PMID- 31501062 OWN - NLM STAT- MEDLINE DCOM- 20200706 LR - 20200706 IS - 1743-6109 (Electronic) IS - 1743-6095 (Linking) VI - 16 IP - 11 DP - 2019 Nov TI - Long-Term Follow-Up After Penile Prosthesis Implantation-Survival and Quality of Life Outcomes. PG - 1827-1833 LID - S1743-6095(19)31359-1 [pii] LID - 10.1016/j.jsxm.2019.08.001 [doi] AB - INTRODUCTION: Hydraulic penile prostheses have shown an overall good mechanical reliability up to 10 years after surgery; however, few data have been published on very long-term follow-up. AIM: We looked at long-term (>/=15 years) complications, including functional and quality of life (QoL) outcomes, after 3-piece inflatable penile prosthesis (IPP) implantation in patients with erectile dysfunction (ED). METHODS: Data regarding 149 patients submitting to IPP placement before 2001 were analyzed. All patients were implanted with AMS CX and Ultrex Plus 3-piece prostheses. MAIN OUTCOME MEASURE: Patients were reassessed to evaluate rates of complications and functional outcomes. The validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) was used to assess patient QoL. Kaplan-Meier analysis estimated the probability of prosthesis survival (defined as working device/not-explanted). RESULTS: Median follow-up of 51 patients was 206 months (interquartile range [IQR], 145-257). The etiology of ED was vasculogenic (n = 20; 39%), Peyronie's disease (n = 15; 29%), pelvic surgery (n = 4; 7.8%), organic other than vasculogenic (n = 3; 5.9%), or other (n = 9; 18%). Throughout the follow-up, 24 patients (49%) experienced complications: mechanical failure (n = 19; 79%), pain (n = 3; 12%), orgasmic dysfunctions (n = 1; 4.5%), or device infection (n = 1; 4.5%). The estimated IPP survival was 53% (95% CI, 36-67) at 20-year follow-up. Baseline characteristics (age, Charlson comorbidity index, body mass index, and erectile dysfunction etiology) were not significantly associated with the risk of IPP failure over time by Cox regression analysis. At 20-year follow-up, 41% (95% CI, 19-49) of the patients were still using the device. Among them, QoLSPP median domain scores were high: functional 22/25 (IQR, 20-23), relational 17/20 (IQR, 15-18), personal 14/15 (IQR, 12-15), and social 14/15 (IQR, 11-15). CLINICAL IMPLICATIONS: The longevity of the device and long-term satisfaction rates should be comprehensively discussed during patient consultation for IPP surgery. STRENGTHS & LIMITATIONS: To our knowledge, this is the first study reporting long-term QoL outcomes using a dedicated questionnaire for penile prostheses. The low response rate for the telephone interviews, the retrospective design of the study, and the relatively small number of patients are the main limitations. CONCLUSION: Long-term follow-up data after IPP placement showed that almost half of the devices still worked properly 20 years after the original penile implant, as 60% of patients were still using the device with high satisfaction and adequate QoL outcomes. Both patients and physicians should be aware of the expected life and outcomes of IPP implants. Chierigo F, Capogrosso P, Deho, et al. Long-Term Follow-Up After Penile Prosthesis Implantation-Survival and Quality of Life Outcomes. J Sex Med 2019;16:1827-1833. CI - Copyright (c) 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved. FAU - Chierigo, Francesco AU - Chierigo F AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Capogrosso, Paolo AU - Capogrosso P AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Deho, Federico AU - Deho F AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Pozzi, Edoardo AU - Pozzi E AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Universita Vita-Salute San Raffaele, Milan, Italy. FAU - Schifano, Nicolo AU - Schifano N AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. FAU - Belladelli, Federico AU - Belladelli F AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Universita Vita-Salute San Raffaele, Milan, Italy. FAU - Montorsi, Francesco AU - Montorsi F AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Universita Vita-Salute San Raffaele, Milan, Italy. FAU - Salonia, Andrea AU - Salonia A AD - Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Universita Vita-Salute San Raffaele, Milan, Italy. Electronic address: salonia.andrea@hsr.it. LA - eng PT - Journal Article DEP - 20190906 PL - Netherlands TA - J Sex Med JT - The journal of sexual medicine JID - 101230693 SB - IM CIN - J Urol. 2020 Mar;203(3):448. PMID: 31821077 MH - Aged MH - Erectile Dysfunction/etiology/surgery MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Patient Satisfaction MH - Penile Implantation/adverse effects/*statistics & numerical data MH - Penile Induration/surgery MH - *Penile Prosthesis/adverse effects MH - Prosthesis Failure MH - *Quality of Life MH - Reproducibility of Results MH - Retrospective Studies MH - Sexual Behavior MH - Surveys and Questionnaires OTO - NOTNLM OT - Erectile Dysfunction OT - Long-Term Follow-Up OT - Penile Prosthesis OT - QoLSPP OT - Satisfaction EDAT- 2019/09/11 06:00 MHDA- 2020/07/07 06:00 CRDT- 2019/09/11 06:00 PHST- 2019/05/09 00:00 [received] PHST- 2019/07/29 00:00 [revised] PHST- 2019/08/04 00:00 [accepted] PHST- 2019/09/11 06:00 [pubmed] PHST- 2020/07/07 06:00 [medline] PHST- 2019/09/11 06:00 [entrez] AID - S1743-6095(19)31359-1 [pii] AID - 10.1016/j.jsxm.2019.08.001 [doi] PST - ppublish SO - J Sex Med. 2019 Nov;16(11):1827-1833. doi: 10.1016/j.jsxm.2019.08.001. Epub 2019 Sep 6.