Outcomes of Inflatable Penile Prosthesis following Radical Cystectomy: A Matched Cohort Analysis

Area of Science:

• Urology
• Andrology
• Surgical Outcomes

Background:

• Radical-cystectomy can lead to erectile dysfunction (ED), necessitating treatment options like inflatable penile prosthesis (IPP) implantation.
• Outcomes of IPP in patients with a history of radical-cystectomy compared to other ED etiologies are not well-defined.

Purpose of the Study:

• To evaluate the outcomes of inflatable penile prosthesis (IPP) implantation in patients who have undergone radical-cystectomy compared to those with other causes of erectile dysfunction (ED).

Main Methods:

• A retrospective review of 2600 patients who received IPP implantation over 20 years was conducted.
• Erectile dysfunction (ED) etiologies were categorized as radical-cystectomy, radical-prostatectomy, or organic/other.
• Propensity score matching was used to create comparable cohorts, and complication rates, reoperation rates, and time to reoperation were assessed.

Main Results:

• Patients undergoing IPP after radical-cystectomy experienced higher overall complication rates (24% vs. 9%) and reoperation rates (21% vs. 7%) compared to non-cystectomy groups.
• Clavien-Dindo complication grades did not significantly differ between groups.
• Mechanical failure accounted for 85% of reoperations in the cystectomy cohort.

Conclusions:

• Inflatable penile prosthesis (IPP) implantation following radical-cystectomy is associated with an increased risk of complications and surgical revisions within 90 days.
• Despite increased risks, IPP remains a valid and effective treatment option for erectile dysfunction (ED) in patients post-cystectomy.
• The risk of high-grade complications is not greater in the cystectomy group.