What are the success rates of penile prosthetic implants?

From the Guidelines

Penile implants have high success rates, with approximately 90-95% of patients reporting satisfaction with the devices, and a low infection rate of 1-6%. The two main types are inflatable implants (2-piece or 3-piece) and malleable (semi-rigid) rods, with the 3-piece inflatable implants generally providing the most natural results and highest satisfaction rates 1. These devices typically last 10-15 years before requiring replacement. Complication rates are relatively low at 5-10%, with infection being the most serious potential issue (occurring in 1-3% of cases) 1.

Key Considerations

• The use of antibiotic impregnated/coated devices, antiseptic surgical scrub, no-touch technique, wound irrigation, and perioperative antimicrobial prophylaxis can help decrease infection rates 1.
• Recent evidence suggests that the use of antifungal agents, especially in high-risk groups, may provide more robust prophylaxis and lower the risk of infection (HR: 0.08,95% CI: 0.03 to 0.19, P < .001) 1.
• Diabetes is a significant risk factor for infection, with a higher risk of infection (HR: 1.9,95% CI: 1.03 to 3.4, P < .04) 1.

Post-Operative Care

• Most patients can resume sexual activity within 4-6 weeks after surgery.
• Recovery involves some pain and swelling for several weeks, with complete healing taking about 6 weeks.
• Insurance coverage varies, but many plans cover the procedure when medically necessary.

Outcome

• The high satisfaction rates are attributed to the reliable, on-demand erections the implants provide, allowing for spontaneous sexual activity without the planning required for medications.
• The overall success rate of penile implants is high, with a significant improvement in quality of life for patients with erectile dysfunction.

From the Research

Penile Implants Success Rates

• The success rates of penile implants are generally high, with patient and partner satisfaction rates ranging from 73.7% to 93% 2, 3, 4.
• A study published in 2019 found that 83.2% of patients and 85.4% of partners reported satisfaction with the implantation of an inflatable penile prosthesis (IPP) 2.
• Another study published in 2018 found that 93% of patients reported high satisfaction (score ≥4) after penile implant surgery, with the absence of major complications being a significant predictor of high satisfaction 3.
• The occurrence of postoperative complications and complaints, such as postoperative penile length shortening, pain, and floppy glans syndrome, can negatively influence patient and partner satisfaction rates 2, 5.

Complications and Satisfaction

• Major complications, such as device infection, erosion, and mechanical malfunction, can significantly reduce patient satisfaction rates, with 25% of patients experiencing a major complication reporting dissatisfaction 3.
• Minor complications, such as penile or scrotal hematoma, superficial wound breakdown, can also affect patient satisfaction, but to a lesser extent 3.
• The presence of comorbidities, such as diabetes, hypertension, and Peyronie's disease, can also impact patient satisfaction rates 3, 4.

Assessment of Satisfaction

• Several studies have used validated tools, such as the International Index of Erectile Function, the Erectile Dysfunction Inventory of Treatment Satisfaction, and the Treatment Satisfaction Scale, to assess patient and partner satisfaction after penile implant surgery 6.
• However, there is a lack of a systematic approach and quantitative data analysis in the assessment of satisfaction after penile implant surgery, and most studies have used suboptimal or non-validated questionnaires 6.
• The development and validation of a specific, complete, and easy-to-use questionnaire to assess satisfaction after penile implant surgery is needed 6.