Elaborate medical and psychological technologies now provide options to men with erectile difficulties. An increasingly popular option is the penile prosthesis. However, physicians and sex therapists should have concerns about inadequate evaluation and counseling, the increasing numbers of unnecessary or inappropriate implants, and inadequate provision of treatment options. Concerns of sex therapists who treat dissatisfied postimplant patients include: What proportion of implants performed each year are unnecessary or inappropriate? How many patients receive a prosthesis as the initial and only treatment option? How does a sex therapist let offending surgeons know of continuous errors in clinical judgment? A plea is made for attention to and investigation of this issue.