{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:37:21Z","timestamp":1789155441922,"version":"build-2803163510"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non-organic erectile dysfunction (ED) and premature ejaculation (PE) are common conditions for which European Association of Urology guidelines lack specific recommendations on penile prosthesis implantation (PPI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To establish expert consensus on the role of PPI in non-organic ED and PE using the Delphi method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A panel of 24 international penile implant surgeons with significant experience in PPI participated in a 3-round Delphi consensus between February and May 2025. Participants were mainly European-based (Italy, n\u2009=\u200916; Turkey, n\u2009=\u20094; United Kingdom, n\u2009=\u20092; Spain, n\u2009=\u20091; Germany, n\u2009=\u20091). Two online questionnaire rounds were followed by a final virtual meeting. Topics included diagnostics, treatment hierarchy, indications for PPI, ethical concerns, surgical risks, patient satisfaction, partner\u2019s involvement, and follow-up strategies. Consensus was defined as \u226575% agreement or disagreement on Likert-scale items.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Expert consensus was reached on all 53 items, including the ones regarding the appropriateness of PPI in non-organic ED and PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Experts agreed on the importance of thorough psychosexological assessment, standardized diagnostic tools, and exhausting conservative treatments before considering PPI in non-organic ED. Seventy-five percent supported PPI as a last-resort option in non-organic ED, provided psychological evaluation and informed consent protocols are in place. In contrast, the panel rejected PPI as a treatment for pure PE due to insufficient evidence and lack of clinical experience. Emphasis was placed on ethical safeguards, long-term follow-up, and partner involvement in decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>These findings suggest that, under strict conditions, PPI may have a role in treatment-resistant non-organic ED but not in pure PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>Limitations include the inherent subjectivity of the Delphi methodology and the restricted representativeness of the panel, which was mainly European-based and composed exclusively of urologists specializing in penile implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Selective use of PPI in non-organic ED is supported by expert consensus, while its use in pure PE is not; updated guidelines and further research are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf332","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T14:22:28Z","timestamp":1762266148000},"source":"Crossref","is-referenced-by-count":2,"title":["Evaluating the appropriateness of penile prosthesis in non-organic erectile dysfunction and premature ejaculation: a Delphi consensus among penile implant surgeons"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0138-6294","authenticated-orcid":false,"given":"Andrea","family":"Cocci","sequence":"first","affiliation":[{"name":"Department of Urology, University of Florence , 50134 Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Pezzoli","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Florence , 50134 Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Pizziconi","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Florence , 50134 Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Bettocchi","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Foggia , 71122 Foggia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-7165","authenticated-orcid":false,"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele , 20132 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suks","family":"Minhas","sequence":"additional","affiliation":[{"name":"Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital , W6 8RF London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Boeri","sequence":"additional","affiliation":[{"name":"Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan , 20122 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2347-9504","authenticated-orcid":false,"given":"Paolo","family":"Capogrosso","sequence":"additional","affiliation":[{"name":"Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation , 21100 Varese ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nusret 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Mart\u00ednez","family":"Salamanca","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario Puerta del Hierro Majadahonda , 28222 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Modgil","sequence":"additional","affiliation":[{"name":"Manchester Andrology Centre, Manchester Royal Infirmary, Manchester University Hospitals NHS Foundation Trust , M13 9WL Manchester ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4687-7353","authenticated-orcid":false,"given":"Giorgio Ivan","family":"Russo","sequence":"additional","affiliation":[{"name":"Urology Section, Department of Surgery, University of Catania , 95125 Catania ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ege Can","family":"Serefoglu","sequence":"additional","affiliation":[{"name":"Department of Urology, Biruni University 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