Comparing the outcome and adverse events in malleable versus inflatable penile implants
Habous, M1; Nassar, M1; Mahmoud, S1; Abdelrahman, Z1; Elserafy, A1; Abdelwahab, O2; Mekawi, Z1; Binsaleh, S3; Ralph, D4; Christopher, N4
1: Elaj Medical Centers, Saudi Arabia; 2: Benha university,Benha,Egypt; 3: King Saud University,Riyadh,Saudi,Arabia; 4: st Peters Andrology Center,UCLH,London,uk
Objective: to evaluate the outcome and adverse events of penile prosthesis impanation(PPI) in both types of implants: malleable(MPP)and inflatable(IPP) in one year.
Methods: All patients who underwent PPI between January 1st, 2015 till December 31st, 2015 in three surgical facilities, were prospectively enrolled in this study. Thorough medical and demographic data were collected for all patients. All patients were counselled about all the details concerning their surgical procedure including the advantages and disadvantages of both types of implants, possible complications. They were informed also that the preoperative stretched penile length(SPL) is usually correlated with the postoperative functional length(FL). All patients signed a detailed consent contains all these data. Patient satisfaction was measured 3 months postoperatively, using Likert Scale from 0(unsatisfied) to 5(most satisfied). Detailed statistical analysis was done.
Results: 237 patients were included in this analysis. The median age was 57(26-76), and the average BMI is 30.42% of them were diabetics and two thirds of those had uncontrolled DM(HgA1c³8%).One third of them diagnosed with Peyroni disease(PD) and 64 patients(27%) were hypertensive. 184(77.6%)had MPP and the remaining IPP. There were 55 patients (23%)with adverse events ranged from edema and ecchymosis to implant infection and erosion. Most adverse events resolved with conservative therapy.13/237(5.48%) implants (7/184 MPP&6/53 IPP) had to be removed because of infection. Two patients with IPP had device malfunction and needed reposition of the pump. There was statistically significant increase in adverse events in IPP over MPP(p-value=03). The overall postoperative satisfaction score was 4.21(86%).There was no significant change between SPL and immediate postoperative FL. Seven patients (3%), all had MPP, were not satisfied about penile size postoperatively.DM(p-value=02) was a predictor of increase adverse events, while hypertension, obesity and PD were not.
Conclusion: while the adverse events are higher in patients who had IPP, the perception of small size penis was higher in MPP patients. Both types of implants had a comparable postoperative high satisfaction rate.
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