Inflatable penile prosthesis (IPP) implantation is a highly effective surgical treatment for men suffering from refractory erectile dysfunction, with satisfaction rates exceeding 90% in most series. Despite significant advancements in device design and surgical techniques, which have dramatically reduced mechanical failures and infectious complications, anatomical complications such as SST deformity, also known as floppy glans syndrome, persist as a source of post-operative dissatisfaction. This condition, characterized by an abnormal droop of the glans penis despite adequate implant rigidity, can lead to cosmetic dissatisfaction, painful intercourse, and, in severe cases, an inability to engage in sexual activity.

This review synthesizes historical perspectives, evolving diagnostic approaches, and contemporary surgical management strategies for SST deformity. It begins by exploring the epidemiology and etiologies of SST deformity, highlighting that the condition primarily arises from inadequate corporal dilation, undersized or malpositioned cylinders, or true glans hypermobility due to weakened corporo-glanular ligaments. The diagnosis of SST deformity is largely clinical, supported by adjunctive imaging when needed, and the recently introduced glans hypermobility scale (GHS) provides an objective tool for intra-operative grading and decision-making. The review outlines a structured diagnostic and therapeutic algorithm (FIGURE 1), detailing steps for intra-operative and post-operative management based on the severity of glans hypermobility and clinical presentation. Conservative approaches, including observation, phosphodiesterase type-5 inhibitors, intraurethral vasoactive agents, and vacuum therapy, may offer benefit in mild cases. However, durable correction is most consistently achieved through glanulopexy techniques, which now demonstrate success rates exceeding 85%–95% with low morbidity.

The innovation of this review lies in its comprehensive examination of SST deformity, integrating historical data with contemporary practices. It not only consolidates existing knowledge but also introduces the GHS as a novel tool for objective assessment, enhancing the precision of surgical decision-making. Furthermore, the review discusses emerging minimally invasive fixation techniques and injectable bulking agents, expanding the treatment armamentarium for this complex condition.

This work significantly advances the understanding and management of SST deformity following IPP implantation. By providing a structured approach to diagnosis and treatment, it aids clinicians in optimizing patient outcomes and satisfaction. The work titled “Supersonic transporter (SST) deformity of penile prosthesis: Current management strategies,” was published on UroPrecision (published on 10 January 2026).
DOI：10.1002/uro2.70044