Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Technological advances in penile implants: past, present, future

International Journal of Impotence Research volume 35, pages 629–633 (2023)Cite this article

Subjects

Abstract

Attempts to “cure” erectile dysfunction (ED) are as old as recorded history. The history of penile prosthetic devices dates back over 500 years, when a French military surgeon designed the first known wooden prosthesis to support micturition. There have since been a great many technological advancements in penile prosthetics. Penile implants for the improvement of sexual function date to the twentieth century. Like all human endeavors, penile prosthesis innovations have progressed via trial and error. This review aims to provide an overview of penile prostheses for the treatment of ED since their introduction in 1936. More specifically, we aim to highlight important advances in penile prosthesis development and discuss dead ends that were abandoned. Highlights include two-piece inflatables, three-piece inflatables, and malleable/semirigid, along with modifications and updates to each basic design that improved both insertion and usability. Dead ends include innovative ideas that were lost to history due to a variety of factors. We also look to the future and discuss expected advances, including remotely activated devices and prostheses designed for special populations, including transgender men.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Historic Malleable Implants.
Fig. 2: Historic Malleable Implants.
Fig. 3: Historic Self-contained Inflatable Implants.
Fig. 4: Historic Self-contained Inflatable Implants.
Fig. 5: Historic Two-piece Inflatable Implants.
Fig. 6: Historic Two-piece Inflatable Implants.
Fig. 7: Historic Self-contained Mechanical Implants.
Fig. 8: Historic Self-contained Mechanical Implants.

Similar content being viewed by others

References

  1. Gee WF. A history of surgical treatment of impotence. Urology. 1975;5:401–5.

    Article  CAS  Google Scholar 

  2. Carson CCI, editor. Urologic prostheses: the complete practical guide to devices, their implantation, and patient follow up. 2002nd ed. Totowa, NJ: Humana; 2001. p. 321.

  3. Hakky TS, Wang R, Henry GD. The evolution of the inflatable penile prosthetic device and surgical innovations with anatomical considerations. Curr Urol Rep. 2014;15:410.

    Article  PubMed  Google Scholar 

  4. Schultheiss D, Gabouev AI, Jonas U. Nikolaj A. Bogoraz (1874-1952): pioneer of phalloplasty and penile implant surgery. J Sex Med. 2005;2:139–46.

    Article  PubMed  Google Scholar 

  5. Small MP, Carrion HM, Gordon JA. Small-Carrion penile prosthesis. New implant for management of impotence. Urology. 1975;5:479–86.

    Article  CAS  PubMed  Google Scholar 

  6. Scott FB, Bradley WE, Timm GW. Management of erectile impotence. Use of implantable inflatable prosthesis. Urology. 1973;2:80–2.

    Article  CAS  PubMed  Google Scholar 

  7. Finney RP. New hinged silicone penile implant. J Urol. 1977;118:585–7.

    Article  CAS  PubMed  Google Scholar 

  8. Jonas U, Jacobi GH. Silicone-silver penile prosthesis: description, operative approach and results. J Urol. 1980;123:865–7.

    Article  CAS  PubMed  Google Scholar 

  9. Merrill DC. Mentor inflatable penile prostheses. Urol Clin North Am. 1989;16:51–66.

    Article  CAS  PubMed  Google Scholar 

  10. Kabalin JN, Kessler R. Experience with the Hydroflex penile prosthesis. J Urol. 1989;141:58–9.

    Article  CAS  PubMed  Google Scholar 

  11. Anafarta K, Yaman O, Aydos K. Clinical experience with Dynaflex penile prostheses in 120 patients. Urology. 1998;52:1098–100.

    Article  CAS  PubMed  Google Scholar 

  12. Stanisic TH, Dean JC, Donovan JM, Beutler LE. Clinical experience with a self-contained inflatable penile implant: the Flexi-Flate. J Urol. 1988;139:947–50.

    Article  CAS  PubMed  Google Scholar 

  13. Mulcahy JJ. The development of modern penile implants. Sex Med Rev. 2016;4:177–89.

    Article  PubMed  Google Scholar 

  14. Dorflinger T, Bruskewitz R. AMS malleable penile prosthesis. Urology. 1986;28:480–5.

    Article  CAS  PubMed  Google Scholar 

  15. Fein RL. The G.F.S. Mark II inflatable penile prosthesis. J Urol. 1992;147:66–8.

    Article  CAS  PubMed  Google Scholar 

  16. Levine LA, Estrada CR, Morgentaler A. Mechanical reliability and safety of, and patient satisfaction with the Ambicor inflatable penile prosthesis: results of a 2 center study. J Urol. 2001;166:932–7.

    Article  CAS  PubMed  Google Scholar 

  17. Levinson K, Whitehead ED. OmniPhase penile prosthesis: delayed bilateral central cable breakage. J Urol. 1989;141:618–9.

    Article  CAS  PubMed  Google Scholar 

  18. Mulcahy JJ, Krane RJ, Lloyd LK, Edson M, Siroky MB. Duraphase penile prosthesis-results of clinical trials in 63 patients. J Urol. 1990;143:518–9.

    Article  CAS  PubMed  Google Scholar 

  19. Khera M, Mulcahy J, Wen L, Wilson SK. Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18. Int J Impot Res. 2020;1–8. https://doi.org/10.1038/s41443-020-00376-6.

