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Patient selection, counseling and preparation for penile prosthesis

International Journal of Impotence Research volume 35, pages 609–612 (2023)Cite this article

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Abstract

The penile prosthesis has revolutionized the management of erectile dysfunction and is a mainstay in the treatment of this clinical entity. The goal of proper patient selection and counseling is to achieve a satisfactory outcome for the patient. Most patients receiving a penile prosthesis are satisfied with their outcome, and while the penile prosthesis generally allows for high satisfaction rates, avenues for dissatisfaction can arise. Our aim is to aid the prosthetic urologist in identifying such avenues by discussing what factors can lead to a dissatisfied patient. Even a technically successful surgical outcome in the improperly counseled patient can have negative consequences for the patient and the patient-physician relationship. Satisfaction in the penile prosthesis arena can be variably defined and viewed from different perspectives. As such, establishing a personalized framework of expectation management, even in the patient who poses challenging factors, is paramount in preparation for penile prosthesis implantation.

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References

  1. Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200:633–41. https://doi.org/10.1016/J.JURO.2018.05.004.

    Article  PubMed  Google Scholar 

  2. Trost L, Wanzek P, Bailey G. A practical overview of considerations for penile prosthesis placement. Nat Rev Urol. 2016;13:33–46. https://doi.org/10.1038/NRUROL.2015.270.

    Article  PubMed  Google Scholar 

  3. 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. https://doi.org/10.1111/J.1743-6109.2011.02524.X.

    Article  PubMed  Google Scholar 

  4. Barton GJ, Carlos EC, Lentz AC. Sexual quality of life and satisfaction with penile prostheses. Sex Med Rev. 2019;7:178–88. https://doi.org/10.1016/J.SXMR.2018.10.003.

    Article  PubMed  Google Scholar 

  5. Fernandez-Crespo RE, Buscaino K, Carrion R. Optimizing outcomes in penile implant surgery. Urol Clin North Am. 2021;48:527–42. https://doi.org/10.1016/J.UCL.2021.06.010.

    Article  PubMed  Google Scholar 

  6. Kohler T, Gupta N, Wilson S. Wilson’s pearls, perils and pitfalls of penile prosthesis surgery. 2nd ed. Fort Smith, AR: Calvert McBride Publishers; 2018.

  7. Swanton A, Munarriz R, Gross M. Updates in penile prosthesis infections. Asian J Androl. 2020;22:28–33. https://doi.org/10.4103/AJA.AJA_84_19.

    Article  PubMed  Google Scholar 

  8. Akin-Olugbade O, Parker M, Guhring P, Mulhall J. Determinants of patient satisfaction following penile prosthesis surgery. J Sex Med. 2006;3:743–8. https://doi.org/10.1111/J.1743-6109.2006.00278.X.

    Article  PubMed  Google Scholar 

  9. Caire AA, Boonjindasup A, Hellstrom WJG. Does a replacement or revision of an inflatable penile prosthesis lead to decreased patient satisfaction? Int J Impot Res. 2011;23:39–42. https://doi.org/10.1038/IJIR.2011.1.

    Article  CAS  PubMed  Google Scholar 

  10. Trost LW, Baum N, Hellstrom WJG. Managing the difficult penile prosthesis patient. J Sex Med. 2013;10:893–907. https://doi.org/10.1111/JSM.12115.

    Article  PubMed  Google Scholar 

  11. Ziegelmann M, Köhler TS, Bailey GC, Miest T, Alom M, Trost L. Surgical patient selection and counseling. Transl Androl Urol. 2017;6:609–19. https://doi.org/10.21037/TAU.2017.07.19.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gupta AD, Streiff M, Resar J, Schoenberg M. Coronary stent management in elective genitourinary surgery. BJU Int. 2012;110:480–4. https://doi.org/10.1111/J.1464-410X.2011.10821.X.

    Article  PubMed  Google Scholar 

  13. Lacy JM, Walker J, Gupta S, Davenport DL, Preston DM. Risk factors for removal or revision of penile prostheses in the veteran population. Urology. 2016;98:189–94. https://doi.org/10.1016/J.UROLOGY.2016.06.039.

    Article  PubMed  Google Scholar 

  14. Penile Prosthesis Information Form. 2020. https://www.smsna.org/images/IPP_Consent.pdf.

  15. Miller LE, Khera M, Bhattacharyya S, Patel M, Nitschelm K, Burnett AL. Long-term survival rates of inflatable penile prostheses: systematic review and meta-analysis. Urology. 2022;166:6–10. https://doi.org/10.1016/J.UROLOGY.2022.03.026.

    Article  PubMed  Google Scholar 

  16. Hebert KJ, Kohler TS. Penile prosthesis infection: myths and realities. World J Mens Health. 2019;37:276–87. https://doi.org/10.5534/WJMH.180123.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Montorsi F, Rigatti P, Carmignani G, Corbu C, Campo B, Ordesi G, et al. AMS three-piece inflatable implants for erectile dysfunction: a long-term multi-institutional study in 200 consecutive patients. Eur Urol. 2000;37:50–5. https://doi.org/10.1159/000020099.

