Inflatable penile prosthesis placement in men with Peyronie's disease and drug-resistant erectile dysfunction: A single-center study.
BACKGROUND
Erectile dysfunction (ED) frequently accompanies Peyronie's disease (PD) and changes the therapeutic approach.


OBJECTIVE
To evaluate a single-center experience with inflatable penile prostheses (IPP) in men with medication refractory ED and PD.


METHODS
Ninety men underwent placement of an IPP with straightening maneuvers as necessary to address their deformity and ED.


METHODS
Preoperative assessment included International Index of Erectile Function-erectile function domain (IIEF-EF) and duplex ultrasound to confirm ED and measure erect deformity. Postoperative assessment included a modified Erectile Dysfunction Index of Treatment Satisfaction (EDITS) questionnaire, as well as office visits at 1, 6, and every 12 months thereafter.


RESULTS
Complete chart review was performed with mean follow-up of 49 months. Mean preoperative IIEF-EF score was 11. Full rigidity was not obtained in any patient during duplex ultrasound. Mean curvature at maximum erection was 53°. There were seven mechanical failures requiring device replacement, two revision surgeries for pump or reservoir malposition, one infected device, and two corporoplasties for distal tunica erosion. Postoperative office assessment revealed a functionally straight (i.e., <20°) erect penis and a properly positioned as well as operational device in all patients. The modified EDITS questionnaire was returned by 56 (62%). Overall, 84% of patients were satisfied with their outcome, yet only 73% were satisfied with their straightness. Patient perceived postoperative curvature correction stabilized quickly and was complete by 3 months in 84% of patients. Satisfaction with ease of inflation, deflation, and concealability was 84%, 71%, and 91%, respectively. Coital activity was reported by 91% of men in this group.


CONCLUSIONS
In men with PD and ED, IPP placement allowed reliable and satisfactory coitus for the great majority of men. Mechanical failure was 7%. Men with PD undergoing IPP placement should be counseled regarding potential penile length loss and residual curvature, neither of which appeared to interfere with coitus but may reduce satisfaction.
Levine
Laurence A
LA
Department of Urology, Rush University Medical Center, Chicago, IL, USA. drlevine@hotmail.com
Benson
Jonas
J
Hoover
Christopher
C
D000328:Adult; D000368:Aged; D004351:Drug Resistance; D006305:Health Status Indicators; D006801:Humans; D018783:Impotence, Vasculogenic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D015917:Penile Prosthesis; D010413:Penis / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014463:Ultrasonography