Safety and Efficacy of Inflatable Penile Prostheses for the Treatment of Erectile Dysfunction: Evidence to Date

Abstract

Erectile dysfunction (ED) is a common problem, and prevalence rates are expected to rise as life expectancy increases worldwide. In more severe cases of ED, penile prosthesis implantation has been an excellent option for patients. Over the past few decades, significant design improvements have been made to the penile prosthesis and modifications to surgical technique to improve clinical outcomes. The purpose of this review is to summarize the safety and efficacy of FDA-approved penile implants in the US market. Design modifications have greatly improved the safety and reliability of the implant. Development of improved surgical techniques has decreased intraoperative injuries and reservoir-related complications. With its high overall satisfaction rates and low risk of complications, the inflatable penile prosthesis remains an excellent option for patients with erectile dysfunction.

Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis

“…It is plausible that unmeasured factors, such as improvements in surgical technique, prosthesis technology advancements, or stricter patient selection protocols may be responsible for higher device survival over time. 27 Specific factors of interest that may warrant additional research include prosthesis material and design; utilization of antibiotic coatings; patient demographics, medical history, and surgical indication; and the influence of concurrent procedures. Ultimately, the device survival rates in this review are likely the most reliable long-term results available; however, future studies should strive to identify the factors that influence long-term device survival, which we identified as a gap in the literature during this review.…”

The erectile and ejaculatory implications of the surgical management of rectal cancer

“…[80][81][82] While IPP placement is typically safe, intraoperative complications that can occur are proximal corporal perforation; distal corporal perforation; urethral injury; corporal crossover; and bowel, bladder, or vascular injury. 83 Postoperatively, complications that can occur are reservoir herniation, reservoir erosion, auto-inflation, implant infection, mechanical failure, hematoma, and venous compression syndrome, although the incidence of these complications is quite low. [83][84][85] As IPPs are more invasive than other treatment options and associated with surgical risks, this approach should be reserved for ED patients who have not responded to other treatments, which may be due to comorbidities such as diabetes, severe penile fibrosis, or Peyronie's disease.…”

“…While IPP placement is typically safe, intraoperative complications that can occur are proximal corporal perforation; distal corporal perforation; urethral injury; corporal crossover; and bowel, bladder, or vascular injury 83 . Postoperatively, complications that can occur are reservoir herniation, reservoir erosion, auto‐inflation, implant infection, mechanical failure, hematoma, and venous compression syndrome, although the incidence of these complications is quite low 83–85 .…”

Narrative review of immediate salvage for penile prosthesis infection

“…Implantation of a penile prostheses is a reliable treatment for men with ED refractory to less invasive therapies ( 2 - 4 ), as well as for female to male transgender patients ( 2 ). Improvements over the past decades in penile prosthesis technology and surgical techniques have improved the safety, reliability, and patient satisfaction rates for implants ( 2 , 3 ). Recently reported rates of patient and partner satisfaction with penile prosthesis are high ( 5 ), and frequency of penile prosthesis implantation has increased steadily since the mid-2000’s ( 4 ).…”

“…Recently reported rates of patient and partner satisfaction with penile prosthesis are high ( 5 ), and frequency of penile prosthesis implantation has increased steadily since the mid-2000’s ( 4 ). The rate of penile prosthesis infections has also decreased over time due to improvements in both prosthesis technology (e.g., antibacterial coating of prostheses) as well as in surgical technique (e.g., the “no touch” technique) ( 3 ). However, despite the decreasing rate of penile prosthesis infections, infections occur and remain a devastating complication.…”