Department of Urology and Renal Transplantation, Bellvitge University Hospital, IDIBELL, Barcelona, Spain.
Int J Impot Res. 2020 Nov;32(6):606-610. doi: 10.1038/s41443-019-0198-8. Epub 2019 Sep 24.
Penile prosthesis is the treatment of choice for erectile dysfunction (ED) refractory to medical treatment; vasculogenic ED and ED postradical prostatectomy (PRP) are the main aetiologies. Few studies have compared surgical outcomes of penile prosthesis placement for vasculogenic versus PRP severe erectile dysfunction. This study includes 117 cases corresponding to virgin implants for ED of either vasculogenic aetiology or PRP (58 for PRP and 59 for vasculogenic cases). We analysed data corresponding to: age, comorbidity, type of prosthesis, presence of fibrosis that hinders dilation, need for modelling, size of implanted cylinders and complications (intra and postoperative). In the results the rate of hypertension, diabetes, dyslipidaemia and ischemic heart disease was higher in vasculogenic ED. All of the prostheses were hydraulic; 24.1% of two components and 75.9% of three in the PRP group; 39% components of two and 61% of three in the vasculogenic group. With regard to the presence of cavernous fibrosis and need for modelling, no significant differences were found. However, significant differences were observed in the size of the implanted cylinders; PRP of 18.30 ± 2.11 cm versus 19.21 ± 1.71 cm in vasculogenic ED (p = 0.01643). There were no significant differences between the groups in infection rates, mechanical failure or extrusion. In conclusion the implantation of penile prosthesis in ED after PRP is associated with a shorter cylinder length compared with vasculogenic origin. Although there was a certain non-significant tendency to the need for modelling manoeuvres in PRP, there were no significant differences in postoperative outcomes including infection or mechanical failure.
阴茎假体是治疗对药物治疗有抗性的勃起功能障碍（ED）的首选方法；血管性 ED 和根治性前列腺切除术后 ED（PRP）是主要病因。很少有研究比较过血管性和 PRP 严重勃起功能障碍的阴茎假体植入手术结果。本研究包括 117 例因血管性病因或 PRP 导致的 ED 而首次植入假体的病例（58 例 PRP，59 例血管性病例）。我们分析了以下数据：年龄、合并症、假体类型、是否存在妨碍扩张的纤维化、是否需要塑形、植入圆柱体的大小以及并发症（术中及术后）。结果显示，血管性 ED 患者的高血压、糖尿病、血脂异常和缺血性心脏病的发生率更高。所有假体均为液压假体；PRP 组中 24.1%为两部件，75.9%为三部件；血管性组中 39%为两部件，61%为三部件。在是否存在海绵体纤维化和是否需要塑形方面，两组间无显著差异。然而，在植入圆柱体的大小方面存在显著差异；PRP 为 18.30±2.11cm，而血管性 ED 为 19.21±1.71cm（p=0.01643）。两组间在感染率、机械故障或脱出方面无显著差异。结论：与血管性病因相比，PRP 后勃起功能障碍植入阴茎假体与较短的圆柱体长度相关。尽管 PRP 存在一定的非显著倾向需要进行塑形操作，但在术后结果包括感染或机械故障方面无显著差异。
