[From Rib Cartilage to Nitinol: The Penile Prosthesis Evolution]

The implantation of a penile prosthesis represents the gold standard in the treatment of therapy-refractory erectile dysfunction. Since the first documented corporal reconstruction using costal cartilage by Bogoraz in 1936, the field has undergone a remarkable technological development. The introduction of alloplastic materials in the 1950s, the development of semi-rigid prostheses with bendable metal cores in the 1970s, and the establishment of hydraulic one-, two-, and three-component systems from the 1980s onward represent major milestones. Innovations in cylinder material, pump mechanics, reservoir design, and antibacterial coating have increased mechanical reliability and substantially reduced complication rates. Current developments include novel semi-rigid prostheses with nitinol shape-memory cores, improved pump designs, and promising future concepts such as magnetically activated and electronically controlled implants. This narrative review provides a comprehensive overview of the history and further development of penile prostheses.