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Majority of erectile dysfunction patients would have preferred earlier implantation of their penile prosthesis: validation of the recently changed EAU guidelines


Until 2019, the European Association of Urology guidelines recommended the implantation of a penile prosthesis as a third-line therapy, which has since then changed to “if other treatments fail or depending on the patient’s preference”. Primary endpoint was to assess whether patients with a penile prosthesis and their partner would have preferred earlier implantation. Secondary endpoints were the reason why patient and partner wanted earlier implantation, how much earlier they wanted it, satisfaction of patient and partner and if patient and partner would have recommended the intervention. We selected patients with a virgin inflatable penile prosthesis operated between April 2013 and December 2019. We included 155 patients and 65 partners. Telephonic interview was conducted in a structured manner. Further data were collected retrospectively. The preference for earlier implantation was reported in 59.4% of patients and 46.2% of partners. Of them, respectively 53.2% and 46.6% would have wanted the prosthesis more than 5 years earlier. Satisfaction was seen in 83.2% of patients and 73.8% of partners. Respectively 82.6% and 78.4% of patients and partners would recommend the procedure. Our results indicate that a more patient-oriented approach with good counseling is desirable and that the “three-level” concept must be abandoned.

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Fig. 1: Preference for earlier penile implant predicted by Peyronie’s disease and after RP.

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All relevant data are available in the article. Additional data are available upon request.


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All contributors to the article are mentioned in the author list. We would like to thank our surgical team for their great work resulting in our high quality of care.

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KVR was responsible for research conceptualization. AVH and JM were responsible for data collection. AVH, JM, and KVR were responsible for data analysis and interpretation. AVH and KVR were responsible for writing the original draft. AVH was responsible for creating graphical representations. AVH, EC, and KVR were responsible for final review and editing. KVR was responsible for supervision of the project.

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Correspondence to Andries Van Huele.

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The authors declare no competing interests.

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This study was approved by the local ethics committee (f/2021/043).

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Van Huele, A., Mennes, J., Chung, E. et al. Majority of erectile dysfunction patients would have preferred earlier implantation of their penile prosthesis: validation of the recently changed EAU guidelines. Int J Impot Res 35, 731–735 (2023).

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