Prosthesis-specific survey: characterizing sexual quality of life in men with a 3-piece penile prosthesis
Carlos, EC1; Davis, LG1; Peters, CE1; Lentz, AC1
1: Duke University, United States
Objective: Prior studies evaluating quality of life after a penile prosthesis have often not used validated questionnaires. Those that do often rely on the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the International Index of Erectile Function (IIEF). Unfortunately, each lacks a granular assessment of how a prosthesis affects sexual quality of life (SQoL). The Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire was designed and validated to specifically evaluate SQoL after a prosthesis with four sub-domains: functional, personal, relational and social. With this tool, we aim to refine our understanding of SQoL after prosthesis placement in the United States.
Material and Methods: 122 men (mean age 65.9 yrs) who received a 3-piece prosthesis from 1 Aug 2013-1 Feb 2017 and had functional emails were sent the QoLSPP. 46 were returned including 7 patients with removal/ replacements (RR). Surveys were completed on average 2.0 yrs from the most recent prosthesis placement. The QoLSPP has a Likert-like 0-5 scale. Responses were considered positive if ≥3, except #5 which was considered positive if ≥2. Subpopulation analysis was done by age in years (<55, 55-65, ≥66), device model (Coloplast Titan, AMS 700 CX, and LGX), etiology of erectile dysfunction (ED), diabetes status, and body mass index (BMI) (< or ≥30). RRs were compared against those with their first prosthesis. Analysis with Fisher’s Exact.
Results: 84.6% of men with their first implant had positive overall responses with sub-domains as follows: Functional-87.2%, Relational-87.2%, Social-79.5%, and Personal-76.9%. There were no differences in the proportion of overall and sub-domain positive responses by age, RR status, device model, etiology of ED, or BMI (all p>0.05). Diabetics had fewer overall positive scores (93.3% vs 66.7%, p=0.07) with Functional (93.3% vs 66.7%, p=0.07) and Relational sub-scores (96.7% vs 55.6%, p=0.065) trending toward significance.
Conclusions: This is the first study outside Europe to provide prosthesis-specific SQoL data. 85% of men in this study believe that their first prosthesis positively impacted their SQoL. Men are most pleased with their device’s Functional and Relational aspects, particularly non-diabetics. Age, device model, etiology of ED, and BMI do not affect SQoL in men with their first penile prosthesis. Lastly, there was no difference in SQoL between these men and those who had a RR.
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