Abstract
Increasing age and comorbidities are independent risk factors, as shown by the fact that young men with multiple comorbidities experience ED to the same extent as healthy men. Various conditions, such as a history of ischemic priapism, pelvic or penile trauma, or penile reconstructive procedures, may indicate the need for PPI, even in the primary setting. In this study, we recruited a cohort of male patients under 40 years of age who underwent PPI as a primary treatment.
A total of 75 patients who underwent PPI under the age of 40 were included in the study. All surgeries were performed by a single surgeon, and the data were evaluated retrospectively. Preoperative assessments included patient history (age, comorbidities, ED duration, smoking status, and previous surgical history), physical examination, a combined injection and stimulation test with Alprostadil, and penile PDDU. The IPP model and type of incision used were also recorded.
Seventy-five patients who underwent PPI under the age of 40 were included in the study. The mean age was 31.6 ± 5.6 years. According to PDDU results, 15 patients had arterial deficiency, 23 had cavernosal deficiency, 3 had both arterial and cavernosal deficiencies, and 4 had ischemic priapism. Ten patients had a history of pelvic or penile trauma, 14 had diabetes mellitus, and 3 had hypertension. Eleven patients underwent PPI following phalloplasty. Twenty patients had no identifiable etiological factor for organic ED. Penoscrotal incision was preferred in 33 patients and infrapubic incision in 42 patients. In the median 7 year follow up period, 11 patients required revision. The reason for revision was mechanical failure in six patients, impending erosion in one patient and infection in three patients.
Our results showed that both the clinical profile and the complication/reoperation rates in this cohort are comparable to those of the general male population treated with PPI, except for the absence of malignancy-related etiology for ED. Further studies are needed to optimize the preoperative condition of young men scheduled for PPI and to maximize their satisfaction with the procedure.
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