Open Access

ARTICLE

Satisfaction and surgical outcomes in patients undergoing penile prosthesis implantation for drug-refractory erectile dysfunction: mid-term results in a single center French cohort

Emilie Dardenne¹, Quentin Manach¹, Pietro Grande^1,2, Riccardo Campi^1,3, Florie Gomez¹, Benjamin Granger⁴, Vincent Misrai⁵, Marc-Olivier Bitker¹, Pierre Mozer¹, Morgan Roupret¹

1 Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Urology, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
2 Department of Obstetrical and Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Italy
3 Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
4 Department of Medical Information, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris, France
5 Department of Urology, Clinique Pasteur, Toulouse, France
Address correspondence to Prof. Morgan Roupret, Hopital Pitie-Salpetriere, Urologie, Pavillon Gaston Cordier, 47-83 boulevard de l’hopital, 75651 Paris Cedex 13 France

Canadian Journal of Urology 2019, 26(6), 10039-10044.

Abstract

Introduction: To investigate the mid-term results of penile prosthesis (PP) implantation in patients with erectile dysfunction (ED) from a “real-life” historic cohort in a French academic center.
Materials and methods: All patients receiving an inflatable PP between 2004 and 2014 in our institution were included in this study. ED was assessed preoperatively using the IIEF-5 questionnaire. Postoperative satisfaction with the PP was assessed using the EDITS questionnaire at each follow-up visit. Postoperative complications were classed according to the Clavien classification. Surgical and functional outcomes were recorded prospectively.
Results: Seventy-six men received a PP during the 10-year study period. Median (IQR) age was 62 (58-69) years. The main causes of ED were radical prostatectomy (n = 40; 53%) and diabetes mellitus (n = 28; 36.8%). Five patients (6.6%) had a non-functioning PP in place requiring complete substitution or a previous penile implant which had already been removed at the time of surgery. Sixty-nine (90.8%) patients received an AMS 700 CX device and seven (9.2%) a Coloplast Titan. The surgical approach was penoscrotal in 45 (59.2%) and infrapubic in 31 (40.8%). Intraoperative complications occurred in four (5%) patients, without compromising the intervention. Postoperative complications occurred in 27 (35.5%) patients: 17 (22%) were Clavien I-II and 10 (13%) Clavien III. All major complications resulted in prosthesis removal (n = 9; 11.8%) or revision (n = 1; 1.3%). Median (IQR) follow-up was 43 (34-55) months. At the end of follow-up, 70 (92.1%) patients had a functional implant. Fifty-four (71.1%) patients were satisfied with the device at the 6-month follow-up visit and beyond. Early satisfaction (at 3 months) was reported by 44 (57.9%) patients. A previous PP was the only significant risk factor for prosthesis removal (p = 0.001).
Conclusion: PP implantation is a safe and satisfactory treatment for ED. However, patient selection remains crucial in determining the post-surgical success of this procedure.

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