Dighero Isabel, Naylor Katy, Looney Aisling, Holden Fiona, Mount Chloe, Johnson Mark, Lee Wai Gin, Ralph David, Sangster Philippa
University College London Hospital (UCLH), London, UK.
University College London (UCL), London, UK.
Int J Impot Res. 2025 Jul 25. doi: 10.1038/s41443-025-01073-y.
Penile prosthesis insertion is recommended for long-duration ischaemic priapism patients with refractory erectile dysfunction. There is a paucity of published data focusing on long term outcomes and quality of life reporting for patients in this setting. We contacted patients who had a post-ischaemic priapism penile prosthesis inserted in our department via telephone and conducted the previously validated Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Question items were answered on a Likert scale from 0-5 with satisfactory scores ≥3. Two-tailed Z-tests were used to determine satisfactory scores at significant levels (p < 0.05). We chose to add two additional questions on regret and feelings towards living the rest of their lives with a penile prosthesis. 167 patients had penile prostheses inserted post- ischaemic priapism between 2002-2022. Of these, 39 (23.4%; implants between 2007-2021) completed our questionnaire. The median age was 56 years (IQR 50-63) with a median time to questionnaire post-ischaemic priapism of 9 years (IQR 3-11). Analysing the QoLSPP mean item responses, the penile prosthesis resulted in satisfactory scores in 7 of 16 QoLSPP questionnaire items: device adequacy, device rapidity, device duration, meeting expectations, contentment with life, general well-being and sexual experience. The pooled mean score by domain was 3.7 ± 1.2 for functional, 3.3 ± 1.4 for relational, 3.2 ± 1 for social and 3.4 ± 1.1 for personal. Sub-group analysis demonstrated no significant difference in mean score by prosthesis type (inflatable versus malleable). Ten respondents cited specific reasons for how the penile prosthesis caused dissatisfaction. All 39 respondents (100%) answered 'yes', they did not regret penile prosthesis insertion as a treatment option and that they would be satisfied living the remainder of their lives with a device in situ. This study can be used to inform patient counselling, that penile prosthesis insertion is a suitable surgical technique to maintain sexual function post-ischaemic priapism.
对于患有难治性勃起功能障碍的长期缺血性阴茎异常勃起患者，建议进行阴茎假体植入。目前针对这一情况的患者长期预后及生活质量报告的已发表数据较少。我们通过电话联系了在我院接受缺血性阴茎异常勃起后阴茎假体植入的患者，并进行了先前经验证的阴茎假体生活质量与性功能问卷（QoLSPP）调查。问卷项目采用0至5分的李克特量表进行回答，满意分数≥3分。采用双侧Z检验确定在显著水平（p < 0.05）下的满意分数。我们选择增加两个关于后悔以及对余生携带阴茎假体生活感受的额外问题。2002年至2022年间，有167名患者在缺血性阴茎异常勃起后植入了阴茎假体。其中，39名（23.4%；2007年至2021年间植入）完成了我们的问卷。中位年龄为56岁（四分位间距50 - 63岁），缺血性阴茎异常勃起后至问卷调查的中位时间为9年（四分位间距3 - 11年）。分析QoLSPP平均项目回答，阴茎假体在QoLSPP问卷的16个项目中的7个项目上获得了满意分数：装置充足性、装置快速性、装置持续时间、符合期望、生活满意度、总体幸福感和性体验。各领域的合并平均分数为：功能领域3.7 ± 1.2分，关系领域3.3 ± 1.4分，社会领域3.2 ± 1分，个人领域3.4 ± 1.1分。亚组分析表明，不同类型假体（可膨胀型与可弯曲型）的平均分数无显著差异。10名受访者列举了阴茎假体导致不满意的具体原因；所有39名受访者（100%）回答“是”，他们不后悔将阴茎假体植入作为一种治疗选择，并且对余生携带该装置生活感到满意。本研究可用于指导患者咨询，即阴茎假体植入是维持缺血性阴茎异常勃起后性功能的一种合适手术技术。
