Comparative analysis of penile prosthesis implantation in patients with vasculogenic aetiology versus radical prostatectomy
Torremadé Barreda, J1; Cocera Rodriguez, R1; Suarez Novo, JF1; Pujol Galarza, L1; Ferreiro Pareja, C1; Fernandez-Concha , J1; Riera Canals, L1; Vigues Julia, F1
1: Hospital universitario de bellvitge, Spain
Objective: To analyse the surgical differences, sizes of the implanted cylinders and complications between vasculogenic ED and ED after RP.
Material and methods: In the period between February 2006 and July 2017, a total of 170 penile prosthesis were implanted in our centre. This study includes 117 cases corresponding to virgin implants for ED of either vasculogenic aetiology or post RP (58 for RP and 59 vasculogenic cases). We analysed data corresponding to: age, comorbidity, type of prosthesis, presence of fibrosis that hinders dilation, need for modelling, size of implanted cylinders and complications (intra and post-operative).
Results: The mean patient age was 60 ± 5.35 years for the RP group and 57.2 ± 6.07 years for the vasculogenic group (p = 0.0103). The rate of hypertension, diabetes, dyslipidaemia and ischemic heart disease was higher in vasculogenic ED (p = 0.012, p = 0.000009, p = 0.03 and p = 0.0014 respectively). All of the prostheses were hydraulic; 24.1% of two components and 75.9% of three in the RP group; 39% components of two and 61% of three in the vasculogenic group (p = 0.1233). With regard to the presence of cavernous fibrosis, no significant differences were found, with 17.24% in PR vs. 11.8% in vasculogenic ED (p = 0.409). As to the need for modelling, no significant differences were found either, with a 12.1% in PR vs. 3.4% in vasculogenic ED (p = 0.078). However, significant differences were observed in the size of the implanted cylinders; PR of 18.30 ± 2.11 cm vs. 19.21 ± 1.71 cm in vasculogenic ED (p = 0.01643). There were no significant differences between the groups in infection rates (2 in PR and 1 in vasculogenic), mechanical failure (2 cases for both) or extrusion (2 in PR and 0 in vasculogenic).
Conclusions: The implantation of penile prosthesis in ED after RP is associated with an inferior cylinder length compared to vasculogenic origin. Although there is certain non-significant tendency to the need for modelling manoeuvres in RP, there are no significant differences in surgical approach or complications.
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