A 10-year Audit of Penile Prosthesis Insertion

Area of Science:

• Urology
• Andrology
• Surgical Outcomes

Background:

• Penile prosthesis (PP) insertion is a primary surgical treatment for refractory erectile dysfunction (ED).
• While effective, PP insertion is associated with known complications.
• Assessing outcomes in specific patient cohorts is crucial for refining surgical practice.

Purpose of the Study:

• To evaluate the outcomes of penile prosthesis insertion performed by a single surgeon in an Irish patient cohort.
• To document complication rates, revision needs, and patient satisfaction following PP surgery.

Main Methods:

• A retrospective review of the Hospital In-Patient Enquiry (HIPE) system was conducted.
• Data from 111 PP insertions in 96 patients between 2008-2017 were analyzed.
• Patient charts and an electronic database were used to gather information on aetiology, device type, surgical approach, complications, and satisfaction.

Main Results:

• Post-prostatectomy was the most common cause of ED (26%).
• The 3-piece inflatable penile prosthesis (3p-IPP) was most frequently used, with a peno-scrotal approach in 77.5% of cases.
• No intraoperative complications occurred; 12.5% experienced peri-operative complications, and 13.5% required revision, primarily for device failure. Patient satisfaction was high (85.9%).

Conclusions:

• Single-surgeon PP insertion for ED yields complication rates consistent with international benchmarks.
• Comprehensive patient counseling regarding potential risks, including device failure and erosion, is essential.
• PP insertion remains a viable and effective option for carefully selected patients with refractory ED.