Penile Prosthesis Implantation: Past, Present and Future

M. Simmons; D.K. Montague

Disclosures

Int J Impot Res. 2008;20(5):437-444. 

In This Article

Abstract and Introduction

Abstract

Penile prosthesis implantation is the oldest effective treatment for erectile dysfunction. This review examines the past, present and future of penile prosthesis implantation. Advances in prosthetic design and implantation techniques have resulted today in devices that produce nearly normal flaccid and erect states, and have remarkable freedom from mechanical failure. The future of prosthetic design holds promises for even more improvements.

Introduction

Before the early 1970s erectile dysfunction (ED), then known as impotence, was widely believed almost always to be due to psychogenic causes.[1,2,3] Because of this belief, as well as the lack of effective therapy, there was little interest in the treatment of this disorder.

Three sentinel events have defined progress in our knowledge of the pathogenesis and treatment of ED. The first in 1973 was the introduction of the inflatable penile prosthesis.[4] The second in 1983 was the introduction of intracavernous vasoactive drug injection.[5,6] The third in 1998 was the introduction of sildenafil citrate, the first significantly effective oral therapy for ED.[7]

The attractiveness of oral therapy with the phosphodiesterase type 5 inhibitors and the widespread publicity concerning their use has made ED a household concept. While first line oral therapies are helpful for many men with ED, they are not helpful for all. Second line therapies (vacuum erection devices, intraurethral prostaglandin and penile injections) have mixed popularity and success. When first and second line treatments either fail or are unacceptable, penile prosthesis implantation is often considered.

This review will deal with the past, present and future of penile prosthesis implantation.

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