Physical penile sensations and levels of sexual satisfaction and activity were assessed in a questionnaire survey of 52 penile implant recipients. Although technical surgical success rates were high and 90% of recipients would elect to have surgery again, overall sexual adjustment did not approach premorbid conditions. Reasons for incomplete satisfaction included altered sensations of erection, decreased penile dimensions when compared with recalled preoperative dimensions, and decreased sensations during ejaculation. Some of these changes may have been due to decreased arousal during intercourse. Potential implant recipients should be counseled regarding realistic expectations of the benefits of penile prosthesis implant surgery.