Introduction Managing and understanding expectations of patients prior to inflatable penile prosthesis (IPP) surgery is a critical. Clinicians vary in the way they explain the operation, and patients have varied expectations prior to surgery. Aims The goal is to understand the role that preoperative counseling and patients’ realistic understanding of IPP surgery play in determining postoperative satisfaction. Methods 21 Patients underwent IPP surgery, and received a preoperative expectations survey, then, 4 months later, gave a single score of 1–100 (1 is very dissatisfied, 100 is extremely satisfied). Main Outcome Measures The results were correlated with an R2 value and visualized on a scatter plot. This significance is tested using a two-tailed test. Results Lower preoperative expectations scores correlated almost linearly with higher satisfaction scores after surgery. The R (Pearson) value was −0.489, with an R2 of 0.239. This was significant using a two-tailed test, with a P value of 0.0245. Conclusion Giving patients an accurate description of the procedure and setting realistic expectations leads to higher postoperative satisfaction.

Inflatable penile prostheses (IPPs) are widely accepted as a means of surgical treatment of erectile dysfunction. It has been suggested that surgeon volume influences patient outcomes after IPP implantation. We used a written questionnaire to ask urologists who perform IPP surgery about their practice patterns. Our analysis correlated specific practices to self-reported IPP volume. A written questionnaire was distributed to 1968 urologists. Responses were collated and analyzed. Respondents were defined as high volume implanters (HVIs) if they placed X20 IPPs in the year preceding the survey, or low volume implanters (LVIs) if they placed p19. Our main outcome measures were surgeon volume, approach to initial IPP placement (penoscrotal vs infrapubic), strategy for reservoir management during IPP revision surgery, strategy for reservoir replacement when deemed necessary, approach to suspected IPP infections, and utilization of revision washout protocols. This study does not require institutional review board approval from our institution, given that patient information is not used at all, this is a practitioner survey only. HVIs were significantly more likely to incorporate both penoscrotal and suprapubic approaches into their armamentarium, more likely to manipulate previously placed IPP reservoirs during revision surgery, and more likely to operate immediately when confronted with a suspected IPP infection. They were also more likely than LVIs to use the Mulcahy revision washout protocol. There are significant differences in the self-reported practice patterns of HVIs and LVIs. The importance of these differences for patient outcomes remains undefined.