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Complications, functional and quality of life outcomes following primary and secondary implantation of penile prosthesis at a tertiary referral center


The implantation of a penile prosthesis (PP) may be recommended in patients with severe erectile dysfunction (ED) who do not respond to conservative treatments. The aim of this study was to evaluate complications, as well as functional and quality of life outcomes following primary and secondary implantation of PP at a tertiary referral center. In this retrospective study, a total of 51 patients (41 patients with primary (PPP) and 10 with secondary PP (SPP)) were included. Patients and operative characteristics were recorded and complications were analyzed using the Clavien-Dindo classification. To evaluate satisfaction of patients and their partners, as well as PP long-term function, follow-up data were collected by using questionnaires (Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and QLQC30). Fifty-one patients with a median age of 61 years (IQR 52–68) received PP implantation (44 AMS 700, 7 Coloplast Titan). Main causes of ED were after radical prostatectomy (27.5%), diabetes (21,6%), and other unknown reasons (43.1%). Median time of intervention was 94.5 min (IQR 80.8–110.3) with no significant difference between PPP and SPP. Only one patient undergoing PPP surgery had grade 3 complication. Follow-up data from a total of 43 patients (84.3%) with a median follow-up of 26 months (IQR 17–41 mo) was recorded. At the time of follow-up, 88.4% of the PPs were still functional (PPP n = 34 (94.4%), SPP n = 4 (57.1%), p = 0.024). Overall estimated mean PP survival was 63.0 mo ((95% CI) 56.2–70.8 mo) with no significant difference between PPP and SPP. Overall satisfaction (EDITS und QLQC30) was high in both groups with no significant difference. PP implantation shows to be a safe treatment option in the management of severe ED.

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Fig. 1


  1. 1.

    NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. JAMA 1993;270:83–90.

    Article  Google Scholar 

  2. 2.

    Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Fisher WA, Eardley I, McCabe M, Sand M. Erectile dysfunction (ED) is a shared sexual concern of couples I: couple conceptions of ED. J Sex Med 2009;6:2746–60.

    Article  PubMed  Google Scholar 

  4. 4.

    Salonia A, Castagna G, Sacca A, Ferrari M, Capitanio U, Castiglione F, et al. Is erectile dysfunction a reliable proxy of general male health status? The case for the International Index of Erectile Function-Erectile Function domain. J Sex Med 2012;9:2708–15.

    Article  PubMed  Google Scholar 

  5. 5.

    Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010;57:804–14.

    Article  PubMed  Google Scholar 

  6. 6.

    Wilson SK, Delk JR, Salem EA, Cleves MA. Long-term survival of inflatable penile prostheses: single surgical group experience with 2,384 first-time implants spanning two decades. J Sex Med 2007;4(4 Pt 1):1074–9.

    Article  PubMed  Google Scholar 

  7. 7.

    Levine LA, Becher E, Bella A, Brant W, Kohler T, Martinez-Salamanca JI, et al. Penile prosthesis surgery: current recommendations from the international consultation on sexual medicine. J Sex Med 2016;13:489–518.

    Article  PubMed  Google Scholar 

  8. 8.

    Martinez-Salamanca JI, Mueller A, Moncada I, Carballido J, Mulhall JP. Penile prosthesis surgery in patients with corporal fibrosis: a state of the art review. J Sex Med 2011;8:1880–9.

    Article  PubMed  Google Scholar 

  9. 9.

    Henry GD, Donatucci CF, Conners W, Greenfield JM, Carson CC, Wilson SK, et al. An outcomes analysis of over 200 revision surgeries for penile prosthesis implantation: a multicenter study. J Sex Med 2012;9:309–15.

    Article  PubMed  Google Scholar 

  10. 10.

    Lledo-Garcia E, Jara-Rascon J, Moncada Iribarren I, Pinero-Sanchez J, Aragon-Chamizo J, Hernandez-Fernandez C. Penile prosthesis first and replacement surgeries: analysis of patient and partner satisfaction. J Sex Med 2015;12:1646–53.

    Article  PubMed  Google Scholar 

  11. 11.

    Althof SE, Corty EW, Levine SB, Levine F, Burnett AL, McVary K, et al. EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction. Urology 1999;53:793–9.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Hellstrom WJ, Montague DK, Moncada I, Carson C, Minhas S, Faria G, et al. Implants, mechanical devices, and vascular surgery for erectile dysfunction. J Sex Med 2010;7(1 Pt 2):501–23.

    Article  PubMed  Google Scholar 

  13. 13.

    Carson CC, Mulcahy JJ, Govier FE. Efficacy, safety and patient satisfaction outcomes of the AMS 700CX inflatable penile prosthesis: results of a long-term multicenter study. AMS 700CX Study Group. J Urol 2000;164:376–80.

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Rajpurkar A, Dhabuwala CB. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice. J Urol 2003;170:159–63.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Salonia A, Burnett AL, Graefen M, Hatzimouratidis K, Montorsi F, Mulhall JP, et al. Prevention and management of postprostatectomy sexual dysfunctions part 2: recovery and preservation of erectile function, sexual desire, and orgasmic function. Eur Urol 2012;62:273–86.

    Article  PubMed  Google Scholar 

  16. 16.

    Bettocchi C, Palumbo F, Spilotros M, Lucarelli G, Palazzo S, Battaglia M, et al. Patient and partner satisfaction after AMS inflatable penile prosthesis implant. J Sex Med 2010;7(1 Pt 1):304–9.

    Article  PubMed  Google Scholar 

  17. 17.

    Chung E, Van CT, Wilson I, Cartmill RA. Penile prosthesis implantation for the treatment for male erectile dysfunction: clinical outcomes and lessons learnt after 955 procedures. World J Urol 2013;31:591–5.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Kim DS, Yang KM, Chung HJ, Choi HM, Choi YD, Choi HK. AMS 700CX/CXM inflatable penile prosthesis has high mechanical reliability at long-term follow-up. J Sex Med 2010;7:2602–7.

    Article  PubMed  Google Scholar 

  19. 19.

    Natali A, Olianas R, Fisch M. Penile implantation in Europe: successes and complications with 253 implants in Italy and Germany. J Sex Med 2008;5:1503–12.

    Article  PubMed  Google Scholar 

  20. 20.

    Vitarelli A, Divenuto L, Fortunato F, Falco A, Pagliarulo V, Antonini G, et al. Long term patient satisfaction and quality of life with AMS700CX inflatable penile prosthesis. Arch Ital Urol Androl 2013;85:133–7.

    Article  PubMed  Google Scholar 

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Bernhard Ralla is participant in the Charité - Junior Clinical Scientist Program funded by the Charité - Universitaetsmedizin Berlin and the Berlin Institute of Health. Jonas Busch is participant in the Charité—Twinning Grant Program funded by the Charité—Universitaetsmedizin Berlin and the Berlin Institute of Health.

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Correspondence to Bernhard Ralla.

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Ralla, B., Goranova, I., Börnstein, N. et al. Complications, functional and quality of life outcomes following primary and secondary implantation of penile prosthesis at a tertiary referral center. Int J Impot Res 30, 49–53 (2018).

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