Valenzuela Robert J, Elist James J, Moon Daniel, Cvijanovic Luka, Wilson Steven K
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Emeritus, Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Int J Impot Res. 2024 Mar 5. doi: 10.1038/s41443-024-00857-y.
Erectile dysfunction is a major postoperative complication following radical prostatectomy. Various treatments for post- radical prostatectomy erectile dysfunction including nonsurgical phosphodiesterase-5 inhibitors, intraurethral alprostadil, intracavernosal injections and penile implant prosthesis, often yield suboptimal results. In this prospective single-center case series, we examine the efficacy and outcomes of Himplant, a subcutaneous silicone penile implant, placement in four patients with post-radical prostatectomy erectile dysfunction who experienced limited benefits with phosphodiesterase-5 inhibitors. Patient data including demographics, prostate cancer diagnoses, erectile dysfunction characteristics, previous treatments, and outcomes were collected. Himplant placement was performed in a standardized manner through a high scrotal incision in all cases. Follow-up evaluations were conducted to assess the effectiveness of the procedure and any associated complications. Patients were contacted and asked 15 questions regarding satisfaction and erectile function with the responses recorded. This study presents findings of high patient satisfaction, increases in flaccid penile length and girth, no incidence of adverse events, and improved erectile function following Himplant placement post-radical prostatectomy. Accordingly, we suggest Himplant placement in patients who are frustrated by their penile appearance and suffering from erectile dysfunction after radical prostatectomy. Further multicenter studies are warranted to validate these findings and assess long-term outcomes and patient-reported satisfaction.
勃起功能障碍是根治性前列腺切除术后的主要并发症。根治性前列腺切除术后勃起功能障碍的各种治疗方法,包括非手术的磷酸二酯酶-5抑制剂、尿道内前列地尔、海绵体内注射和阴茎植入假体,往往效果欠佳。在这个前瞻性单中心病例系列中,我们研究了皮下硅胶阴茎植入物Himplant对4例根治性前列腺切除术后勃起功能障碍患者的疗效和结果,这些患者使用磷酸二酯酶-5抑制剂的获益有限。收集了患者的数据,包括人口统计学资料、前列腺癌诊断、勃起功能障碍特征、既往治疗情况及结果。所有病例均通过高位阴囊切口以标准化方式进行Himplant植入。进行随访评估以评估该手术的有效性及任何相关并发症。与患者联系并询问了15个关于满意度和勃起功能的问题,并记录了回答。本研究呈现了患者满意度高、疲软阴茎长度和周长增加、无不良事件发生以及根治性前列腺切除术后植入Himplant后勃起功能改善的结果。因此,我们建议对因阴茎外观而沮丧且在根治性前列腺切除术后患有勃起功能障碍的患者进行Himplant植入。有必要进行进一步的多中心研究以验证这些发现并评估长期结果及患者报告的满意度。