Xu Mark, Policastro Connor, Wolff Dylan, Namugosa Mary, Ritts Rory, Escott Megan, Terlecki Ryan
Department of Urology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Int J Impot Res. 2025 Aug 6. doi: 10.1038/s41443-025-01149-9.
Depression and anxiety are often comorbid with erectile dysfunction and are linked to worse surgical outcomes. We aimed to determine if depression/anxiety increased complication rates in inflatable penile prosthesis (IPP) surgery. All IPP cases by a single surgeon at our institution from 2020-2022 were reviewed. Data was collected on demographics, medical/psychiatric history, intraoperative details, and post-operative outcomes. Univariate, multivariate, and survival analysis were performed to assess relationships between patient factors and complications. 279 IPP cases were performed. Anxiety/depression was significantly associated with post operative complications (p = 0.002) and infection (p = 0.024). Anxiety/depression is independently associated with increased complications in a multivariable logistic regression model including age, BMI, diabetes, primary surgery, smoking status, pelvic surgery, radiation, Peyronie's disease, and correctly holding anticoagulation. Survival analysis showed that anxiety and depression both resulted in faster times to complication and re-operation (all p < 0.05). This is the first study assessing the impact of mental health on IPP outcomes. Urologists should consider mental health when evaluating patients for IPP surgery, and mental health treatment prior to surgery may improve outcomes.
抑郁症和焦虑症常与勃起功能障碍合并出现，且与更差的手术结果相关。我们旨在确定抑郁/焦虑是否会增加可膨胀阴茎假体（IPP）手术的并发症发生率。回顾了我们机构一名外科医生在2020年至2022年期间进行的所有IPP病例。收集了有关人口统计学、医学/精神病史、术中细节和术后结果的数据。进行单变量、多变量和生存分析以评估患者因素与并发症之间的关系。共进行了279例IPP手术。焦虑/抑郁与术后并发症（p = 0.002）和感染（p = 0.024）显著相关。在一个包括年龄、体重指数、糖尿病、初次手术、吸烟状况、盆腔手术、放疗、佩罗尼氏病和正确使用抗凝药物的多变量逻辑回归模型中，焦虑/抑郁与并发症增加独立相关。生存分析表明，焦虑和抑郁均导致并发症和再次手术的时间更快（所有p < 0.05）。这是第一项评估心理健康对IPP手术结果影响的研究。泌尿外科医生在评估患者进行IPP手术时应考虑心理健康，术前进行心理健康治疗可能会改善手术结果。
