title: Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation.
abstract: BACKGROUND
  Studies have demonstrated high levels of satisfaction with penile prosthesis implantation (PPI). However, qualitative research exploring the experience of PPI through men's narratives is scarce.
  
  
  OBJECTIVE
  The main goals were to analyze (i) the level of sexual satisfaction (quantitatively), and (ii) the reasons for satisfaction and/or dissatisfaction with PPI (qualitatively).
  
  
  METHODS
  Participants were 47 men with erectile dysfunction who underwent surgery between 2003 and 2012, placed by a single surgeon. Structured telephone interviews were carried out.
  
  
  METHODS
  Satisfaction with PPI was a qualitative and quantitative measure assessed through the following four items: (i) "Would you repeat the PPI surgery?"; (ii) "Would you recommend the PPI surgery?"; (iii) "How satisfied are you with the PP?"; and (iv) "Could you explain the motives of your satisfaction/dissatisfaction?".
  
  
  RESULTS
  The majority of men (79%) reported to be satisfied with PPI. Content analysis revealed four main themes for men's satisfaction with the PPI: (i) psychological factors were reported 54 times (n = 54) and included positive emotions, self-esteem, confidence, enhancement of male identity, major live change, and self-image; (ii) improvement of sexual function was reported 54 times (n = 54) and referred to achievement of vaginal penetration, increase of sexual desire, sexual satisfaction, penis size, and improvement of erectile function; (iii) relationship factors were reported 11 times (n = 11) and referred to relationship improvement and the possibility of giving pleasure to the partner; and (iv) improvement in urinary function (n = 3).
  
  
  CONCLUSIONS
  The level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for erectile dysfunction with a positive impact on the experience of men at sexual, psychological and relational level.
authors.affiliation: William James Center for Research, ISPA-University Institute, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Carvalheira
authors.affiliation: ISPA-University Institute, Lisbon, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Santana
authors.affiliation: iSex-Association of Advanced Study of Human Sexuality, Lusófona University, Lisbon, Portugal.
authors.forename: Nuno M
authors.initials: NM
authors.lastname: Pereira
mesh_terms: D007172:Erectile Dysfunction / Q000523:psychology* / Q000601:surgery; D006801:Humans; D007989:Libido; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010410:Penile Erection / Q000523:psychology*; D019935:Penile Implantation / Q000379:methods / Q000523:psychology; D015917:Penile Prosthesis / Q000523:psychology*; D010413:Penis / Q000601:surgery; D010549:Personal Satisfaction; D012189:Retrospective Studies; D012747:Sexual Partners / Q000523:psychology*
keywords: Erectile Dysfunction; Penile Prosthesis Implantation; Satisfaction