Predictors of Satisfaction in Men After Penile Implant Surgery

Despite the high satisfaction with penile implant (PI) surgery reported in the literature, a significant proportion of patients remain dissatisfied.

To evaluate satisfaction after PI surgery, using a single question and a scoring system. Furthermore, we attempted to define factors that predicted high patient satisfaction.

The study population consisted of all patients undergoing PI surgery between 2009 and 2015. Comorbidity, demographic, and implant information were recorded. Complications recorded included: minor (requiring no re-operation) such as penile or scrotal hematoma, superficial wound breakdown; major (requiring hospitalization or re-operation) such as device infection, erosion, and mechanical malfunction. Patient satisfaction was defined using a single question posed to the patient 6 months after surgery using a 5-point Likert scale (5 being the most satisfied). Descriptive statistics were used to define complication rates and multivariable analysis (MVA) was performed to define predictors of high satisfaction (score ≥ 4), including presence and degree of complications, Peyronie's disease (PD), diabetes mellitus (DM), number of vascular comorbidities, body mass index (BMI) > 30, and patient age.

Patients with a major complication, with or without an additional minor complication, had a higher likelihood of being dissatisfied (25%) compared to patients with no complication or only minor complication 1.9% (no complications) and 3.7% (only minor complications), P < .001.

902 patients were analysed. Mean age was 56.6 ± 10.6 years. Mean BMI was 30 ± 5. Comorbidity profile was diabetes 75%, dyslipidaemia 44%, hypertension 33%, cigarette smoking 32%, and PD 34%. 76% had a malleable implant (MPP) and 24% an inflatable implant (IPP). 31% had a minor complication and 9% a major complication. 93% had high satisfaction (score ≥4). Patients with any complication had a reduced rate of high satisfaction (97.5% vs 87.7%; P < .001) and even more pronounced with a major complication (96.7% vs 64.2%; P < .001). On MVA, only the absence of a major complication was a significant predictor of high satisfaction (OR 20, 95% CI 9-50, P < .001).

A high percentage of men are satisfied after penile implant surgery. Only the presence of a major complication is linked to a lower likelihood of achieving high satisfaction. Habous M, Tal R, Tealab A, et al. Predictors of Satisfaction in Men After Penile Implant Surgery. J Sex Med 2018;XX:XXX-XXX.

The journal of sexual medicine. 2018 Jul 12 [Epub ahead of print]

Mohamad Habous, Raanan Tal, Alaa Tealab, Mohammed Aziz, Hammoda Sherif, Saad Mahmoud, Osama Abdelwahab, Mohammed Nassar, Usama Kamil, Ziad Abdelrahman, Saleh Binsaleh, Simone Giona, David Ralph, Carlo Bettocchi, John P Mulhall

Urology and Andrology Department, Elaj Medical Centers, Riyadh, Saudi Arabia. Electronic address: ., Sexual and Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Urology Department, Zagazig University, Zagazig, Egypt., Urology Department, Menoufia University, Al Minufya, Egypt., Urology Department, Benha University, Benha City, Egypt., Urology and Andrology Department, Elaj Medical Centers, Riyadh, Saudi Arabia., Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia., King's College, Hospital, London, UK., St. Peter's Institute of Andrology, University College London Hospital, London, UK., Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.