Patient and partner satisfaction with the mentor alpha-1 inflatable penile prosthesis

Sexual functions of females married to males with semi-rigid penile implant: A cross-sectional study

Erectile dysfunction is a highly prevalent disorder. It is estimated that more than 50% of men who ranged in age from 40 to 70 years old suffer from erectile dysfunction to some degree. We aimed in this pilot cross-sectional study to determine female sexual function and social satisfaction before and 6 months after penile prosthesis implant. This study was carried on 50 consecutive married women whose husbands underwent malleable penile prosthesis implant in our department from July 2015 to July 2016. Our results showed significant increase in desire, lubrication, orgasm, and satisfaction scores after 6 months of penile prosthesis operation compared to scores before penile prosthesis implant (p < 0.001). Moreover, our study demonstrated significant increase in lubrication score in non-female genital mutilation after penile prosthesis implant (p 0.049). In addition, the results showed inverse correlations between age and female genital mutilation and female sexual function index scores after penile prosthesis implant. On the contrary, there were no correlations between number of offsprings and residence and duration of marriage and different domains of female sexual function index scores. Finally, penile prosthesis operation for patients with erectile dysfunction has a great impact on sexual functions of their female partners. We recommend preoperative and postoperative female partner involvement as a part of the treatment strategy for men undergoing penile prosthesis implant.

Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation

INTRODUCTION

Studies have demonstrated high levels of satisfaction with penile prosthesis implantation (PPI). However, qualitative research exploring the experience of PPI through men's narratives is scarce.

AIM

The main goals were to analyze (i) the level of sexual satisfaction (quantitatively), and (ii) the reasons for satisfaction and/or dissatisfaction with PPI (qualitatively).

METHOD

Participants were 47 men with erectile dysfunction who underwent surgery between 2003 and 2012, placed by a single surgeon. Structured telephone interviews were carried out.

MAIN OUTCOME MEASURES

Satisfaction with PPI was a qualitative and quantitative measure assessed through the following four items: (i) "Would you repeat the PPI surgery?"; (ii) "Would you recommend the PPI surgery?"; (iii) "How satisfied are you with the PP?"; and (iv) "Could you explain the motives of your satisfaction/dissatisfaction?".

RESULTS

The majority of men (79%) reported to be satisfied with PPI. Content analysis revealed four main themes for men's satisfaction with the PPI: (i) psychological factors were reported 54 times (n = 54) and included positive emotions, self-esteem, confidence, enhancement of male identity, major live change, and self-image; (ii) improvement of sexual function was reported 54 times (n = 54) and referred to achievement of vaginal penetration, increase of sexual desire, sexual satisfaction, penis size, and improvement of erectile function; (iii) relationship factors were reported 11 times (n = 11) and referred to relationship improvement and the possibility of giving pleasure to the partner; and (iv) improvement in urinary function (n = 3).

CONCLUSIONS

The level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for erectile dysfunction with a positive impact on the experience of men at sexual, psychological and relational level.

A questionnaire for the evaluation of quality of life after penile prosthesis implant: quality of life and sexuality with penile prosthesis (QoLSPP): to what extent does the implant affect the patient's life?

INTRODUCTION

Penile prosthesis implantation is considered to be a satisfactory treatment for erectile dysfunction. Previous studies have assessed mainly prosthesis function and perioperative complications and have measured satisfaction only with regard to sexual performance. Very little, if anything, has been reported on the most relevant question: To what extent does the implant affect the patient's life?

AIM

To develop and validate the pathology-specific Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire, which evaluates patients' quality of life after penile prosthesis implantation.

METHODS

Sixty-nine patients aged 32-82 years who received a three-component hydraulic prosthesis between 1997 and 2009 participated in the study; 47 participated in the retest of the instrument. The QoLSPP questionnaire was developed to examine general and sexual quality of life in four domains: functional, personal, relational, and social. All psychometric properties of the QoLSPP were validated. Internal validity was assessed by means of exploratory factor analysis. Cronbach's alpha was used to evaluate the internal consistency of the items within each factor. Paired-sample t-tests were used to investigate metric stability. Independent-samples t-tests and nonparametric tests were used to evaluate the sensitivity.

MAIN OUTCOME MEASURES

The main outcome measure for the questionnaire was quality of life as biological and psychosocial-relational well-being. Main outcome measures for validation were internal validity, metric stability, and sensitivity of the QoLSPP.

