Login to Access Video or Poster Abstract: MP25-02
Sources of Funding: none

Introduction

Despite reportedly high satisfaction with penile implant (PI) surgery, some patients remain dissatisfied. Complications such as infection, mechanical malfunction and erosion remain significant concerns and are major contributors to patient dissatisfaction and regret. We aimed to explore outcomes and complications after PI surgery and to search for predictors of patient satisfaction.

Methods

All patients who underwent PI surgery were included in the analysis. Comorbidity, demographic and implant information were recorded. Complications recorded included: minor (requiring no re-operation) such as, penile edema, hematoma, superficial wound breakdown; major (requiring hospitalization or re-operation) such as device infection, erosion, mechanical malfunction. Patient satisfaction was defined using a single question posed to the patient 6 months after surgery with a 5-point Likert scale (1 dissatisfied, 2 somewhat dissatisfied, 3 neutral, 4 somewhat satisfied, 5 satisfied). Descriptive statistics were used to define complication rates and multivariable analysis (MVA) was performed to define predictors of high (satisfaction score ?4), including degree of complication, Peyronie’s disease (PD), diabetes (DM), number of vascular comorbidities, BMI >30 and patient age.

Results

901 patients were analyzed. Mean age 56.6±10.6 years. Mean BMI 30.2±5.1. Comorbidity profile was: diabetes 75%, dyslipidemia 44%, hypertension 33%, cigarette smoker 32%, PD 34%. 76% had a malleable implant and 24% an inflatable implant. 31% had a minor complication and 9% a major complication. 93% had high satisfaction (?4). Patients with any complication had a reduced rate of high satisfaction compared to those without (88% vs 98%; p<0.001) and likewise with a major complication (64% vs 98%; p<0.001). On MVA, BMI >30, number of vascular risk factors, type of implant and DM were not predictive of high satisfaction. Only the absence of a major complication was a significant predictor of high satisfaction (OR 20, 95% CI 9-50, p <0.001). The presence of PD was almost statistically significant.

Conclusions

A high percentage of men are satisfied after penile implant surgery. Only the presence of a major complication is robustly linked to a lower likelihood of achieving high satisfaction.

Funding

none