Università Vita-Salute San Raffaele, Milan, Italy.
Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
BJU Int. 2019 Feb;123(2):360-366. doi: 10.1111/bju.14462. Epub 2018 Jul 20.
To investigate scores and predictors of patient satisfaction at 1 year after penile prosthesis implantation (PPI) using the validated Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire.
Analyses were performed for 142 patients prospectively included in the national multicentre registry Italian Nationwide Systematic Inventarization of Surgical Treatment for Erectile Dysfunction (INSIST-ED), which provided 1-year follow-up data. Postoperative patient satisfaction was assessed using the validated QoLSPP tool. Linear logistic regression analyses assessed predictors of QoLSPP total and single domain scores, including age at surgery, erectile dysfunction aetiology, type of prosthesis, surgical approach, surgeon experience and complications. Locally weighted regression methods were used to explore the relationship between surgeon experience and QoLSPP scores.
Overall, high median functional, relational, social, personal and total QoLSPP scores were reported at 1 year after PPI. Patients implanted with hydraulic devices had higher functional (23 vs 21.5; P = 0.01) and total scores (68 vs 65.5; P = 0.03) than those with a malleable prosthesis. Surgeon experience emerged as the only independent predictor of higher satisfaction scores, depicting a non-linear association with both QoLSPP total and single domain scores (all P < 0.03). Data suggested that the higher the number of procedures per year, the greater the satisfaction scores, reaching a plateau after l5 procedures/year.
This study reports high functional and patient satisfaction scores at 1 year after PPI surgery using a dedicated tool for the first time. Better outcomes should be expected for patients treated by surgeons with greater experience.
使用经过验证的生活质量和阴茎假体相关性问卷（QoLSPP）调查阴茎假体植入（PPI）后 1 年患者满意度评分和预测因素。
对前瞻性纳入全国多中心登记研究意大利全国性功能障碍手术系统登记（INSIST-ED）的 142 例患者进行分析，该研究提供了 1 年随访数据。使用经过验证的 QoLSPP 工具评估术后患者满意度。线性逻辑回归分析评估了 QoLSPP 总分和单个域评分的预测因素，包括手术时的年龄、勃起功能障碍病因、假体类型、手术入路、手术医生经验和并发症。局部加权回归方法用于探索手术医生经验与 QoLSPP 评分之间的关系。
总体而言，PPI 后 1 年报告了较高的功能、关系、社会、个人和总 QoLSPP 评分。使用液压装置的患者在功能（23 分比 21.5 分；P = 0.01）和总分（68 分比 65.5 分；P = 0.03）方面的评分更高。手术医生经验是更高满意度评分的唯一独立预测因素，与 QoLSPP 总分和单个域评分均呈非线性关联（均 P < 0.03）。数据表明，每年手术次数越多，满意度评分越高，每年 15 次手术后达到平台期。
本研究首次使用专门的工具报告了 PPI 手术后 1 年的高功能和患者满意度评分。经验丰富的手术医生治疗的患者应获得更好的结果。
