title: Penile Prosthesis First and Replacement Surgeries: Analysis of Patient and Partner Satisfaction.
abstract: BACKGROUND
  Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Prosthesis replacement has become an accepted procedure in the event of device malfunction or complications, but to our knowledge, there are no data regarding the impact of implant replacement on patients and partner satisfaction.
  
  
  OBJECTIVE
  The aim of our study was to assess and to compare the level of satisfaction, with a first or second penile prosthesis implantation (PPI), in men with refractory erectile dysfunction and their partners.
  
  
  METHODS
  A survey study based on a five-item questionnaire was carried out at our center between January 1999 and January 2012.
  
  
  METHODS
  The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after PPI.
  
  
  RESULTS
  Of the 190 eligible patients, 149 (78%) completed the survey (110 underwent a first implant and 39 a reimplant). Seventy-nine percent of first-time implanted patients and 80% of the reimplanted patients (P > 0.05; not significant [ns]) reported satisfactory sexual intercourse (very or moderately satisfied), while 74% and 80% of their partners reported satisfactory intercourses, respectively (P > 0.05; ns). Overall, 73.7% of first implants and 70% of second implants reported that they would undergo the procedure again if the PPI failed (P > 0.05; ns). With regards to cosmetic aspects, 13% of the first implants' and 15% of second implants' partners reported either penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of first implants and 1% of reimplanted patients expressed difficulty in manipulating the device.
  
  
  CONCLUSIONS
  PPI is successful in returning the ability for satisfactory sexual intercourse to both first implant and reimplanted patients and their respective partners.
authors.affiliation: Andrology and Urethro-Genital Reconstructive Surgery Unit, Urology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Lledó-García
authors.affiliation: Andrology and Urethro-Genital Reconstructive Surgery Unit, Urology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Jara-Rascón
authors.affiliation: Urology Service, Hospital La Zarzuela, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Moncada Iribarren
authors.affiliation: Andrology and Urethro-Genital Reconstructive Surgery Unit, Urology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Piñero-Sánchez
authors.affiliation: Andrology and Urethro-Genital Reconstructive Surgery Unit, Urology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Aragón-Chamizo
authors.affiliation: Andrology and Urethro-Genital Reconstructive Surgery Unit, Urology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Hernández-Fernández
mesh_terms: D000328:Adult; D003075:Coitus / Q000523:psychology*; D007172:Erectile Dysfunction / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019935:Penile Implantation / Q000379:methods* / Q000523:psychology; D015917:Penile Prosthesis / Q000706:statistics & numerical data*; D010549:Personal Satisfaction; D012092:Replantation; D057566:Self Report; D012747:Sexual Partners / Q000523:psychology*
keywords: Erectile Dysfunction; Implantation; Penile Prosthesis; Satisfaction