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[Disappointing long-term experiences of patients with penile prosthesis]
E J Meuleman1, L Deunk, C S Schreuders Bais
1Academisch Medisch Centrum St Radboud, afd. Urologie en Polikliniek Medische Seksuologie, Postbus 9101, 6500 HB Nijmegen. e.meuleman@uro.azn.nl
Objective:
To describe the long-term experience with the implantation of a penile prosthesis as a last resort treatment for erectile dysfunction.
Design:
Retrospective and descriptive.
Method:
During the period 1986-1996, 124 men received a penile prosthesis. Basic information was obtained from medical files. Seventy-six men could be traced and were sent a questionnaire. Sixty patients and 44 partners participated in the study.
Results:
The median time since the implantation was 81.3 months (range: 13-139). The chance of reoperation was 35%. Seventeen percent of the patients and 25% of the spouses regretted the decision to have the implantation. Thirty-one percent no longer used the prosthesis and 15% had never used it. Twenty percent of the patients and 31% of the partners noticed an improvement in their sexual relationship whereas 26% and 23% respectively noticed a decline. Twenty percent of the patients sometimes failed to penetrate despite the prosthesis. Nevertheless, 66% would advise implantation to someone else. Almost 50% of the men reported spontaneous tumescence during sexual arousal.
Conclusion:
After the implantation of a penile prosthesis, the reoperation rate was high, and many patients and their partners were dissatisfied with their sexual relationship despite regaining a functional erection. Implantation requires thorough sexological counselling both before and after the operation.