Supersonic transporter (SST) deformity of penile prosthesis: Current management strategies

Supersonic transporter (SST) deformity, also known as floppy glans syndrome, represents a persistent source of post‐operative dissatisfaction among patients undergoing inflatable penile prosthesis (IPP) implantation. Although infection and mechanical failure rates have declined with advances in device design and surgical technique, SST deformity remains a challenging anatomical complication. It results primarily from inadequate corporal dilation, undersized or malpositioned cylinders, or true glans hypermobility due to disruption or weakness of the corporo‐glanular ligament. Diagnosis is largely clinical, supported by adjunctive imaging when needed, while the glans hypermobility scale has emerged as an objective tool for intra‐operative grading and decision‐making. Conservative approaches such as observation, phosphodiesterase type‐5 inhibitors, intraurethral vasoactive agents, and vacuum therapy may offer benefit in mild cases, but durable correction is most consistently achieved through glanulopexy techniques, which now demonstrate success rates exceeding 85%–95% with low morbidity. This review synthesizes historical perspectives, evolving diagnostic approaches, and contemporary surgical management strategies for SST deformity. Future research into minimally invasive fixation and injectable bulking agents may further expand the treatment armamentarium for this complex but correctable cause of dissatisfaction following IPP implantation.