Comparison of Satisfaction With Penile Prosthesis Implantation in Patients With Radical Prostatectomy or Radical Cystoprostatectomy to the General Population

Abstract

Introduction: Penile prosthesis implantation is a widely used treatment option for erectile dysfunction. Data is limited with regard to patient satisfaction with a penile prosthesis following radical prostatectomy/cystoprostatectomy vs patients with erectile dysfunction of other etiologies. Aim: To examine patient satisfaction with penile prosthesis implantation and determine if a difference in satisfaction exists in post-prostatectomy/cystoprostatectomy patients vs patients with erectile dysfunction of other etiologies. We hypothesize that etiology does not affect satisfaction. Methods: A total of 164 patients underwent penile prosthesis implantation at our institution between August 2017 and December 2019, with 102 patients completing a validated 14 item questionnaire, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), at 6 months postoperation. Demographics, surgical characteristics, and erectile dysfunction etiology were recorded. Patients were assigned to one of 2 groups: postprostatectomy/ postcystoprostatectomy erectile dysfunction or other etiologies. The study group was further analyzed between radical prostatectomy or radical cystoprostatectomy. Main Outcome Measures: Satisfaction based on key EDITS questions with postradical prostatectomy/cystoprostatectomy vs patients with erectile dysfunction of other etiologies. Results: Responses to 3 questions were analyzed: overall satisfaction, expectations met in the past 4 weeks, and confidence in the ability to participate in sexual activity. Chi-square analysis was performed to determine the difference in responses. No difference was seen in overall satisfaction (P ¼ .96), expectations (P ¼ .78), or confidence (P ¼ .78) between groups. On subgroup analysis, there was no difference in reported overall satisfaction (P ¼ .47) or confidence (P ¼ .080) between postprostatectomy and postcystoprostatectomy patients. Postprostatectomy and postcystoprostatectomy patients differed in whether the penile prosthesis implantation met expectations (P ¼ .033). Postprostatectomy patients reported a mean score of 3.5/4 compared to postcystoprostatectomy patients, who reported a mean of 3.0/4. Conclusions: Our analysis suggests that key erectile function scores are not significantly different between postprostatectomy/postcystoprostatectomy patients compared to other etiologies. The difference in measures between postprostatectomy and postcystoprostatectomy patients is not significant or of unclear significance. Registration # of clinical trial: HSC-MS-19-0320 Howell S, Palasi S, Green T, et al. Comparison of Satisfaction With Penile Prosthesis Implantation in Patients With Radical Prostatectomy or Radical Cystoprostatectomy to the General Population. Sex Med 2020;XX:XXXeXXX.

Comparison of satisfaction with penile prosthesis implantation in patients with prostate cancer radiation therapy versus radical prostatectomy

“…It is also possible that EDITS questionnaire participants had differing satisfaction levels from the high number of non-participants, introducing response bias to our study. Subsequently as a limitation, the three additional questions asked of patients following the EDITS questionnaire are currently unvalidated questions but had been used in evaluation of patients in our prior published work (11). Given the retrospective nature of our study we chose to include these answers as well.…”

“…There also remains limited data available regarding patient satisfaction with PPS stratified by etiology of ED including following prostate cancer treatment such as surgical management or targeted radiation therapy. Our group previously studied satisfaction levels of patients with PPS following RP or radical cystoprostatectomy (RCP) versus the general population (11). For clinically localized prostate cancer, both surgery and radiation can be available as options through shared decision making between clinicians and patients, therefore, many patients at our institution undergo radiation in their genitourinary cancer treatment (12).…”

Assessing psychiatric risk with a focus on optimizing patient satisfaction with penile prosthesis placement—a narrative review

“…Patient populations also differ. For example, patients who are receiving an implant for ED after radical pelvic surgery as compared to those with organic sexual dysfunction ( 8 ).…”