    Article  CAS  PubMed  Google Scholar 

  18. Osterberg EC, Maganty A, Ramasamy R, Eid JF. Pharmacologically induced erect penile length and stretched penile length are both good predictors of post-inflatable prosthesis penile length. Int J Impot Res. 2014;26:128–31. https://doi.org/10.1038/IJIR.2013.50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Deveci S, Martin D, Parker M, Mulhall JP. Penile length alterations following penile prosthesis surgery. Eur Urol. 2007;51:1128–31. https://doi.org/10.1016/J.EURURO.2006.10.026.

    Article  PubMed  Google Scholar 

  20. Krughoff K, Bearelly P, Apoj M, Munarriz NA, Thirumavalavan N, Pan S, et al. Multicenter surgical outcomes of penile prosthesis placement in patients with corporal fibrosis and review of the literature. Int J Impot Res. 2020;34:86–92. https://doi.org/10.1038/s41443-020-00373-9.

    Article  PubMed  Google Scholar 

  21. Sellers T, Dineen M, Salem EA, Wilson SK. Vacuum preparation, optimization of cylinder length and postoperative daily inflation reduces complaints of shortened penile length following implantation of inflatable penile prosthesis. Adv Sex Med. 2013;3:14–8. https://doi.org/10.4236/asm.2013.31003.

    Article  Google Scholar 

  22. Perito PE, Wilson SK. Traditional (retroperitoneal) and abdominal wall (ectopic) reservoir placement. J Sex Med. 2011;8:656–9. https://doi.org/10.1111/J.1743-6109.2011.02202.X.

    Article  PubMed  Google Scholar 

  23. Mulhall JP, Jahoda A, Aviv N, Valenzuela R, Parker M. The impact of sildenafil citrate on sexual satisfaction profiles in men with a penile prosthesis in situ. BJU Int. 2004;93:97–9. https://doi.org/10.1111/J.1464-410X.2004.04564.X.

    Article  CAS  PubMed  Google Scholar 

  24. Alter GJ. Correction of penoscrotal web. J Sex Med. 2007;4:844–7. https://doi.org/10.1111/J.1743-6109.2007.00512.X.

    Article  PubMed  Google Scholar 

  25. Fernandez-Crespo RE, Buscaino K, Carrion R. “Pumpology”: the realistic issues associated with pump placement in prosthetic surgery. Curr Urol Rep. 2021;22:10 https://doi.org/10.1007/S11934-020-01027-5.

    Article  PubMed  Google Scholar 

  26. Wilson SK, Delk JR, Salem EA, Cleves MA. Long-term survival of inflatable penile prostheses: single surgical group experience with 2384 first-time implants spanning two decades. J Sex Med. 2007;4:1074–9. https://doi.org/10.1111/J.1743-6109.2007.00540.X.

    Article  PubMed  Google Scholar 

  27. Çayan S, Aşcı R, Efesoy O, Bolat MS, Akbay E, Yaman Ö. Comparison of long-term results and couples’ satisfaction with penile implant types and brands: lessons learned from 883 patients with erectile dysfunction who underwent penile prosthesis implantation. J Sex Med. 2019;16:1092–9. https://doi.org/10.1016/J.JSXM.2019.04.013.

    Article  PubMed  Google Scholar 

  28. Habous M, Tal R, Tealab A, Aziz M, Sherif H, Mahmoud S, et al. Predictors of satisfaction in men after penile implant surgery. J Sex Med. 2018;15:1180–6. https://doi.org/10.1016/J.JSXM.2018.05.011.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kramer AC, Schweber A. Patient expectations prior to coloplast titan penile prosthesis implant predicts postoperative satisfaction. J Sex Med. 2010;7:2261–6. https://doi.org/10.1111/J.1743-6109.2010.01799.X.

    Article  PubMed  Google Scholar 

  30. Kava BR, Kanagarajah P, Ayyathurai R. Contemporary revision penile prosthesis surgery is not associated with a high risk of implant colonization or infection: a single-surgeon series. J Sex Med. 2011;8:1540–6. https://doi.org/10.1111/J.1743-6109.2011.02222.X.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University of South Florida, 2 Tampa General Circle, Tampa, FL, 33603, USA

    Florian A. Stroie, Laura Taylor, Raul Fernandez-Crespo, Justin Parker & Rafael Carrion

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  1. Florian A. Stroie
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  2. Laura Taylor
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  3. Raul Fernandez-Crespo
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  4. Justin Parker
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  5. Rafael Carrion
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Contributions

The authors confirm contribution to the paper as follows: Study conception and design: RF-C; Data collection: N/A; Analysis and interpretation of results: N/A; Draft manuscript preparation: FAS, LT, RF-C, JP, and RC. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Rafael Carrion.

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Stroie, F.A., Taylor, L., Fernandez-Crespo, R. et al. Patient selection, counseling and preparation for penile prosthesis. Int J Impot Res 35, 609–612 (2023). https://doi.org/10.1038/s41443-023-00735-z

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