depends on your situation to figure out what works best for you.

I really encourage men to consider and where possible try them all. 

Often, what we think is best for us is not always the case and the only way to be certain is to give it a go.

I have also found many men and their partners use injections for a while, then as things improve, if illness or treatment was the cause of the erectile dysfunction, they can try oral medication. If it works transition to this.

Likewise, other couples use injections for a few years and then decide they would like to get some spontaneity back so go for an implant.

Others use injections for 20 or more years with no issues.

No option is better than the other, it all depends on you.


  • Montorsi R, Rigatti P, Carmingnani G, et al. AMS three-piece inflatable implants for erectile dysfunction: a long-term multi-institution study in 200 consecutive patients. Eur Urol. 2000 Jan;37(1):50-55.

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