Inflatable penile prostheses for the treatment of erectile dysfunction: an update

Male erectile dysfunction (ED) is a common medical condition. Three oral medications (sildenafil, vardenafil and tadalafil, all phosphodiesterase type 5 inhibitors) have been developed and approved for the treatment of ED by the US FDA. Extensive worldwide marketing of these medications has raised public awareness of ED, and allowed many previously untreated men to seek and receive effective therapy. A variety of other ED treatments are available and approved by the FDA, including vacuum-constriction devices and intracavernous or intraurethral alprostadil. However, roughly 30-40% of men with ED are not adequately served by these treatments due to their cost, side effects, contraindications, the need to 'time' sexual activity, or lack of satisfactory erectile response. For men who do not respond to less invasive therapy, an inflatable penile prosthesis can provide a satisfying and effective alternative. This article will review and critique the inflatable penile prostheses that are currently available in the USA and the EU for the treatment of ED.