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M. Habous, S. Mahmoud, R. Tal, O. Abdelwahab, S. Binsaleh, J. Mulhall, HP-08-002 Exploring the Predictors of Low Satisfaction After Penile Prosthesis Implantation, The Journal of Sexual Medicine, Volume 14, Issue Supplement_4a, April 2017, Page e158, https://doi.org/10.1016/j.jsxm.2017.03.060
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Objective
To explore outcomes and complications after penile implant (PI) surgery and to search for predictors of patient satisfaction.
Methods
All patients who underwent PI surgery were included in the analysis. Comorbidity, demographic and implant information were recorded. Complications recorded included: minor (requiring no re-operation) such as, penile edema, hematoma, superficial wound breakdown; major (requiring hospitalization or re-operation) such as device infection, erosion, mechanical malfunction. Patient satisfaction was defined using a single question posed to the patient 6 months after surgery with a 5-point Likert scale (1 dissatisfied, 2 somewhat dissatisfied, 3 neutral, 4 somewhat satisfied, 5 satisfied). Descriptive statistics were used to define complication rates and multivariable analysis (MVA) was performed to define predictors of high (satisfaction score ≥4), including degree of complication, Peyronie’s disease (PD), diabetes (DM), number of vascular comorbidities, BMI >30 and patient age.
Results
901 patients were analyzed. Mean age 56.6±10.6 years. Mean BMI 30.2±5.1. Comorbidity profile was: diabetes 75%, dyslipidemia 44%, hypertension 33%, cigarette smoker 32%, PD 34%. 76% had a malleable implant and 24% an inflatable implant. 31% had a minor complication and 9% a major complication. 93% had high satisfaction (≥4). Patients with any complication had a reduced rate of high satisfaction compared to those without (88% vs 98%; p<0.001) and likewise with a major complication (64% vs 98%; p<0.001). On MVA, BMI >30, number of vascular risk factors, type of implant and DM were not predictive of high satisfaction. Only the absence of a major complication was a significant predictor of high satisfaction (OR 20, 95% CI 9-50, p <0.001). The presence of PD was almost statistically significant.
