Historical review of penile prosthesis design and surgical techniques: part 1 of a three-part review series on penile prosthetic surgery.

INTRODUCTION Throughout history, many attempts to cure complete impotence have been recorded. Early attempts at a surgical approach involved the placement of rigid devices to support the natural process of erection formation. However, these early attempts placed the devices outside of the corpora cavernosa, with high rates of erosion and infection. Today, most urologists in the United States now place an inflatable penile prosthesis (IPP) with an antibiotic coating inside the tunica albuginea. AIM The article describes the key historical landmarks in penile prosthesis design and surgical techniques. METHODS The article reviews and evaluates the published literature for important contributions to penile prosthesis design and surgical techniques. MAIN OUTCOME MEASURES The article reviews and evaluates the historical landmarks in penile prosthesis design and surgical techniques that appear to improve outcomes and advance the field of prosthetic urology for the treatment of erectile dysfunction. Results. The current review demonstrates the stepwise progression starting with the use of stenting for achieving rigidity in the impotent patient. Modern advances were first used in war-injured patients which led to early implantation with foreign material. The design and techniques of penile prostheses placement have advanced such that now, more complications are linked to medical issues than failure of the implant. CONCLUSIONS Today's IPPs have high patient satisfaction rates with low mechanical failure rates.