RESULTS

The QoLSPP met the psychometric requirements of internal validity and reliability. Metric stability and sensitivity were tested and confirmed. Respondents reported high satisfaction levels in all quality of life domains. All domains were significantly and positively correlated; the functional domain was most predictive of overall quality of life. More than half of respondents perceived their partners to be very satisfied.

CONCLUSIONS

Prosthesis implantation was correlated with high quality of life in recipients and high perceived quality of couple relationships; partner satisfaction affected patients' quality of life, self-image, relation to the outside world, and satisfaction with implant function.

High patient satisfaction after inflatable penile prostheses implantation correlates with female partner satisfaction

INTRODUCTION

Patient and female partner satisfaction after implantation of an inflatable penile prosthesis (IPP) assessed by objective means, and the correlation between the partners, is important for determining postoperative sexual life.

AIM

The primary goal was to evaluate patients' erectile function and patients' and their partners' satisfaction after IPP implantation. A secondary aim was to investigate potential determinative factors of satisfaction according to device characteristics, demographics, and cause of erectile dysfunction (ED).

METHODS

Ninety patients, who underwent IPP implantation as an alternative to refractory or undesirable medical treatment for ED, were evaluated. Patients who could not or refused to participate, or were out of a relationship, were excluded. The 69 remaining patients were evaluated for their pre- and postoperative erectile function and posttreatment satisfaction for themselves and their partners.

MAIN OUTCOME MEASURES

Preoperative and postoperative scores on the International Index of Erectile Function Questionnaire-five items (IIEF-5) were compared. The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) was given to males and their female partners. Patient demographics, etiology of ED, and implant characteristics were correlated also with patients' EDITS scores.

RESULTS

Mean IIEF-5 scores demonstrated a significant improvement after IPP implantation: from 8.88±3.75 to 20.97±4.37 (P<0.001). The mean patients' EDITS score was 75.48±20.54, whereas mean female partners' score was 70.00±22.92, highlighting high posttreatment satisfaction for both. Regression analysis suggested a direct linear correlation of satisfaction between the sexual partners as a degree of satisfaction. There were no statistically significant differences according to level of education or implant characteristics. Concerning the etiology of ED, no conclusions could be made.

CONCLUSIONS

Overcoming previous limitations in determining post-IPP implantation satisfaction, our study reiterates high rates of patient and partner satisfaction. Of particular note, patient satisfaction appears independent of prosthesis type and cylinder length.

Satisfaction and complications with the Titan® one-touch release penile implant

OBJECTIVE

The aim of this study was to assess complication rates and patient satisfaction with Coloplast Titan® one-touch release (OTR) inflatable penile implants inserted at one university hospital centre between November 2008 and April 2011.

MATERIAL AND METHODS

Overall, 33 patients with organic erectile dysfunction underwent penile implant surgery during the study period. The Titan OTR inflatable penile implants were inserted using a penoscrotal approach. Patient and partner satisfaction was assessed with the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire.

RESULTS

One implant was removed because of infection, and three patients underwent revision surgery due to problems with autoinflation, deflation, and a displaced reservoir, respectively. In all cases the problems were solved and the implants were salvaged. Further complications included one patient with haematoma and sustained scrotal pain, one patient with meatal stenosis, and four patients with infections not related to the implant. In total, 30 EDITS questionnaires were administered and 26 (87%) were completed. Twenty-two patients (85%) reported being satisfied with the implant and two (8%) were dissatisfied. Twenty-four patients (92%) would recommend a penile implant to someone with a similar medical condition. Eighteen patients (72%) believed that their partner was satisfied with the implant. Nineteen patients (76%) felt that the process of achieving an erection with the implant was natural.

CONCLUSION

Although it is important to inform patients about potential problems such as infection, pain and mechanical failure, the results show that inflatable penile implants are a good treatment choice for erectile dysfunction when conservative measures have failed.

Three-piece Inflatable Penile Prosthesis: Surgical Techniques and Pitfalls

Penile prosthesis surgery plays a vital role in the treatment of erectile dysfunction (ED). As far as outcome is concerned, it is one of the most rewarding procedures for both patients and surgeons. We describe our surgical technique for implantation of the three-piece inflatable penile prosthesis and point out the major surgical pitfalls accompanying this procedure and their specific management. The psychological outcome of penile prosthesis surgery is also discussed. Different surgical approaches are available when performing the procedure. A number of procedure-related problems can be encountered and a thorough knowledge of these is of paramount importance. Penile prosthesis surgery has a favorable psychological outcome. Surgery for implantation of an inflatable penile prosthesis is a rewarding procedure, with a high yield of patient satisfaction. Urologists should have thorough understanding of the surgical pitfalls peculiar to this procedure and their management.

