Abstract
Erectile dysfunction (ED) is a prevalent condition affecting quality of life. Penile prostheses are effective for non-responsive cases, with malleable and inflatable types commonly used. Yet, a thorough comparison between them is absent. This systematic review aims to evaluate and compare malleable and inflatable penile prostheses in terms of efficacy, complications, patient satisfaction, and quality of life outcomes. A systematic search was conducted on PubMed, Embase, and Cochrane Library databases for relevant studies published between 2010 and 2022. Studies meeting predefined inclusion and exclusion criteria were selected, and their methodological quality was assessed. Data on surgical success rates, postoperative complications, patient satisfaction, sexual function, and quality of life were extracted and synthesized. A total of 40 studies were included in the review. Analysis of surgical success rates revealed comparable outcomes between malleable and inflatable penile prostheses. Postoperative complications varied, with malleable prostheses associated with lower rates of infection and mechanical failure compared to inflatable prostheses. Patient satisfaction was high for both types of prostheses, although some studies reported higher satisfaction rates with inflatable devices. Sexual function improvements were observed in both groups, but malleable prostheses had a shorter operative time and fewer device-related adverse events. Quality of life outcomes showed positive changes in psychosocial aspects for patients with both types of prostheses. This systematic review provides a comprehensive evaluation of malleable and inflatable penile prostheses for the treatment of ED. Although both prosthesis types effectively address ED, malleable ones show potential benefits: reduced infection/mechanical issues, quicker surgery, and fewer device-related problems. Yet, patient satisfaction leans toward inflatables, highlighting personal preferences in choices. Future research should probe lasting results and patient input to aid optimal prosthesis selection.

Key words: Erectile dysfunction, penile prostheses, infection, operative time, malleable, inflatable, systematic review, Embase.