LONG TERM RESULTS OF PENILE PROSTHESIS INSERTION FOR TREATMENT OF ERECTILE DYSFUNCTION: OUR EXPERIENCE WITH 447 PATIENTS

Objective: To evaluate the long-term results of penile prosthesis surgery performed at one institution comparing satisfaction rates with different type of prosthesis. Materials and Methods: We review the notes of 447 men who had 504 penile prosthesis implanted between August 1975 and December 2000. The mean follow-up was 50 months (range 1-¬297) and included a questionnaire or telephone call. Results: Patients mean age was 52 years (range 21-78) with 404 being primary implants and 43 having had a previous failed implantation elsewhere. Types of prosthesis inserted: 3-piece inflatable device (81), inflatable self-contained device (30), malleable prosthesis (393). Twenty-two patients were lost to follow up and 26 (5,8%) had their prosthesis removed and not replaced. Of the remaining 399 patients, 377 (94,5%) were having sexual intercourse and 338 (84,7%) were satisfied with the outcome. Specific satisfaction rates of different type of prosthesis were as follow: Mentor 3-piece inflatable, 86% (24 patients, mean follow up 32 months, range 1-144 months); AMS 3-piece inflatable, 81% (34 patients, mean 39 months, range 1¬142); Mentor malleable, 88% (206 patients, mean 55 months, range 1-199); AMS malleable, 89% (40 patients, mean 59 months, range 1-168) and Small Carrion, 75% (70 patients, 46 months, range 1-297). Overall, the AMS self contained prosthesis were inserted in 25 patients of whom 5 have their prosthesis replaced with a different type and 4 have their prosthesis removed and not replaced. The satisfaction rate of the remained sixteen patients was 81% (mean 46 months, range 1¬-150). Conciusion: The majority of patients (84,7%) are extremely satisfied with penile prosthetic surgery. Satisfaction rates with different types of prosthesis are very similar and very high with the exception of Small Carrion prosthesis.