Penile Implant Pain: How We Reduce It Before the First Incision

Q: Does a penile implant hurt?

There is real post-operative discomfort, managed with a plan that starts before the incision. In our published study, patients who received the pre-incision anesthetic block reported significantly lower pain scores in the first hours after surgery than patients without a block. Soreness then fades over the following days to weeks.

Q: How long does penile implant pain last?

The most uncomfortable window is the first days after surgery. Most men describe soreness rather than sharp pain by the end of the first week, and it continues to fade from there. Our week-by-week recovery guide covers what to expect at each stage.

Q: What is injected before the incision?

Dr. Gheiler injects 30 cc of bupivacaine, a long-acting local anesthetic, as a dorsal penile nerve block and penile ring block before the incision is made — so the anesthetic is already working before there is anything to hurt.

Q: Does the block reduce the need for narcotics?

That is the goal of blocking pain before it starts. Patients still receive a pain-management plan for home, but a well-executed block covers the hardest window — the first hours — when narcotic demand is otherwise highest.

Penile implant pain is the number-one worry men bring to a consultation — and the part of surgery we plan for most deliberately. Our protocol starts before the incision: 30 cc of bupivacaine, injected as a penile nerve block, so the anesthetic is working before there is anything to hurt.

Written and medically reviewed by Dr. Edward Gheiler, MD, FACS — July 25, 2026

Why pain control starts before surgery, not after

Pain is easier to prevent than to chase. Once the nervous system is processing surgical pain, more medication is needed to bring it down. Blocking the nerves first — before the incision — means the first and hardest hours of recovery happen while the surgical site is still numb.

Before the first incision of every inflatable penile prosthesis (IPP) procedure, Dr. Gheiler injects 30 cc of bupivacaine, a long-acting local anesthetic, as a dorsal penile nerve block combined with a penile ring block. It is a small step that shapes the entire first day of recovery.

What our published study found

This is not a marketing claim — it is a technique our practice studied prospectively and published in a peer-reviewed journal. The study followed 131 men undergoing first-time penile implant surgery: 40 received the nerve block with bupivacaine, 47 with ropivacaine, and the rest served as a control group without a block.

Two hours after surgery — when pain normally peaks — men who received a block reported significantly lower pain scores than men without one (p < 0.0001 on the Visual Analog Scale).
Both anesthetics worked equally well — there was no significant difference between the bupivacaine and ropivacaine groups.
By days 2 through 7, pain scores converged across all groups — the block wins the hardest window, and normal healing takes it from there.

The conclusion was direct: a penile nerve block during implant surgery provides effective analgesia in the immediate post-operative recovery — exactly the window men fear most.

What this means for your recovery

You wake up with the block still working. The first hours — normally the peak of post-surgical pain — pass with the site numb, and by the time sensation returns, you are already ahead of the pain curve with your home plan. From there, most men describe soreness rather than sharp pain, fading week by week. Our recovery timeline walks through each stage, and our guide to how painful a penile implant really is sets honest expectations for the whole arc.

Frequently asked questions about penile implant pain

Does a penile implant hurt?

There is real post-operative discomfort, managed with a plan that starts before the incision. In our published study, patients who received the pre-incision anesthetic block reported significantly lower pain scores in the first hours after surgery than patients without a block. Soreness then fades over the following days to weeks.

How long does penile implant pain last?

The most uncomfortable window is the first days after surgery. Most men describe soreness rather than sharp pain by the end of the first week, and it continues to fade from there. Our week-by-week recovery guide covers what to expect at each stage.

What is injected before the incision?

Dr. Gheiler injects 30 cc of bupivacaine, a long-acting local anesthetic, as a dorsal penile nerve block and penile ring block before the incision is made — so the anesthetic is already working before there is anything to hurt.

Does the block reduce the need for narcotics?

That is the goal of blocking pain before it starts. Patients still receive a pain-management plan for home, but a well-executed block covers the hardest window — the first hours — when narcotic demand is otherwise highest.

Reference: Xie D, Nicholson M, Azaiza M, Gheiler V, Lopez I, Nehrenz GM, Klopukh B, Bianco FJ, Perito P, Gheiler E. Effect of operative local anesthesia on postoperative pain outcomes of inflatable penile prosthesis: prospective comparison of two medications. International Journal of Impotence Research 2018;30(3):93–96. PMID 29795532.

This article is patient education and does not replace a medical consultation. Individual results and experiences vary. Discuss your specific case with your urologist.

Worried about pain? Ask us exactly how we manage it.

Request a confidential consultation with Dr. Gheiler. English · Spanish · Hebrew.

Private and confidential from your first call: these are problems our office treats every day, with discretion and respect.

Request a Confidential Consultation