Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Sección de Urología Funcional, Reconstructiva y Andrología-Servicio de Urología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Actas Urol Esp (Engl Ed). 2024 Jun;48(5):392-397. doi: 10.1016/j.acuroe.2024.02.003. Epub 2024 Feb 15.
Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. However, patients with coexistent Peyronie's disease (PD) and refractory erectile dysfunction and/or severe deformities may show different results. The aim of our study was to assess and to compare the level of satisfaction, with an inflatable penile prosthesis (IPP), in men with/without coexistent PD.
A survey study based on a five-item satisfaction questionnaire was submitted to all those live patients implanted in the period 1992-2022 at our center (n=570) and their partners. Ninety-two percent of implants were inflatable devices. Surgeries were mainly performed by two surgeons. The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after IPP.
Of the 570 eligible patients, 479 (84%) completed the survey (393 Non-PD: GROUP 1; 70 non-complex PD-Group 2; 16 complex PD). Eighty-six per cent of patients in Group 1 reported satisfactory sexual intercourse (very or moderately satisfied). Non-complex PD implanted patients (Group 2) reported a global 81% satisfactory sexual intercourse (very or moderately satisfied) (p>0.05). However, when we evaluated the PD subgroup of patients with severe PD who require incision/excision/grafting at the time of implant (Group 3: n=20), only 61% reported satisfactory sexual intercourse (p<0.01) with predominance of moderately satisfied patients over very satisfied: 78% vs. 22%). Additionally, 84% (Group 1), 80% (Group 2) and 54% (Group 3) of partners reported satisfactory intercourses, respectively (p<0.01). Overall, 84% of Group 1 implants and 79% of Group 2 reported that they would undergo the procedure again if the IPP failed (p>0.05; ns). Only 50% of Group 3 patients would do it again. With regard to cosmetic aspects, 48% of the Group 3 implant reported penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of total PP patients expressed difficulty in manipulating the device.
The presence of PD alone may not impact PP patient and partner satisfaction, but patients with more severe baseline deformity who require incision/grafting may be less satisfied with outcomes including penile length and glans sensation.
在治疗勃起功能障碍的众多方法中，阴茎假体植入术已被证明能带来较高的患者满意度。然而，对于同时患有 Peyronie 病（PD）和难治性勃起功能障碍以及/或严重畸形的患者，结果可能有所不同。本研究旨在评估和比较伴有/不伴有 PD 的患者对可膨胀性阴茎假体（IPP）的满意度。
本研究采用基于五项满意度问卷的调查研究，向在我们中心接受植入治疗的所有患者（n=570）及其伴侣发放问卷。92%的植入物为可膨胀设备。手术主要由两位外科医生进行。主要的观察指标是患者和伴侣对 IPP 后性生活的满意度。
在 570 名符合条件的患者中，有 479 名（84%）完成了调查（393 名非 PD 患者：第 1 组；70 名非复杂 PD 患者：第 2 组；16 名复杂 PD 患者：第 3 组）。第 1 组 86%的患者报告性生活满意（非常满意或满意）。非复杂 PD 植入患者（第 2 组）报告的总体性生活满意度为 81%（非常满意或满意）（p>0.05）。然而，当我们评估 PD 亚组中需要在植入时进行切口/切除/移植的严重 PD 患者（第 3 组：n=20）时，只有 61%报告性生活满意（p<0.01），中度满意患者多于非常满意患者：78%比 22%）。此外，第 1 组、第 2 组和第 3 组的伴侣分别有 84%、80%和 54%报告性生活满意（p<0.01）。总体而言，第 1 组的 84%和第 2 组的 79%的植入患者表示如果 IPP 失败，他们将再次接受该手术（p>0.05；无统计学意义）。只有 50%的第 3 组患者会再次接受该手术。关于美容方面，第 3 组植入患者中 48%报告阴茎缩短或龟头柔软是他们不满意的主要原因。只有 2.4%的总 IPP 患者表示在操作设备方面有困难。
单纯 PD 本身可能不会影响患者和伴侣对 IPP 的满意度，但基线畸形程度更严重、需要切口/移植的患者可能对包括阴茎长度和龟头感觉在内的结果满意度较低。
