Habous Mohamad, Omar Mohamed, Farag Mohammed, Abdelwahab Osama, Laban Osama, Binsaleh Saleh, Mulhall John P, Ralph David, Aziz Mohammed
Al-Themal Medical Center, Abha, Saudi Arabia.
Urology Department, Menofia University, Egypt.
Sex Med. 2022 Apr;10(2):100486. doi: 10.1016/j.esxm.2021.100486. Epub 2022 Feb 23.
One of the most common complaints after malleable prosthesis implantation (MPI) is thinning of the penis and decreasing girth. Some surgeons try to insert the largest diameter they can to improve patient satisfaction AIM: To investigate if malleable rod diameter (MRD) has an impact on outcome and patient satisfaction METHODS: Consecutive malleable prosthesis implantation (MPI) was assessed in a high-volume center over 1 year. The same preoperative, intraoperative, and postoperative protocols were used for all patients and one brand of the malleable device was used only. We recorded MRD and length for all patients. All patients had data on comorbidities including glycated hemoglobin (HbA1c) and clinical Peyronie's disease (PD). Revision cases and those who lost for follow-up were excluded from the study. We also excluded patients operated on by low-volume surgeons. All complications, minor (edema, ecchymosis, pain), and major (infection and erosion) were recorded. After 1-year, patients were assessed and given a Likert scale from 1 to 5 where 5 is most satisfied with their MPI. We stratified patients according to MRD into 2 groups: group A for diameter 9.5 and 11 mm and group B for 13 mm.
Larger diameter of malleable penile implants may be associated with more complications RESULTS: 183 patients had full data and filled the questionnaire after 1-year follow-up. All patients had Coloplast, Genesis penile implants. Major complications rate (infection, erosion, and removal) was significantly higher in group B 11% vs 1.2% in group A (P = .016). At 4 weeks postoperative visit, 90 % of group A showed no complications vs 60% only in group B that was statistically significant (P = .0003). Satisfaction rate was more in patients in group A (88.6%) compared to patients in group B (75.7%) but this did not reach to be statistically significant (P = .0519) CLINICAL IMPLICATIONS: MRD predicts outcome.
STRENGTHS & LIMITATIONS: The strengths of our study include that it is the first prospective study with good number of malleable implants. Limitations include: no validated satisfaction instrument and MRD choice was based on surgeon preference.
Larger diameter of malleable penile implants are not associated with a higher rate of patient satisfaction Habous M, Omar M, Farag M et al. Malleable Penile Implant Rod Diameter Predicts Complications and Patient Satisfaction. Sex Med 2022;10:100486.
可弯曲阴茎假体植入术（MPI）后最常见的主诉之一是阴茎变细和周长减小。一些外科医生试图尽可能插入最大直径的假体以提高患者满意度。目的：研究可弯曲阴茎假体直径（MRD）是否对手术结果和患者满意度有影响。方法：在一家大型中心对连续1年进行的可弯曲阴茎假体植入术进行评估。所有患者均采用相同的术前、术中和术后方案，且仅使用一个品牌的可弯曲阴茎假体。我们记录了所有患者的MRD和长度。所有患者都有包括糖化血红蛋白（HbA1c）和临床佩罗尼氏病（PD）在内的合并症数据。翻修病例和失访患者被排除在研究之外。我们还排除了由经验较少的外科医生实施手术的患者。记录所有并发症，包括轻微并发症（水肿、瘀斑、疼痛）和严重并发症（感染和侵蚀）。1年后，对患者进行评估，并给予1至5分的李克特量表评分，5分表示对MPI最满意。我们根据MRD将患者分为两组：A组直径为9.5和11毫米，B组直径为13毫米。
可弯曲阴茎假体直径越大，可能与更多并发症相关。结果：183例患者在1年随访后有完整数据并填写了问卷。所有患者均使用康乐保公司的创世纪阴茎假体。B组的严重并发症发生率（感染、侵蚀和取出）显著高于A组，分别为11%和1.2%（P = 0.016）。术后4周随访时，A组90%的患者无并发症，而B组仅为60%，差异有统计学意义（P = 0.0003）。A组患者的满意度（88.6%）高于B组患者（75.7%），但差异无统计学意义（P = 0.0519）。临床意义：MRD可预测手术结果。
我们研究的优点包括这是第一项对大量可弯曲阴茎假体进行的前瞻性研究。局限性包括：没有经过验证的满意度评估工具，且MRD的选择基于外科医生的偏好。
可弯曲阴茎假体直径较大与患者满意度较高无关。哈布斯M、奥马尔M、法拉格M等。可弯曲阴茎假体直径预测并发症和患者满意度。性医学2022；10：100486。
