Complication and Explantation Rates of Penile Prostheses in Transmasculine Patients: A Meta-analysis

Area of Science:

• Urology
• Gender-affirming surgery
• Medical device research

Background:

• Penile prosthesis implantation is a critical component of gender-affirming phalloplasty for transgender men.
• Understanding complication rates associated with different prosthesis types is essential for patient counseling and surgical decision-making.

Approach:

• A meta-analysis was conducted on studies published up to December 2022, including randomized clinical trials, cohort studies, and cross-sectional studies.
• Data from nine eligible studies, encompassing penile prosthesis complications in transmasculine patients, were analyzed.
• Inclusion criteria focused on penile prosthesis implantation post-phalloplasty, excluding non-relevant study designs and patient populations.

Key Points:

• Overall complication rates were comparable between inflatable (38%) and malleable (37%) penile prostheses.
• Common complications included infection, mechanical dysfunction, and dislocation for both implant types.
• Explantation rates did not significantly differ between inflatable (19%) and malleable (13%) penile prostheses.

Conclusions:

• Penile prosthesis type (inflatable vs. malleable) does not appear to significantly influence complication or explantation rates following gender-affirming phalloplasty.
• Further research may focus on patient-reported outcomes and long-term device durability.
• These findings support informed consent discussions regarding prosthesis selection in gender-affirming care.