Profile of candidates to penile prosthesis implantation for ED; pooled analysis from two prospective population-based registry
Capogrosso, P1; Pescatori, E1; Jani, K2; Caraceni, E1; Karpman, E3; Palmieri, A1; Brant, W4; Salonia, A1; Silvani, M1; Vitarelli, A1; Pozza, D1; Fiordelise, S1; Carlo, B1; Deho', F1; Henry, G2
1: Italian Society of Andrology - SIA, Italy; 2: Ark-La-Tex Urology, US; 3: El Camino Urology Medical Group, Mountain View, California, US; 4: Veterans Affairs, Salt Lake City Healthcare System, US
Objective: We compared baseline characteristics data of patients submitted to penile prosthesis implantation (PPI), from two prospective multicenter population-based registries on penile prostheses surgery.
Materials and Methods: Data were collected from the Italian multi-institutional, monitored and internal review board (IRB) approved registry on PPI (INSIST-ED) including data from 33 institutions. Similarly, data from the IRB-approved Prospective Registry of Outcomes with Penile Prosthesis for Erectile Restoration (PROPPER), a large prospective dataset including data from 13 North American sites, were also collected. Both registries include data on patient’s baseline characteristics, ED etiology, surgical and peri-operative management strategies. As a primary outcome of this study, a pooled data analysis was conducted to assess differences in patient’s baseline characteristics between the two registries; continuous and categorical variables were analyzed with the Wilcoxon Rank Sum test and the Pearson’s Chi square test, accordingly.
Results: Data from 405(23.2%) patients from the INSIST-ED registry and 1340(76.8%) from the PROPPER study were analyzed. Patients in the PROPPER study were older compared to those included in the Italian registry [median (IQR): 65 (58- 70)vrs 62 (56-67); p<0.001]. Overall, radical prostatectomy (RP) was the most common ED etiology, reported in 486(27.9%) cases; however, the distribution of ED etiologies was significantly different between the two registries: cardiovascular disease [251(18.7%)] and diabetes [282 (21%)] were more frequently reported as a main cause of ED in the PROPPER study compared to the INSIST-ED [31(7.7%) and 43(10.6%), respectively; p<0.001]. Conversely, more patients were submitted to PPI for ED secondary to Peyronie’s disease [68(16.8%) vs 123(9.2%); p<0.001] and pelvic surgery other than RP [40(9.9%) vs 21 (1.6%); p<0.001] in the INSIST-ED registry compared to the PROPPER. Moreover, although being infrequent in both studies, more patients were submitted to PPI after radiation therapy in the PROPPER study compared to the INSIST-ED [36 (2.7%) vs 1(0.2%);p=0.003].
Conclusions: Our findings show that post-RP ED is the most common reason for PPI in both Europe and North America. The differences in patient’s baseline characteristics between the two population-registries provide insights into different candidate’s profile for surgical treatment of ED in the real-world setting.
Work supported by industry: yes, by AMS - Boston Scientific (industry funding only - investigator initiated and executed study).Go Back