Xardel V, Guy L, Neuville P, Morel Journel N
Service d'urologie, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Service d'urologie, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Prog Urol. 2021 Mar;31(4):223-230. doi: 10.1016/j.purol.2021.01.001. Epub 2021 Jan 21.
Penile prosthesis for erectile dysfunction in patients with spinal cord injury or multiple sclerosis is sometimes discussed after failure of drug or instrumental treatments (vacuum). The objective of this study was to evaluate the complications, evolution and patient satisfaction after the implantation of a penile prosthesis in the neurological patient.
Multi-center retrospective study of 27 consecutive patients including 18 spinal cord injured patients and 9 patients with multiple sclerosis benefiting from the implantation of a penile prosthesis for erectile dysfunction purposes in two French centers between 2009 and 2019. Post-implantation complications, evolution of the use of the prosthesis and global patient satisfaction were evaluated using the standardized questionnaire Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) during a telephone call between March and May 2020.
The average age of implantation was 46.4 years (±12.74). The length of follow-up to date of call was 6.05 years (±2.86). 8/27 patients (29.6 %) had at least one complication of any Clavien-Dindo grade included 2 infection. 2/27 (7,4 %) patients had a mechanical prosthesis injury during follow-up. The patient's dexterity with inflation of the prosthesis was perfect in 85 % of cases, and 75 % for deflation. The satisfaction rate for prosthesis use at the time of the call was 75.36/100pts for the patient and 66.88/100pts for the partner.
This study found an increased rate of prothesis infection compared to the general population in the neurologic patient, but patient and partner satisfaction remain sustainable after more than 5 years of implantation. Dexterity was maintained over the long term, demonstrating a good selection of indications. These data invite to favorably consider the installation of a penile prosthesis in neurological patients who have failed first-line treatments.
对于脊髓损伤或多发性硬化症患者的勃起功能障碍，在药物或器械治疗（真空疗法）失败后，有时会讨论阴茎假体植入。本研究的目的是评估神经科患者植入阴茎假体后的并发症、进展情况以及患者满意度。
对2009年至2019年期间在法国两个中心接受阴茎假体植入以治疗勃起功能障碍的27例连续患者进行多中心回顾性研究，其中包括18例脊髓损伤患者和9例多发性硬化症患者。在2020年3月至5月的一次电话随访中，使用标准化问卷“治疗满意度勃起功能障碍量表”（EDITS）评估植入后的并发症、假体使用情况的进展以及患者总体满意度。
植入时的平均年龄为46.4岁（±12.74）。至随访电话时的随访时长为6.05年（±2.86）。27例患者中有8例（29.6%）发生了至少一种任何Clavien-Dindo分级的并发症，其中包括2例感染。27例患者中有2例（7.4%）在随访期间发生了假体机械性损伤。85%的病例中患者对假体充气操作熟练，放气操作熟练的比例为75%。随访电话时患者对假体使用的满意度为75.36/100分，伴侣的满意度为66.88/100分。
本研究发现，与普通人群相比，神经科患者假体感染率有所增加，但植入超过5年后患者及其伴侣的满意度仍较高。长期保持了操作熟练程度，表明适应证选择良好。这些数据促使人们积极考虑为一线治疗失败的神经科患者安装阴茎假体。
4级。
