Penile prosthesis (PP) is one of the main approved therapies for erectile dysfunction (ED). Greater than 50 years of clinical use has led to considerable innovation in PP surgery and patient care.
To summarize the current literature and provide updated clinical evidence to inform healthcare providers on best practices with PP.
A consensus panel was held with leading sexual medicine experts during the 5th International Consultation on Sexual Medicine (ICSM). Relevant peer-reviewed literature was reviewed with focus on research from but not limited to the last 10 years. The quality of each individual study was judged with Oxford levels of evidence (LOE) criteria, but overall LOE were not used as systematic review was not performed. The expert panel generated consensus statements based on the quality of evidence and criteria of GRADE (Grading of Recommendations Assessment, Development and Evaluation).
PP provides excellent outcomes for the treatment of ED. The panel developed 35 recommendations building upon previous recommendations. Nine recommendations (4, 5, 11,13,17, 25, 26, 31, and 32) are retained without change from 2015. Twelve recommendations (1, 2, 3, 7, 9,14,16,19,21, 28, 33, and 34) change syntax to make statements more active or change details. Fourteen recommendations (6, 8, 10, 12, 15, 18, 20, 22, 23, 24, 27, 29, 30, and 35) are novel in this update.
Since the 4th ICSM, new evidence has emerged to guide PP use in modern sexual medicine. While multi-institutional studies are needed to improve outcomes, key challenges remain: reducing infections, enhancing devices, and improving awareness and accessibility. We recommend following 5th ICSM guidelines while emphasizing the importance of clinical judgment and shared decision-making for optimal PP outcomes.
Sexual medicine reviews. 2025 Mar 12 [Epub ahead of print]
Tobias S Köhler, Ricardo Munarriz, Justin Parker, Carlo Bettocchi, Georgios Hatzichristodoulou, Francisco E Martins, Ignacio Moncada, Daniar Osmonov, Sung Hun Park, David Ralph, Run Wang
Department of Urology, Mayo Clinic, Rochester, MN, 55905, United States., Department of Urology, Boston University School of Medicine Chobanian & Avedisian School of Medicine, Boston, MA, 02118, United States., Department of Urology, Bay Pines VA Health System and University of South Florida College of Medicine, Tampa, FL, 33606, United States., Department of Urology, University Hospital Foggia, Foggia, 71121, Italy., Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, 90491, Germany., Department of Urology, University of Lisbon, School of Medicine, Santa Maria Hospital, 1600-161 Lisbon, Portugal., Department of Urology, Hospital La Zarzuela, Universidad Francisco de Vitoria, Madrid, 28023, Spain., Department of Urology, University Medical Center Schleswig Holstein, 24105 Kiel, Germany., Sewum Prosthetic Urology Center of Excellence for Penile Implants, Seoul, 06612, Korea., University College London Hospitals & St Peter's Andrology, London, NW1 2BU, United Kingdom., Department of Urology, University of Texas MD Anderson Cancer Center and McGovern Medical School at Houston, Houston, 77030, TX, United States.