title: Penile prosthesis implantation for the treatment for male erectile dysfunction: clinical outcomes and lessons learnt after 955 procedures.
abstract: OBJECTIVE
  To evaluate the clinical outcomes of penile prosthesis implantation for the treatment for erectile dysfunction (ED) over 3 decades in a centre of excellence.
  
  
  METHODS
  A total of 955 penile prostheses were implanted between June 1981 and June 2010. The mean age of the men was 53.2 (28-80) years, and the mean follow-up was 76 (12-355) months. A total of 771 men had primary implants. The most common implant was Ultrex cylinder (54 %), and the main cause of ED was organic (32 %).
  
  
  RESULTS
  Primary implants showed higher rate of intra-operative complications than revision surgery (3.5 vs. 0.1 %) (p < 0.05). Prosthesis infection occurred in 0.8 % and equal incidence between diabetic and pelvic trauma patients. The average time to prosthetic revision was 102 (30-210) months. Kaplan-Meier estimates of overall penile prosthesis survival at 5 and 10 years were around 90.8 and 85.0 %. The most common mechanical failures were fluid loss (75 %). The majority of men were satisfied with the surgical outcomes, and 90 % of men would undergo penile prosthesis implant again.
  
  
  CONCLUSIONS
  Penile prosthesis surgery is a safe and durable treatment option for male ED. Strict adherence to antimicrobial prophylaxis and surgical practice is paramount to ensure low complication rates and high patient satisfaction rate.
authors.affiliation: Department of Urology, Princess Alexandra Hospital, Ipswich Rd, Brisbane, QLD, 4103, Australia. ericchg@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Chung
authors.forename: C T
authors.initials: CT
authors.lastname: Van
authors.forename: I
authors.initials: I
authors.lastname: Wilson
authors.forename: R A
authors.initials: RA
authors.lastname: Cartmill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D019468:Disease Management; D007172:Erectile Dysfunction / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019935:Penile Implantation; D015917:Penile Prosthesis; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome