In the case in which none of the above (oral and injectable medications) work, there is the alternative of a surgically-implanted prosthesis.

There are two types of prostheses, semirigid and inflatable. Of course, as the name suggests, in the case of semi-rigid prostheses, the penis will remain somewhat enlarger, with a permanent semi-erection, following the surgery. This is because a rod is implanted in each of the erection chambers of the penis; the rods can be bent upward (to achieve an erection) and bent down (to stop the erection).

The inflatable prosthesis uses reservoir balloons implanted into the corpus carnosa (the erection chambers). Fluid is pumped in when an erection is desired and transferred back when the erection is no longer wanted. This penile prosthesis is barely noticeable. A downside is the fact that opening the pump can be difficult for individuals that have reduced hand sensation or strength.

Studies showed that more than 80% of men using these prosthesis and their partners find them very satisfactory. Most men experience normal erectile sensations and achieve orgasm, and also, they are able to have an erection for the amount of time they choose to.