Soft glans after penile prosthesis surgery: a patient-reported study of prevalence and clinical impact

Abstract Soft glans syndrome, defined as inadequate glans engorgement despite full prosthesis inflation or adequate placement of a malleable implant, is a poorly studied source of dissatisfaction after penile prosthesis surgery, with prevalence often considered low or unknown. We conducted a cross-sectional patient survey of men who underwent penile prosthesis implantation at a tertiary centre between December 2023 and May 2025. The survey addressed glans engorgement, sexual satisfaction, ejaculatory function, cosmetic perception, and treatment interest. Associations were analysed using chi-square tests and univariable logistic regression. Eighty men participated (mean age 59.7 years (SD 9.3), median erectile dysfunction duration of 36 months (IQR 48). Soft glans was reported by 63.3% (n = 50/79), with another 17.7% (n = 14/79) experiencing it half the time or less. Most respondents (79%,n = 62/79) expressed interest in treatment. Soft glans was significantly associated with impaired ejaculatory function (p = 0.019), reduced sexual enjoyment (p < 0.001), and treatment interest (p < 0.001). Older age increased risk (OR 1.07, 95% CI 1.01–1.13, p = 0.014), while BMI, comorbidities, implant type, surgeon seniority, indication, and cosmetic satisfaction showed no association. Based on our single-center cohort analysis, soft glans appears to be a relatively common finding following penile prosthesis surgery. It has important functional and psychosocial consequences, underscoring the need for preoperative counselling and the development of targeted management strategies.