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Erectile dysfunction (ED) treatment can be divided into three main categories. These are oral agents, intracavernosal and intraurethral therapies, and local devices, such as vacuum and penile prosthesis. The first-line treatment for ED is oral phosphodiesterase type 5 inhibitors (PDE5Is); second-line treatment options include any combination of intracavernosal agents, such as papaverine, phentolamine, PGE1, or transurethral alprostadil. For this reason, penile prosthesis continues to be an important form of treatment for ED. Penile prosthesis implantation is a highly effective treatment option which yields high success rates, increased patient satisfaction, and low complication rates for men who fail first- and second-line treatment. Penile prostheses are indicated in a variety of conditions which cause ED, such as diabetes mellitus (DM), Peyronie’s disease, corporal fibrosis following priapism, ED following radical prostatectomy for prostate cancer and spinal cord injury.