Q. What can you tell me about penile implants? Is that the same thing as the pump? How natural does it feel? Is it filled with fluid or made out of something rigid?

A. Penile implants are quite diverse. In general, there are three categories.

First are what we call rigid implants. These are solid rods of plastic or silicone that go in the penis. In this situation, the penis is erect all the time.

The second category are the malleable implants. These are flexible silicone rods with reinforced centers that allow the person to flex the penis up and down. The penis doesn’t stick straight out, and it allows you to tuck it in your pants. Nonetheless, it is still quite rigid regardless of how you bend it.

The third and most common type of implants are the inflatable devices. Their advantage is that the penis can be inflated for sex and deflated for normal daily activities. The two leading manufacturers are Mentor, which makes the Alfa-one device, and AMS, which makes the AMS 700. Both devices are very popular and very reliable.

The devices come in three pieces: a pump that fits comfortably into the scrotum, a reservoir that holds saline (salt water), and two cylinders that fit into the penis, one on each side. To use them, you simply pump the penis up by squeezing the pump mechanism in the scrotum. To deflate the penis, you press the release valve and squeeze the penis, and it will relax. When the penis is inflated, it looks natural, and it feels natural to both parties concerned. If you want to be picky, there are two differences you will notice: The head of the penis will not be engorged and swollen as in the natural erect state, and the man will feel as if he has three testicles because the pump in the scrotum feels like a testicle. Overall, the men in whom I have put these devices — and their partners — have been very satisfied.

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