A 10-year audit of penile prosthesis insertion

Introduction 

Penile prosthesis (PP) insertion is the gold standard surgical treatment option for men with refractory Erectile Dysfunction (ED). PP insertion is considered effective but has a well-documented array of complications. Our aim was to assess outcomes following single-surgeon insertion of PP for ED within an Irish cohort. 

Methods 

Following review of the Hospital In-Patient Enquiry (HIPE) system, a retrospective chart review of all patients who underwent PP insertion over a 10-year period from 2008-2017 inclusive was performed, and an electronic database was analysed for results. 

Results 

One-hundred-and-eleven PPs were inserted in 96 patients. The most common aetiology for ED in our cohort was post-prostatectomy, affecting 25 (26%) patients. The most frequently implanted device was a 3-piece inflatable PP (3p-IPP) (AMS 700TM; American Medical Systems Inc., Minnesota, USA) and the peno-scrotal approach was utilised in the majority of patients (86, 77.5%). No intraoperative complications were recorded. Twelve (12.5%) patients developed peri-operative complications. Thirteen (13.5%) patients required device revision, the majority for device failure. Of the 71 patient satisfaction responses, 61 (85.9%) patients were satisfied with their PP. 

Conclusions 

This single-surgeon retrospective audit of PP surgery demonstrates complication rates in-line with internationally published data. Patients should be adequately counselled regarding possible complications, including device failure and erosion. PP insertion should be considered for suitable patients with refractory ED.