Introduction

The impact of penile prosthesis implantation (PPI) on the overall patient's quality of life (QoL) has been scantly analyzed. The aim of this study was to assess the QoL of patients submitted to PPI, using the validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP).

Methods

Data were collected from the multi-institutional database directly filled out by 43 different surgeons after the surgical procedure on a dedicated website (www.registro.andrologiaitaliana.it) and revised by a data-manager from December 2014 to December 2016. Clinical characteristics of patients, etiology of erectile dysfunction (ED) and type of implanted prosthesis were analyzed. In order to simultaneously evaluate perceived penile prosthesis function and QoL, all patients were re-assessed at 1-yr follow-up with the QoLSPP questionnaire. Descriptive statistics and linear regression analysis were applied to assess the impact of the type of implanted prosthesis (hydraulic vs. non-hydraulic) on functional outcomes and QoL.

Results

Overall, 560 patients were included in the database. Follow-up data were available for 84 (15%) of them [median age 62yrs (IQR: 55 – 67 yrs)]. Of them, 85.1% (71) received an hydraulic penile prosthesis and 14.9% (13) a non-hydraulic model. 52.1% (44) of patients were submitted to PPI for post-radical prostatectomy ED, while 22.5% (19) and 16.9% (14) were affected by Peyronie's disease and vasculogenic ED, respectively. Overall, all patients reported high scores of the QoLSPP domains Functional (F:20.3/25), Personal (P:16.7/20), Relational (R:15.8/20) and Social (S:12.6/15) at 1-yr follow-up. Patients implanted with a non-hydraulic prosthesis reported significantly lower mean scores for all the QoLSPP domains as compared to hydraulic prosthesis (F:21.6 vs 17.7; P:17.6 vs 23.9; R:16.7 vs 13.8; S:13.2 vs 10.4; all p<0.02). At multivariable linear regression analysis, the hydraulic model was significantly associated with higher scores of the QoLSPP domains, after accounting for patient's age and ED etiology.

Conclusions

This is the first study reporting QoL data after PPI using the validated QoLSPP questionnaire. Our results showed a significant advantage of the hydraulic model as compared to the non-hydraulic model in terms of both perceived prosthesis function and QoL, irrespective of patient's age and ED etiology.

Funding

None