Imaging of the Three-Piece Inflatable Penile Prosthesis
A single-author review argues MRI, not CT or ultrasound, is the best tool for spotting penile implant failures
Journal: Radiographics (Radiological Society of North America) | Published: 2026-07 | Type: Journal Article, Review | PMID:42313623Authors: Aswani Yashant (Department of Radiology, University of Iowa Health Care)
Funding/COI: Not listed
Summary
This is an educational review for radiologists on how to read imaging of the three-piece inflatable penile prosthesis (IPP), covering normal anatomy and how to spot complications like infection, mechanical failure, and device malposition. It's not a study with new data; it's a how-to reference piece, built around a proposed structured reporting template, published in a radiology journal alongside an invited commentary.
Claims
Worldwide ED prevalence was projected at 322 million men in 2025.
Roughly 30,000 penile prostheses are implanted annually in the United States.
Inflatable penile prostheses produce higher patient and partner satisfaction than the malleable type.
Per 2018 American Urological Association guidelines, a penile prosthesis can be used as first-line ED treatment, not just a last resort.
MRI is described as the preferred modality for working up suspected IPP complications, with CT and ultrasound offered as complementary tools depending on the complication suspected.
The article proposes a structured reporting template for radiologists evaluating these devices.
Study Quality
This is a narrative review, not a systematic review or meta-analysis, so there's no defined search strategy, inclusion criteria, or pooled data to interrogate. It reads as an educational primer aimed at radiologists who may encounter these implants infrequently, built on the author's clinical experience and existing literature rather than original research. The value here is pedagogical, not evidentiary.
Red Flags
Single author, no funding or conflict-of-interest disclosure listed at all, which is unusual for a device-focused clinical review and worth independent verification.
No stated methodology for how the reviewed literature or cases were selected.
No original outcomes data; claims about MRI's superiority over CT/US for complication detection are asserted rather than quantified with comparative sensitivity/specificity figures in the abstract.
Strengths
Published in Radiographics, a well-regarded RSNA education journal with formal peer review and an accompanying invited commentary.
Addresses a real gap: IPP complications are described as hard to detect on clinical exam alone, and structured imaging guidance is genuinely useful for referring clinicians and radiologists.
Includes a proposed structured reporting template, which is a concrete, reusable output rather than just prose description.
Verdict
This is a reference article, not a research finding, so there's nothing here to fact-check in the usual sense of sample size or effect size. It's useful if you're a radiologist or urologist wanting a refresher on IPP imaging, but the complete absence of any funding/COI disclosure on a device-adjacent review is the one thing worth flagging rather than taking at face value.