Estudio de evaluación de satisfacción en pacientes con/sin enfermedad de Peyronie e implante de prótesis de pene, y sus parejas

Introduction and objective

Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. However, patients with coexistent Peyronie's disease (PD) and refractory erectile dysfunction and/or severe deformities may show different results. The aim of our study was to assess and to compare the level of satisfaction, with an inflatable penile prosthesis (IPP), in men with/without coexistent PD.

Material and methods

A survey study based on a 5-item satisfaction questionnaire was submitted to all those live patients implanted in the period 1992-2022 at our center (n = 570) and their partners. Ninety-two percent of implants were three component inflatable devices. Surgeries were mainly performed by 2 surgeons. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after IPP.

Results

Of the 570 eligible patients, 479 (84%) completed the survey (393 non-PD: group 1; 70 non-complex PD: group 2; 16 complex PD: group 3). Eighty-six percent of patients in group 1 reported satisfactory sexual intercourse (very or moderately satisfied). Non-complex PD implanted patients (group 2) reported a global 81% satisfactory sexual intercourse (very or moderately satisfied) (p > 0.05). However, when we evaluated the PD subgroup of patients with severe PD who require incision/excision/grafting at the time of implant (group 3, n = 20), only 61% reported satisfactory sexual intercourse (p < 0.01) with predominance of moderately satisfied patients over very satisfied: 78 vs. 22%). Additionally, 84% (group 1), 80% (group 2) and 54% (group 3) of partners reported satisfactory intercourses, respectively (p < 0.01). Overall, 84% of group 1 implants and 79% of group 2 reported that they would undergo the procedure again if the IPP failed (p > 0.05; ns). Only 50% of group 3 patients would do it again. With regard to cosmetic aspects, 48% of the group 3 implant reported penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of total IPP patients expressed difficulty in manipulating the device.

Conclusions

The presence of PD alone may not impact IPP patient and partner satisfaction, but patients with more severe baseline deformity who require incision/grafting may be less satisfied with outcomes including penile length and glans sensation.