Quality of life after penile prosthesis implantation – 1-year follow-up data of the INSIST-ED national prospective registry
Capogrosso, P1; Caraceni, E1; Pescatori, E1; Cazzaniga, W1; Silvani, M1; Utizi, L1; Mondaini, N1; Carrino, M1; Pozza, D1; Lagana', A1; Barbieri, A1; Ceruti, C1; Salonia, A1; Palmieri, A1; Deho', F1
1: Italian Society of Andrology - SIA, Italy
Objective: To assess QoL of patients submitted to penile prosthesis implantation (PPI), using the validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP).
Materials and Methods: Data from a national multi-institutional database of PPI including patients treated from 2014 to 2017 in Italy (INSIST-ED) were analysed. All data have been prospectively recorded by 45 surgeons on a dedicated website (www.registro.andrologiaitaliana.it) and revised by a single datamanager. Etiology of erectile dysfunction (ED) and type of implanted prosthesis were analysed. Surgeons were categorized as high-, mid- or low-experienced implanters according to the No. of procedures performed within the investigated time period (low: <20; mid: 20-50; high: ≥50). In order to simultaneously evaluate perceived penile prosthesis function and QoL, all patients were re-assessed at 1-yr follow-up with the QoLSPP questionnaire. Linear regression analyses assessed the correlation between clinical variables, functional outcomes and QoL.
Results: Overall, 643 patients were included in the database. Complete follow-up data were available for 110 (17.1%) patients [median age 60 years (IQR: 56 – 67)]. Of them, 95 (86.3%) patients received a hydraulic penile prosthesis and 15 (13.6%) a non-hydraulic model, respectively. Overall, 40.3% (44) of patients were submitted to PPI for post-pelvic surgery ED, while 40.3% (44) and 17.4% (19) had Peyronie’s disease and vasculogenic ED, respectively. A total of 37%(41) of PPI were conducted by high-experienced surgeons. At 1-yr follow-up, high median scores were reported for the QoLSPP functional (F:23/25), Personal (P:13/15), Relational (R:17/20) and Social (S:13/15) domains. At both univariate and multivariate linear regression analyses, surgeon experience was the only factor significantly associated with higher scores of each QoLSPP domain, after accounting for age, ED etiology, prosthesis type and surgical approach (penoscrotal vs. others). Patients operated by high-experienced surgeons reported a 10.2 (95%CI:6.1-14.2, p<0.001) points higher QoLSPP total score at follow-up.
Conclusions: This is the first study reporting QoL data after PPI using the validated QoLSPP questionnaire. Current findings suggest that patients are highly satisfied after PPI, regardless of age, type of prosthesis received and ED etiology. However, patients operated by highly experienced surgeons are likely to show better outcomes in terms of perceived prosthesis function and QoL.
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