Preto Mirko, Falcone Marco, Plamadeala Natalia, Schifano Nicolò, Bettocchi Carlo, Colombo Fulvio, Fiordelise Stefano, Vitarelli Antonio, Silvani Mauro, Mondaini Nicola, Paradiso Matteo, Ceruti Carlo, Varvello Francesco, Palumbo Fabrizio, Avolio Antonio, Antonini Gabriele, Corvasce Antonio, Pozza Diego, Franco Giorgio, Bitelli Marco, Boezio Francesco, Conti Enrico, Caraceni Enrico, Negro Carlo, Carrino Maurizio, Vicini Patrizio, Ghidini Nicola, Alei Giovanni, Italiano Emilio, Timpano Massimiliano, Polito Massimo, Natali Alessandro, Tamai Aldo, Pescatori Edoardo, Dehò Federico, Gideon Blecher, Gontero Paolo, Palmieri Alessandro, Capogrosso Paolo
Department of Urology, A.O.U. Città della Salute e della Scienza - Turin, Umbria, Italy.
Unit of Urology, ASST Sette Laghi, Circolo e Fondazione Macchi Hospital, University of Insubria, Varese, Italy.
Int J Impot Res. 2024 Dec;36(8):842-847. doi: 10.1038/s41443-023-00784-4. Epub 2023 Oct 31.
Like all surgeries, penile prosthesis implantation (PPI) has the potential for both postoperative complications and suboptimal patient satisfaction. In order to assess risk factors for poor satisfaction, we reviewed patients who had been prospectively recruited in a national multi-institutional registry of penile prostheses procedures (INSIST-ED) from 2014 to 20121. Patient baseline characteristics and postoperative complications were recorded. The primary endpoint of this study was unfavorable outcomes after inflatable PPI, defined as significant postoperative complications (Clavien-Dindo ≥2) and/or Sexuality with Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) scores below the 10th percentile. A total of 256 patients were included in the study. The median age was 60 years (IQR 56-67). The most common cause of erectile dysfunction (ED) was organic (42.2%), followed by pelvic surgery/radiotherapy (39.8%) and Peyronie's disease (18.0%). Postoperative complications were recorded in 9.6%. High-grade complications (Clavien ≥2) occurred in 4.7%. At 1-year follow-up, the median QoLSPP total score was 71 (IQR 65-76). In all, 14.8% of patients were classified as having experienced unfavorable outcomes because of significant postoperative complications and/or QoLSPP scores below the 10th percentile. Logistic regression analysis demonstrated patient age to be non-linearly associated with the risk of experiencing unfavorable outcomes. A U-shaped correlation showed a lower risk for younger and older patients and a higher risk for middle-aged men. ED etiology and surgical volume were not associated with PPI outcomes. Physicians should, therefore, be aware that middle-aged men may be at higher risk of being unsatisfied following PPI compared to both younger and older patients.
与所有手术一样，阴茎假体植入术（PPI）术后既有发生并发症的可能性，患者满意度也可能不尽人意。为了评估导致满意度低的风险因素，我们回顾了2014年至2012年在一项全国多机构阴茎假体手术登记处（INSIST-ED）前瞻性招募的患者。记录了患者的基线特征和术后并发症。本研究的主要终点是可膨胀性PPI术后的不良结局，定义为严重术后并发症（Clavien-Dindo≥2级）和/或生活质量与阴茎假体性功能（QoLSPP）评分低于第10百分位数。共有256例患者纳入本研究。中位年龄为60岁（四分位间距56 - 67岁）。勃起功能障碍（ED）最常见的病因是器质性（42.2%），其次是盆腔手术/放疗（39.8%）和佩罗尼氏病（18.0%）。术后并发症发生率为9.6%。高级别并发症（Clavien≥2级）发生率为4.7%。在1年随访时，QoLSPP总分的中位数为71分（四分位间距65 - 76分）。总体而言，14.8%的患者因严重术后并发症和/或QoLSPP评分低于第10百分位数而被归类为经历了不良结局。逻辑回归分析表明，患者年龄与不良结局风险呈非线性相关。呈U形相关性，即年轻和老年患者风险较低，中年男性风险较高。ED病因和手术量与PPI结局无关。因此，医生应意识到，与年轻和老年患者相比，中年男性PPI术后不满意的风险可能更高。
