Cavernous tissue preservation technique versus conventional technique during penile prosthesis implantation: a prospective comparative study.

Background: Few prospective studies in literature with long postoperative follow-up compared between cavernous tissue sparing and conventional penile prosthesis implantation techniques.

Aim: To compare between cavernous tissue sparing and conventional penile prosthesis implantation techniques in terms of patient and partner satisfaction and perioperative outcomes.

Methods: In All, 60 Patients with severe erectile dysfunction were randomized into 2 equal groups; patients undergoing conventional malleable penile prosthesis implantation, and patients undergoing the cavernous tissue-sparing technique. Postoperatively, prosthesis function and patient satisfaction were assessed at 6 weeks after surgery and then 3-6 and 12 months using EDITS and QoLSPP questionnaires. Patients were asked about residual penile tumescence. Perioperative data were recorded.

Results: Modified EDITS questionnaire after 3,6, and 12 months was 76.9 ± 18, 79 ± 17 and 82.3 ± 16 respectively. As QOLSPP questionnaire, 46 (73.8%) subjects were highly satisfied, 25 patients (83.3%) in cavernous tissue sparing and 21 patients (70.00%) in Conventional group. While 14 (26.2%) were less satisfied, 5 patients (16.7%) Cavernous tissue sparing and 9 patients (30.00%) in Conventional group. In the cavernous tissue-sparing group, 26 of 30 patients (86.6%) reported having a significantly higher incidence of residual penile tumescence versus 2 of 30 patients (6.6%) in the conventional surgery group (P < .001). The age of highly satisfied subjects was significantly lower than those less satisfied (p = 0.025), while the BMI of highly satisfied subjects was significantly lower than those less satisfied (p = 0.001).

Conclusion: There is a significantly higher incidence of residual penile tumescence in Cavernous tissue sparing group. Many factors affect male satisfaction rates after PPI as age, and BMI.