Radiographics. 2026 Jul;46(7):e250175. doi: 10.1148/rg.250175.
ABSTRACT
Diagnosis of erectile dysfunction (ED) is increasing due to the prevalence of cardiovascular disease, diabetes, lifestyle changes, and an aging population. The worldwide prevalence of ED in 2025 was projected to be 322 million men. ED can negatively affect a man's psychosocial health and quality of life. Of all the available treatment options for ED, the penile prosthesis offers the highest patient and partner satisfaction rates (the inflatable type more than the malleable type) and is covered by most insurance plans in the United States. Despite being irreversible and invasive, per the 2018 American Urological Association guidelines, it is valid for men to begin with a penile prosthesis as the first line of treatment. Consequently, approximately 30 000 penile prostheses are implanted annually in the United States. However, surgery carries inherent risks and potential complications, and like any other implant, an inflatable penile prosthesis (IPP) can be complicated by infection, mechanical failure, and malpositioning. Detection of these complications can be challenging at clinical examination, and MRI is the preferred modality to interrogate the IPP. Other imaging modalities such as CT and US may be used according to the suspected complication and provide complementary information. MRI permits anatomic evaluation of the IPP and offers functional assessment by allowing acquisition of images during both the inflated and deflated states. The aim of this article is to familiarize radiologists with the normal imaging appearance and complications of the three-piece IPP for accurate diagnosis and effective communication with referring clinicians. A structured reporting template is proposed to guide clinical practice. ©RSNA, 2026 Supplemental material is available for this article. See the invited commentary by Schuch and Chojniak in this issue.
PMID:42313623 | DOI:10.1148/rg.250175