  20. Barnard JT, Grimaud L, Yafi FA. Does Medicaid cover penile prosthesis surgery? A state-by-state analysis. J Sex Med. 2021;18:1455–60.

    Article  PubMed  Google Scholar 

  21. Quesada-Olarte J, Nelwan D, Donato U, Fernandez-Crespo R, Parker J, Carrion RE. Penile implant instrument innovations. Curr Urol Rep. 2023;24:59–67.

  22. Eid JF. No-touch technique. J Sex Med. 2011;8:5–8.

    Article  PubMed  Google Scholar 

  23. Wolter CE, Hellstrom WJG. The hydrophilic-coated inflatable penile prosthesis: 1-year experience. J Sex Med. 2004;1:221–4.

    Article  PubMed  Google Scholar 

  24. Carson CC. Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants. J Urol. 2004;171:1611–4.

    Article  PubMed  Google Scholar 

  25. Falcone M, Garaffa G, Gillo A, Dente D, Christopher AN, Ralph DJ. Outcomes of inflatable penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery. BJU Int. 2018;121:139–44.

    Article  CAS  PubMed  Google Scholar 

  26. van der Sluis WB, Pigot GLS, Al-Tamimi M, Ronkes BL, de Haseth KB, Özer M, et al. A retrospective cohort study on surgical outcomes of penile prosthesis implantation surgery in transgender men after phalloplasty. Urology. 2019;132:195–201.

    Article  PubMed  Google Scholar 

  27. Pigot GLS, Sigurjónsson H, Ronkes B, Al-Tamimi M, van der Sluis WB. Surgical experience and outcomes of implantation of the ZSI 100 FtM malleable penile implant in transgender men after phalloplasty. J Sex Med. 2020;17:152–8.

    Article  PubMed  Google Scholar 

  28. Gon LM, de Campos CCC, Voris BRI, Passeri LA, Fregonesi A, Riccetto CLZ. A systematic review of penile prosthesis infection and meta-analysis of diabetes mellitus role. BMC Urol. 2021;21:1–8.

    Article  Google Scholar 

  29. Tienforti D, Totaro M, Spagnolo L, Di Giulio F, Castellini C, Felzani G, et al. Infection rate of penile prosthesis implants in men with spinal cord injury: a meta-analysis of available evidence. Int J Impot Res. 2022;1–8. https://doi.org/10.1038/s41443-022-00632-x.

  30. Pang KH, Muneer A, Alnajjar HM. A systematic review of penile prosthesis insertion in patients with spinal cord injury. Sex Med Rev. 2022;10:468–77.

    Article  PubMed  Google Scholar 

  31. Krughoff K, Bearelly P, Apoj M, Munarriz NA, Thirumavalavan N, Pan S, et al. Multicenter surgical outcomes of penile prosthesis placement in patients with corporal fibrosis and review of the literature. Int J Impot Res. 2022;34:86–92.

    Article  PubMed  Google Scholar 

  32. Habous M, Tal R, Tealab A, Soliman T, Nassar M, Mekawi Z, et al. Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int. 2018;121:293–300.

    Article  CAS  PubMed  Google Scholar 

  33. Hakim LS, Kulaksizoglu H, Hamill BK, Udelson D, Goldstein I. A guide to safe corporotomy incisions in the presence of underlying inflatable penile cylinders: results of in vitro and in vivo studies. J Urol. 1996;155:918–23.

    Article  CAS  PubMed  Google Scholar 

  34. Chung E. Penile prosthesis implant in the special populations: diabetics, neurogenic conditions, fibrotic cases, concurrent urinary continence surgery, and salvage implants. Asian J Androl. 2020;22:39–44.

    Article  PubMed  Google Scholar 

  35. Robles-Torres JI, Gómez-Guerra L, Ramos-Cuevas D, Sánchez-Uresti A, Gutiérrez-González A. Pd40-04 semiautomatic inflatable electronic penile implant prototype. J Urol. 2018;199:e804–5.

    Article  Google Scholar 

  36. Le BV, McVary KT, McKenna K, Colombo A. Use of magnetic induction to activate a “touchless” shape memory alloy implantable penile prosthesis. J Sex Med. 2019;16:596–601.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. These authors contributed equally: Emily May, Meg Hanley.

Authors and Affiliations

  1. Dartmouth College Geisel School of Medicine, Hanover, NH, USA

    Emily May & Meg Hanley

  2. Department of Urology, University of Arizona, Tucson, AZ, USA

    John J. Mulcahy

  3. Section of Urology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA

    Martin S. Gross

Authors
  1. Emily May
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meg Hanley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John J. Mulcahy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin S. Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MSG and JJM conceived of the presented ideas. MSG supervised the project with support from JJM. MH, EM, and JJM collaborated in drafting the manuscript. All authors provided critical feedback and finalized the manuscript.

Corresponding author

Correspondence to Martin S. Gross.

Ethics declarations

Competing interests

MSG and JJM are consultants/speakers for Coloplast. JJM is a consultant/speaker for Boston Scientific. The other authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

May, E., Hanley, M., Mulcahy, J.J. et al. Technological advances in penile implants: past, present, future. Int J Impot Res 35, 629–633 (2023). https://doi.org/10.1038/s41443-023-00689-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-023-00689-2

This article is cited by

Search

Advanced search

Quick links