Subcutaneous penile silicone sleeve implants for penile augmentation: a systematic review and meta-analysis

Subcutaneous silicone penile sleeve implants, including Penuma and Himplant, are used to increase flaccid penile dimensions and for selected reconstructive indications, but the magnitude of dimensional change and complication profile have not been systematically quantified. This systematic review and single-arm meta-analysis evaluated clinical outcomes after Penuma/Himplant implantation. Cohort studies with clearly defined denominators and extractable outcome data were included in the quantitative synthesis, whereas reports addressing special indications or complications were summarized narratively. Twelve publications from 2018 to 2026 met the inclusion criteria, of which four cohort studies were suitable for primary meta-analysis. The pooled mean increase was 3.77 cm in flaccid girth and 2.94 cm in flaccid length. Pooled complication rates were 3.03% for infection, 5.03% for seroma, 5.12% for erosion or implant exposure, 3.53% for revision, and 7.08% for explantation or implant removal. These descriptive findings are limited to flaccid penile dimensions and do not establish comparative effectiveness; data on erect dimensions and patient-reported outcomes were limited, with validated instruments rarely used. Prospective comparative studies using standardized penile measurements, formal psychological assessment, validated outcome instruments, and longer follow-up are required.