Long-Term Satisfaction With Inflatable Penile Prosthesis Using the Satisfaction Survey for Inflatable Penile Implant in a Veteran Population.

Abstract

Inflatable penile prosthesis (IPP) is the gold standard for refractory erectile dysfunction, yet long-term outcomes in the Veterans Affairs (VA) health care population remain incompletely characterized. Using the Satisfaction Survey for Inflatable Penile Implant (SSIPI)-a recently validated, English-language, IPP-specific instrument (16 items; 1-5 Likert scale; total score 16-80)-we conducted a retrospective chart review and telephone-administered survey as an Institutional Review Board-approved quality improvement project at our regional VA medical center. All men undergoing primary IPP implantation from 1993 to 2021 were identified. Of 114 patients (82 living, 32 deceased at census date), 52 of 82 living patients (63.4%) completed the SSIPI. Median follow-up was 129.4 months (IQR 46.9-203.0), and median age at first surgery was 62 years (IQR 58-67). Median total SSIPI score was 67.5/80 (IQR 58.0-76.0); 67.3% of respondents were satisfied or somewhat satisfied. Smokers reported significantly lower satisfaction with post-implant penile length than non-smokers (SSIPI item #8: median 3.0 vs. 4.5; Mann-Whitney U, p = 0.032), and 48.1% of all respondents scored ≤3 on this domain regardless of smoking status, highlighting the importance of preoperative counseling on length expectations. Patients with lower comorbidity burden (ASA ≤ 2) reported higher overall satisfaction than those with ASA ≥ 3 (mean 70.36 vs. 61.13; p = 0.028). Older age at surgery was positively correlated with overall satisfaction (Spearman ρ = 0.463, p < 0.001), supporting IPP as appropriate management in older patients. No significant differences in overall SSIPI score were observed by diabetes status or BMI. Long-term IPP satisfaction in this VA cohort was favorable overall. Smoking history and higher comorbidity burden identify patients warranting enhanced preoperative counseling. The SSIPI demonstrates utility as a long-term quality improvement outcome measure for IPP in a real-world VA setting.