Penile prosthetic trends in the era of effective oral erectogenic agents

Before the introduction of sildenafil for the treatment of erectile dysfunction (ED), penile implants were recognized as the most effective, though most invasive, therapy with a high satisfaction rate. We compared and evaluated trends in penile prosthesis procedures at a tertiary referral center before and after the introduction of sildenafil. We retrospectively reviewed the clinical records of 561 implant procedures over the past 10 years to categorize the operations (eg, simple/"virgin" implant, replacement, revision, removal) and to establish the duration, severity, and complexity of the ED. No significant change was found in the number of penile implant procedures done annually. Both complexity of the procedures and severity of illness increased. A downward trend was seen in the number of simple penile prostheses implanted. Our data suggest that, with an aging population both aware of and requesting therapy for ED, the number of penile implantations will remain stable or increase, especially at centers specializing in ED treatment.