213 A Prosthesis-Specific Survey Study: The Sexual Quality of Life Benefits of the Inflatable Penile Prosthesis are Generalizable Across Multiple Patient Subpopulations

Introduction: The role of reservoir position was investigated in this series of patients treated with three-pieces penile prosthesis implantation (PPI). The outcomes and the patients’ reported quality of life after insertion of the balloon in the retropubic space, or the Retzius’s space (SOR), were compared with the outcomes of patients who received an intraperitoneal implantation (IP). The study aimed to analyze how the anatomy of the SOR influenced the long-term results of PPI, especially in patients who have been previously exposed to pelvic surgery or radiotherapy. The SOR has usually been identified as ideal for concealing and protecting the reservoir; nevertheless, an increasing rate of patients that ask for a PPI do not conserve the typical favorable characteristic of the SOR. In these cases, the tissue alteration can cause a higher rate of undesired events and can impair the satisfaction from device use. In the recent literature, few articles focus on the topic of reservoir position and very poor information is available about the results of the IP insertion. Materials: Our cohort of patients was retrospectively inspected; the two different subgroups, according to the reservoir position (SOR or IP) were evaluated considering the pre-operative condition, the post-operative complication, the development of undesired events or uncomfortable sensations during the follow-up. The quality of life after PPI was observed as well, with a questionnaire specifically developed for patients treated with PPI. The surgical technique adopted for the intraperitoneal implantation was described. Results: The results of penile prosthesis functionality and patients’ and partners’ reported quality of life (QoL) showed similar results between the two groups but greater satisfaction in the relational domain of the questionnaires adopted was described in the IP subgroup. Conclusion: According to our observations, the IP reservoir insertion guarantees good functionality and lower rates of undesired events after PPI.

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Long term patient satisfaction and quality of life with AMS700CX inflatable penile prosthesis

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2013.3.133 ◽

2013 ◽

Vol 85 (3) ◽

pp. 133 ◽

Cited By ~ 23

Author(s):

Antonio Vitarelli ◽

Lucia Divenuto ◽

Francesca Fortunato ◽

Antonio Falco ◽

Vincenzo Pagliarulo ◽

...

Keyword(s):

Quality Of Life ◽

Erectile Dysfunction ◽

Penile Prosthesis ◽

Standard Reference Materials ◽

Prosthesis Implantation ◽

Satisfaction Rate ◽

Inflatable Penile Prosthesis ◽

Satisfaction Rates

Objective: Penile prosthesis implantation is the solution of choice in patients who have failed or present contraindication to the use of all conservative treatment for erectile dysfunction (ED). Overall, satisfaction rates are high, with more than 80% of patients and partners fully satisfied with cosmetic and functional result of surgery. Chronic postoperative pain, penile shortening, soft or hyposensitive glans, pencil like penis syndrome and difficulty to cycle the device represent the most common causes of patient’s dissatisfaction. Satisfaction rates are better assessed with the use of validated questionnaires such as the International Index of Erectile Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) The aim of our study was to analyze the long-term mechanical reliability of the AMS 700CX/CXM inflatable penile prosthesis and the patient’s satisfaction rate using IIEF and EDITS questionaire as standard reference. Materials and methods: A retrospective case notes review of all patients who have undergone implantation of a three pieces inflatable penile prosthesis AMS 700 CX and CXR between October 1997 and December 2010. Overall, 80 patients have undergone implantation of 3 pieces inflatable penile prosthesis AMS 700 CX InhibiZone. Patients have been administered the IIEF-5 and EDITS questionnaires in combination with a non validated 9 domain questionnaire that assesses penile rigidity, sensation, orgasmic function, frequency of intercourse, impact of surgery on the quality of life, satisfaction rate. Results: Overall 10 years survival estimate according to the Kaplan Meier method of AMS 700 CX touch pump and AMS 700 CX momentary squeeze pump are respectively 77.6% and 82.5%. The median postoperative IIEF5 and EDITS score were respectively 21.46 and 73.11, which show a high level of satisfaction. 59 patients (90.8%) were able to cycle the device and were engaging in penetrative sexual intercourse. Conclusions: Penile prosthesis implantation yields excellent results in terms of cosmetic and functional outcome and therefore has a significant impact on patients’ satisfaction, sex life and overall quality of life. Overall, long term reliability has been significantly improved and complication rates are low in the hands of experienced surgeons.

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