Penile Prosthesis Implantation Compares Favorably in Malpractice Outcomes to Other Common Urological Procedures: Findings from a Malpractice Insurance Database


Andrew C. Kramer, MD, 29 S. Greene St., Suite 500, Baltimore, MD 21201, USA. Tel: (410) 328-6087; Fax: (410) 328-0595; E-mail:


Introduction.  Some urologists choose not to offer penile prostheses because of concern over malpractice liability.

Aim.  The aim of this study was to assess whether urologists performing penile prosthesis surgery are placed at a greater malpractice risk.

Main Outcome Measures.  Percentage of malpractice suits from prosthesis surgery and other urological procedures that result in payment, average resulting payout from these cases, and category of legal issue that ultimately resulted in payout.

Methods.  A database from the Physician Insurers Association of America, an association of malpractice insurance companies covering physicians in North America, was analyzed to quantitatively compare penile implant surgery to other urological procedures in medicolegal terms.

Results.  Compared to other common urological procedures, penile implant is comparable and on the lower end of the spectrum in terms of both the percentage of malpractice suits that result in payment and the amount ultimately paid in indemnity from those cases. Additionally, issues of informed consent play the largest role in indemnities for all urological procedures, whereas surgical technique is the most important issue for prosthesis surgery.

Conclusions.  Urologists who are adequately trained in prosthetic surgery should not avoid penile implant procedures for fear of malpractice suits. A focus on communication and informed consent can greatly reduce malpractice risk for urological procedures. Chason J, Sausville J, and Kramer AC. Penile prosthesis implantation compares favorably in malpractice outcomes to other common urological procedures: Findings from a malpractice insurance database. J Sex Med 2009;6:2111–2114.