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A case series of patients underwent laparoscopic extra-peritoneal radical prostatectomy with simultaneous implant of penile prosthesis: focus on penile length preservation

Mondaini, N 1; Cai, T2; Sarti, E1; Polloni, G3; Gavazzi, A1; Conti, D1Cocci, A4; Albersen, M5; Cito, G4; Bartoletti, R6

1: Santa Maria Annunciata Hospital, Florence, Italy; 2: Santa Chiara Regional Hospital, Trento, Italy; 3: Psychilogist, Como, Italy; 4: Careggi Hospital, Florence, Italy; 5: University Hospitals Leuven, Belgium; 6: University of Pisa, Pisa, Italy

Objectives: There are many grey zones in the field of penile rehabilitation after radical prostatectomy. One of the most important aspect for improve the patient’s compliance to the treatment is the preservation of the full dimensions of the penis after surgery. We show the first cases series of patients treated by laparoscopic extra-peritoneal radical prostatectomy (RP) and simultaneous penile prostheses implantation (PPI), in order to preserve the full length of the penis and improve patients' satisfaction .

Materials & Methods: From June 2013 to June 2014, 10 patients underwent simultaneous PPI (AMS “inibizone”), how shown in Figure 1 and RP by the same surgeon at the same Centre. Patients were evaluated with urological visits, dedicated questionnaires and instrumentation before surgery, at the hospital discharge and on day 21-28, each 3 months for the first year and each 6 months after. The main outcome measures were oncological (biochemical recurrence free rate), functional (penile length) and QoL.

Results: 10 patients [median age of 61.1 (56-65)] completed the study follow-up period (median 41 months). The median penile length at the time of the surgery was 9 cm and 8.9 cm after 2 years follow-up. The pre-surgery SF-36 median value was 97.7 (96.8-98.6). Pts were satisfied with their penile implants, and the couple level of sexual satisfaction was rated 8.5 (7-10). The median SF-36 score was 98.9 (97.8-99.4).

Conclusions: Laparoscopic extra-peritoneal RP surgery and placement of penile prostheses seems to be interesting to propose to motivated patients for preserving the length of the penis and improve satisfaction.

Figure 1: penile prostheses implantation


Work supported by industry: no.

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