Pelvic pain after inflatable penile prosthesis implantation persists despite revision or explantation
Campbell, JD1; Rajih, E1; Burnett, AL1
1: Johns Hopkins School of Medicine, United States
Introduction and Objectives: Inflatable penile prosthesis (IPP) implantation represents an important treatment for erectile dysfunction (ED) that is considered when medical therapy is contraindicated, unsuccessful, or undesirable. New chronic pelvic pain after IPP implantation is an important complication that is rarely discussed in the penile prosthesis literature, and the treatment of this phenomenon is unclear. We aim to evaluate whether revision IPP surgery for the treatment of chronic pain improves patients’ symptomatology, or paradoxically exacerbates their conditions.
Materials and Methods: Retrospective analysis of 198 patients who had an IPP revision or explant at a single centre between May 2006 and March 2017. We included patients who developed chronic pelvic pain after IPP implantation and underwent a revision surgery or IPP explantation for symptomatic relief. We excluded patients who did not have pain for at least 3 months, patients who had pain associated with infection or erosion, and in whom we did not have long-term follow-up data. Persistent pain after surgery was based on patient self-report.
Results: A total of 22 patients underwent surgical revision (n = 17) or IPP explantation (n = 5) for new pelvic pain. Fifteen (68%) patients had persistent pelvic pain despite surgical intervention. Only patients who had pain secondary to a malpositioned device had an improvement after their revision. A prior diagnosis of a chronic pain syndrome was associated with persistent pain after intervention. Pain improvement was not associated with age, comorbid conditions, smoking status, duration of implant, cause of ED, or the number of surgical revisions performed.
Conclusions: Surgical revision for new pelvic pain after IPP implantation is unlikely to relieve patient symptoms unless the device is situated in an improper location. Patients need to be counselled that surgical procedures as a treatment for pain should be avoided and consideration of alternative therapeutic options may be more beneficial.
Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.Go Back