title: Penile implantation in Europe: successes and complications with 253 implants in Italy and Germany.
abstract: BACKGROUND
  Results for prosthesis implantation from everyday clinical practice within Europe are few. This report provides data on the most commonly used penile prostheses (the American Medical Systems [AMS] series).
  
  
  OBJECTIVE
  The study aimed to assess, retrospectively, complications and patient satisfaction with AMS penile implants in 253 consecutive patients with erectile dysfunction from three European centers.
  
  
  METHODS
  Pre, intra- and postoperative data were obtained from chart review, with a mean follow-up of 60 months; 200 patients were available for evaluation. Patient satisfaction data were collected using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire.
  
  
  METHODS
  Complications and patient satisfaction were assessed. Patient satisfaction was evaluated using a standardized assessment tool (the modified EDITS questionnaire).
  
  
  RESULTS
  Major postoperative complications occurred in 40 (20%) patients, including 9 (22.5%) prosthesis infections, 18 (45%) mechanical failures, and 13 (32.5%) erosions. Patient satisfaction with the AMS 700CX, AMS Ambicor, and AMS 600-650 was 97%, 81%, and 75%, respectively; dissatisfaction was 0%, 5%, and 6%, respectively. Partner satisfaction with the AMS 700CX, AMS Ambicor, and AMS 600-650 was 91%, 91%, and 75%, respectively; dissatisfaction was 0%, 5%, and 6%, respectively. Erections were more natural (harder) than before with the AMS 700CX, AMS Ambicor, and AMS 600-650 in 91%, 85%, and 88%, respectively; hardness was the same as before in 9%, 15%, and 13%, respectively; no erections were less hard than before.
  
  
  CONCLUSIONS
  Postoperative complications differed from those reported in the literature, while patient satisfaction rates were roughly similar. The reporting of specific data for different implant types, plus the use of standardized assessment tools for patient satisfaction is significant as in the future, it will allow comparison of data between centers performing penile prosthesis implants using these devices.
authors.affiliation: Uro-Andrological Unit, Department of Urology, University of Florence, Florence, Italy. anatali@dada.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Natali
authors.forename: Roberto
authors.initials: R
authors.lastname: Olianas
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
mesh_terms: D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000601:surgery*; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010410:Penile Erection; D015917:Penile Prosthesis; D011183:Postoperative Complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D012747:Sexual Partners