Presentation Authors: Francesco Chierigo*, Paolo Capogrosso, Federico Dehò, Eugenio Ventimiglia, Walter Cazzaniga, Luca Boeri, Edoardo Pozzi, Nicolò Schifano, Rani Zuabi, Federico Belladelli, Milan, Italy, Vincenzo Mirone, Naples, Italy, Francesco Montorsi, Andrea Salonia, Milan, Italy
Introduction: Hydraulic penile prostheses have shown an overall good mechanical reliability up to 10 years after surgery. However, few data have been published over 10 years. We looked at long-term complications, functional and quality of life (QoL) outcomes following 3-piece inflatable penile prosthesis implantation (IPP) in patients treated more than 17-years ago at a single center.
Methods: Baseline, perioperative and follow-up (FU) data of 51 consecutive patients submitted to IPP before 2001 were analyzed. All patients were implanted with AMS (CX/Ultrex plus) 3-piece prostheses. Patients were reassessed to evaluate rate of complications and functional outcomes. The validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) was used to assess patientsâ€™ QoL. Kaplan Meier analysis estimated the probability of prosthesis survival (defined as working device/not-explanted). Cox regression analysis assessed predictors of IPP failure.
Results: Median (IQR) FU was 206 months (145, 257). Etiology of erectile dysfunction (ED) was vasculogenic (N=20; 39%), Peyronie disease (N=15; 29%), pelvic surgery (N=4; 7.8%), organic other than vasculogenic (N=3; 5.9%) and others (N=9; 18%). Of 51, 42 (83%) and 9 (17%) patients were implanted with either a peno-scrotal or a suprapubic approach, respectively. Throughout the FU, 24 (49%) patients experienced complications [mechanical failure (79%); pain (12%); orgasmic dysfunctions (4.2%); device infection (4.2%)]. The estimated IPP survival was 53% (95%CI: 36-67) at 20-year FU. Baseline characteristics (age; Charlson Comorbidity Index; BMI; ED etiology) were not significant predictors of IPP failure over time at Cox regression analysis. At 20-year FU, 41% (95%CI 19-49) were still using the device. Among them, QoLSPP median (IQR) domain scores were high: functional 22/25 (20, 23), relational 17/20 (15, 18), personal 14/15 (12, 15), and social 14/15 (11, 15).
Conclusions: Long-term FU data after penile prostheses implantation showed that almost 50% of the devices still properly work after 20 years, with 40% of patients still using the device with high satisfaction and QoL outcomes. Both patients and physicians should be aware of the long life and outcomes of IPP.