Prospective evaluation of patient satisfaction, and surgeon and patient trainer assessment of the Coloplast titan one touch release three-piece inflatable penile prosthesis

INTRODUCTION

A single-armed, prospective, multicenter international study evaluated the redesigned Coloplast Titan One Touch Release (OTR) pump inflatable penile prosthesis. The OTR pump has a unique release valve that permits deflation of the implant with one squeeze of opposing touch pads.

AIMS

To assess the impact of a new penile prosthesis design, the Titan OTR, on patient ease of operation. Furthermore, to assess patient satisfaction, surgeon acceptance, and the ease with which patients were trained in device operation in the clinic setting.

METHODS

A total of 113 eligible patients from eight centers were recruited from men presenting with erectile dysfunction without prior prosthetic implantation. The subjects had a mean age of 61 years, and had a number of comorbidities, including diabetes (31.9%), hypertension (34.5%), and Peyronie's disease (23.9%). All underwent implantation of the study device.

MAIN OUTCOME MEASURES

Questionnaires were used to capture patient satisfaction as well as physician feedback on ease of implantation and patient education. A paired analysis was completed for patient satisfaction at 6 (N = 96) and 12 (N = 90) months.

RESULTS

Overall satisfaction with the device was 90.6% and 90.0% at 6 and 12 months, respectively. The primary end point, ease of deflation, was seen in 70.8% and 73.3% at these two time points, with the 12-month value statistically better than historical controls. Physicians overwhelmingly reported straightforward/simple intraoperative product preparation (97.3%) and equivalent or easier training compared with their previous pump of choice (96.4%). Adverse events for all subjects (N = 113) included removal of the device in four cases (3.5%) for infection and one case for chronic pain (0.8%).

CONCLUSIONS

The Titan OTR represents an advance in penile prosthetic technology that is well accepted by patients and physicians. The study design allowed for realistic evaluation of the new technology aimed at enhancing clinical outcomes.

Favorable female sexual function is associated with patient satisfaction after inflatable penile prosthesis implantation

INTRODUCTION

The interrelationship between male and female sexual function suggests that partner outcomes after inflatable penile prosthesis (IPP) implantation must be assessed.

AIM

We examined predictors of patient and partner satisfaction, and the relationship between patient satisfaction and female sexual function, after IPP implantation.

METHODS

We designed a questionnaire (scored 1-5) assessing satisfaction with various domains related to the IPP (e.g., overall satisfaction and satisfaction related to: length, width, ease of use, and partner perception). Scores ≥3 were classified as satisfied. The Female Sexual Function Index (FSFI) was administered to the female partners of patients that underwent an IPP.

MAIN OUTCOME MEASURES

Independent samples Students' t-test was used to compare various FSFI domain scores in relation to male and female satisfaction. Analysis of variance test was used to assess linear regression correlation between various continuous variables.

RESULTS

45 men and 32 partners with a mean follow-up of 2.2 years were contacted. Overall satisfaction for men and women was 3.60 and 3.62 (out of 5), respectively. Partner FSFI scores were higher, respectively, in men with higher implant satisfaction than those with lower implant satisfaction (25.09 ± 6.79 vs. 13.67 ± 12.70, P < 0.001). Regression analysis suggests a direct correlation between FSFI scores and the degree of patient (r = 0.50, r(2) = 0.23; P = 0.001) and partner (r = 0.70 r(2) = 0.50; P < 0.001) satisfaction with the IPP.

CONCLUSION

Patient satisfaction after IPP implantation implies favorable partner sexual function compared to that of unsatisfied patients. The correlation observed suggests that patients not satisfied with their IPP are likely to have female partners at high risk for female sexual dysfunction. Further interventions may be needed to improve patient and partner sexual function, particularly unsatisfied men and their female partners.

Penile prosthesis implantation: surgical implants in the era of oral medication

In patients who are not satisfied with the results of oral agents (phosphodiesterase-5 inhibitors) or in whom oral agents or other medical treatment fails to produce an adequate response, penile prosthesis implantation is an excellent treatment modality for restoring erectile function. Patient/partner acceptance, use, and satisfaction rates of penile pros-theses are better than for many other alternatives including pharmacologic injections. In-flatable penile prostheses are most frequently used and have the highest satisfaction rates. Complications of these multipiece prostheses continue to decline, and patient satisfaction rates, tolerability, and longevity continue to increase.