Penile Implant Surgery Satisfaction Assessment

Abstract

Background: Some studies showed encouraging results on the efficacy and safety of penile traction therapy (PTT) after Peyronie's disease (PD) surgery. The early traction therapy (ETT) could be an effective and safe approach to minimize penile shortening in patients undergoing PD surgery. Aim:To evaluate the feasibility, efficacy, and safety of a novel penile splint as ETT in PD patients undergoing grafting techniques.Methods: PD patients underwent plaque incision and grafting (PIG) technique, at the end of the procedure a novel penile splint (ETT) was applied to all patient. The device consisted of two 10Ch intubating stylets, self-adapted to each patient, that kept the penis stretched with the aid of nonabsorbable sutures. The total expense for the materials needed to build each penile splint was less than 15 euros. This active traction was maintained for 1-3weeks, then we removed the stitches leaving the device on-site for a passive traction. Within 3-4 weeks from surgery, the penile splint was replaced by a standard penile traction device. Outcomes:The main outcomes evaluated at 6 months included stretched penile length (SPL), penile curvature, International Index of Erectile Function -Erectile Function domain (IIEF-EF), patient satisfaction, and time to first satisfactory sexual intercourse.Results: A total of 46 patients were enrolled. The median preoperative IIEF-EF, penile curvature, and SPL were 27 points, 70 degrees, and 13 cm. The median follow-up was 15 months. The median postoperative IIEF-EF was 25 points (p < 0.001). The median residual penile curvature was 10 degrees (p < 0.001). The median postoperative SPL was 13 cm (p = 0.269). Eight patients (17.4%) lose 1 cm of SPL, no shortening greater than 1 cm was recorded. The median time to first satisfactory sexual intercourse and patient satisfaction score was 6 weeks and 9 points, respectively.Clinical Implications: Our results could pave the way for a new line of research, which in turn could lead to an improvement in the postoperative management of the patient undergoing surgery for PD.Strength & Limitations: This is the first study evaluating the ETT after PD surgery. The main limitation of this study is the lack of a randomized control group. Other weaknesses are the small sample size and the short follow-up time. Conclusion:Our novel penile splint is inexpensive, easy to assemble, and adaptable to the patient. ETT using this novel device, followed by standard traction therapy, seems to be feasible, effective, and safe.

Under-recognized factors affecting penile implant satisfaction in patients

“…[1] IPPs are generally well-tolerated with studies reporting an overall patient satisfaction rate of 75-98% and a partner satisfaction rate of 85.4%. [2][3][4][5] These satisfaction rates are similar amidst different patient subgroups with different pathologies for their ED. [3] Side effects commonly cited during patient counselling include decreased penile length and girth, change in penile on a scale of 1-10 (with 10 being the firmest erection), the mean erection strength was 4.15/10 (standard deviation (SD) of 2.83).…”

Impact of extracorporeal shockwave therapy for erectile dysfunction and Peyronie's disease on reproductive and hormonal testicular function

“…Oral PDE5Is, intracavernous or topical alprostadil, vacuum devices, and penile prostheses are some therapeutic options for ED. [17][18][19][20] Non-steroidal anti-inflammatory drugs (NSAIDs), penile traction therapy (PTT), collagenases, and shortening or lengthening surgical procedures are some treatment options for PD. [21][22][23][24] In recent years, ESWT has proven to be an effective treatment in selected patients with ED and PD, to improve erectile function and relieve penile pain, respectively.…”

“…Several effective treatments have been described over the years for these pathologies. Oral PDE5Is, intracavernous or topical alprostadil, vacuum devices, and penile prostheses are some therapeutic options for ED 17–20 . Non‐steroidal anti‐inflammatory drugs (NSAIDs), penile traction therapy (PTT), collagenases, and shortening or lengthening surgical procedures are some treatment options for PD 21–24 .…”

Investigating self-reported efficacy of lifestyle medicine approaches to tackle erectile dysfunction: a cross-sectional eSurvey based study

“…Conventional medical therapy includes the use of phosphodiesterase-5 inhibitors (PDE5I) as first-line treatments for ED [19]. Other treatments include penile self-injections with vasoactive drugs and intraurethral suppositories [30,31], and when other therapeutic treatment options fail to yield results, surgically implanted penile prostheses may be considered [19,32]. Alongside medical treatment, lifestyle and behaviour modifications such as weight management, uptake of physical activity, smoking and alcohol cessation, improving blood glucose, hyperlipidemia and blood pressure control are usually recommended as initial interventions by guidelines [33][34][35].…”