Clinical Outcome: Patient and Partner Satisfaction after Penile Implant Surgery
Cedric Jorissen 1 , Helene De Bruyna 1 , Evert Baten 1 , Koenraad Van Renterghem 2
Curr Urol 2019 Oct;13(2):94-100.
Abstract
Objective: We conducted a retrospective single centre study to analyze mechanical reliability, complication rate, patient satisfaction and quality of life after penile prosthesis implantation.
Materials and methods: A total of 126 electronic patient files after primary implantation of an IPP during a 5-year period were investigated. A structured telephone interview concerning patient and partner satisfaction was conducted at least 1 year after implant surgery.
Results: We found that 15 patients (11.9%) had revision surgery for various reasons. Mechanical failure occurred in 7.14% of the patients and was the main reason for revision surgery. Other major complications and complaints were loss of penile length (18.53%), postoperative pain (11.9%) and altered sensation (8.73%). No patients required explantation for infection, and 1 patient (0.79%) underwent revision surgery for an imminent erosion. One year or more after surgery, the patient and partner satisfaction rates, were 83.2 and 85.4%, respectively. We observed very high patient and partner satisfaction rates for the implantation of an IPP, with improvement of the general quality of life. These rates are negatively influenced by the occurrence of postoperative complications and complaints such as postoperative penile length shortening, pain and floppy glans syndrome. Most patients regain sexual function 6 weeks after surgery with no or minimal effect on the orgasm.
Conclusion: The implantation of a 3-piece IPP has proven an effective, third-line treatment for patients with ED.
Emphasized below, I will highlight the main take home points from the paper:
Regarding failure rate, the mechanical failure rate was 7%, and regarding the failures, the authors state:
Mechanical failure occurred in 9 patients (7.1%) ; 4 patients with pump-dysfunction, 4 patients with leakage of the tubing and/or reservoir and 1 patient with malfunc- tion of the cylinders 5 months after implantation. Two out of 4 patients (50%) with pump-dysfunction needed revision. Of all mechanical failures, 77.8% occurred with an AMS-prosthesis.
find it interesting that 78% of failures involved AMS products (the authors, though , state that the number was not statistically siginificant)
Regarding partner satisfaction and patient satisfaction, the authors state:
Of all patients, 95 could be reached by telephone, of which 79 (83.2%) were satisfied with the penile implant 1 year or longer after surgery and 80 of them (84.2%) would recommend a penile implant to a friend. In the successfully contacted patients, 93 had a regular partner, of which 76 (85.4%) were satisfied, 1 year or longer after penile implant surgery.
Regarding satisfaction rate for AMS versus coloplast, the authors state:
So although 91% of the coloplast group was satisfied, this was not significantly different from the LGX groupthe 3-piece IPP seems to be the prosthesis with the highest satisfaction rates and no dif- ference could be found between Boston Scientific and Coloplast penile prosthesis...Most of our patients received either the AMS-LGX or the Coloplast Titan prosthesis. The satis- faction rates were respectively 80.4 and 91.1%, but no significant difference was noted
regarding those patients who felt that they had lost penile length, they were a less satisfied group as documented below by the authors:
A common complaint after penile prosthesis implan- tation is loss of penile length, which has an important negative impact on overall patient satisfaction [12]. The subjective feeling of loss of penile length occurred in 18.53% of our patients and is therefore the most frequent complaint in our study group. It also had a significant impact on the satisfaction rates (p < 0.05). Only 10/17 patients (58.8%) with subjective loss of penile length were satisfied.
