INSIST-ED: Italian Society of Andrology registry on penile prosthesis surgery. First data analysis-Beyond the Abstract
Among them: costs of penile implants - in the present era of continuous budget constraints – that impact in device units availability in public settings, causing long waiting lists.
When it comes to attempts to negotiations with public Health Authorities to pursue, for instance, a better reimbursement for this surgery, it is difficult to provide reliable figures on the dimensions of penile implant surgery field, at least partly due to a significant number of procedures performed in the private environment, and it is not easy to get across with the message that severe ED is a significant medical condition that deserves treatment, and not an “hedonistic” issue.
With all this in mind the Italian Society of Andrology decided to realize the first National Registry of penile Implants created by a Scientific Society, with the chief goal to produce reliable data on the phenomenon “penile implant surgery”, and possibly on the benefits that this surgical intervention produces on recipients quality of life. Our paper presents the first baseline analysis of 367 procedures (that presently have reached the number of 475) entered in the Registry since December 2014 by 31 implanting surgeons operating in Italy, describing: patient demographics, percent of implanted device types (non-inflatable versus two and three-piece inflatable devices), ED etiologies, surgical strategies with focus on cases s/p radical pelvic surgery and Peyronie’s cases, and surgical settings (public versus private). We consider a key finding of our first baseline analysis that radical pelvic surgery is the leading primary cause of severe ED in first implant surgeries, accounting for 35,8% of all causes. Also the PROPPER study (1), the only other existing Registry on penile implants, ongoing in U.S.A., shares this finding. We believe that these data clearly show that penile implant surgery is not a sort of “lifestyle” surgery but a strategic tool to restore a key male function – erections – in men that developed ED as a consequence of significant medical conditions, as for instance cancer treatment.
Evaluation of penile implant impact on recipient quality of life is presently ongoing; possibly resulting data will add an important contribution to make penile prosthesis surgery acknowledged as a strategic, important surgical option for men with severe ED. We do hope that the first experiences of penile prosthesis surgery registries, INSIST-ED in Italy and PROPPER in U.S.A., will be soon followed by other Countries, so to generate a great amount of prospective, multicenter, multinational, comparable data for the benefit of our patients - better Public Health policies, and possibly also of physicians - definition of the best surgical standards.
Written by: Edoardo S. Pescatori Andrology Service, Hesperia Hospital, Modena – ITALY
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Bibliography:
Henry GD, Karpman E, Brant W et al: The Who, How and What of Real-World Penile Implantation in 2015: The PROPPER Registry Baseline Data. J Urol. 2016;195(2):427-33