Upon introduction to treat male erectile dysfunction (ED) in the 1970s, penile prosthesis implantation revolutionized our practice for managing ED. Even in the era of effective oral medications for ED, sales of penile prostheses have been relatively stable in the past decade (1). It is possible to foresee the continuous need for penile prostheses as more and more patients are seeking treatment for ED, thanks to the recent media coverage and the improved knowledge of the general population about ED. The modifications and improvements of penile prostheses have maximized the device’s reliability and longevity. The 5-yr survival of some models has reached more than 92% (2,3). It is our belief that the modern inflatable devices are very mechanically reliable. Reoperations for penile prosthesis implantation are now more likely for infection, patient dissatisfaction, or physician error than for mechanical breakdown. Before 1990, about 57% of the reoperations at the Mayo Clinic were for mechanical failure or device malfunction (4). The mechanical failure of some current devices has been as low as 0.8%/yr for the first 3.5 yr and then 3.1% in the next 1.5 yr of observation (2).