Introduction & objective: Currently, approximately 80% of inflatable penile prosthesis (IPP) are placed by penoscrotal approach (PSA), although no superiority of this technique compared to infrapubic approach has ever been demonstrated. The aim of this study was to compare perioperative results, safety and efficacy profile in patients receiving inflatable penile prosthesis(IPP) via PSA or minimally invasive infrapubic approach(MIIA) for erectile dysfunction. Methods: Data were prospectively collected in our password-secured institutional database of implanted patients. A matched-pair analysis was performed including 42 patients undergoing IPP implantation via PSA(n=21) or MIIA(n=21) between 2011 and 2016. Excluded from the study were those patients with urinary incontinence, simultaneous surgery for congenital or acquired recurvatum, previous urethral or penile surgery and lack of follow-up data. All patients were invited to fill in validated self-administered questionnaires to evaluate various aspects of post-prosthesis sexual life. Specifically, questionnaires included: the International Index of Erectile Function(IIEF), Erectile Dysfunction Inventory of Treatment Satisfaction(EDITS) and Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaires. Results Mean(SD) operative time was 128(40.6) min in group PSA and 91(43.0) min in group MIIA(p=0.041). Complications occurred in 3 (14%) and 2 (10%) patients in groups PSA and MIIA(p=0.832). Overall, no differences were observed concerning the device utilization (p=0.275). However, in group MIIA 4 (19%) patients were able to resume sexual activity prior to 4 postoperative weeks, while in group PSA no patient was (p=0.012). Mean(SD) scores for questionnaires were similar between groups PSA and MIIA: IIEF [20.9(7.3) vs 20.7(4.8); p=0.132], patient EDITS [76.0(25.6) vs 74.7(20.8); p=0.256] and partner EDITS [72.5(29.1) vs 73.1(21.4); p=0.114]. Similarly, QoLSPP showed comparable results among the groups PSA and MIIA: functional domain [3.9(1.4) vs 4.0(1.2); p=0.390], personal [4.0(1.2) vs 4.1(1.0); p=0.512], relational [3.7(1.5) vs 3.9(1.2); p=0.462] and social [4.0 (1.2) vs 3.9 (1.2); p=0.766]. Conclusions Penoscrotal and minimally invasive infrapubic approaches demonstrated to be safe and efficient techniques for IPP implantation, leading to high level of both patients and partners satisfaction. Additionally, the minimally invasive infrapubic approach showed a shorter operative time and a tendency for a faster return to sexual activity.

Prospective trial comparing penoscrotal versus minimally invasive infrapubic approach for inflatable penile prosthesis placement: a single-centre matched paired analysis / Grande, Pietro; Antonini, Gabriele; Cristini, Cristiano; DE BERARDINIS, Ettore; Gentile, Giuseppe; DI LASCIO, Giovanni; Lemma, Andrea; DI PIERRO, GIOVANNI BATTISTA. - In: THE JOURNAL OF UROLOGY. - ISSN 0022-5347. - ELETTRONICO. - (2018), pp. ?-?. (Intervento presentato al convegno Annual Meeting of the American Urological Association 2018 tenutosi a San Francisco, USA nel 18-21 Maggio).

Prospective trial comparing penoscrotal versus minimally invasive infrapubic approach for inflatable penile prosthesis placement: a single-centre matched paired analysis.

Pietro Grande;Gabriele Antonini;Cristiano Cristini;Ettore De Berardinis;Giovanni Di Lascio;Andrea Lemma;Giovanni Battista Di Pierro.
2018

Abstract

Introduction & objective: Currently, approximately 80% of inflatable penile prosthesis (IPP) are placed by penoscrotal approach (PSA), although no superiority of this technique compared to infrapubic approach has ever been demonstrated. The aim of this study was to compare perioperative results, safety and efficacy profile in patients receiving inflatable penile prosthesis(IPP) via PSA or minimally invasive infrapubic approach(MIIA) for erectile dysfunction. Methods: Data were prospectively collected in our password-secured institutional database of implanted patients. A matched-pair analysis was performed including 42 patients undergoing IPP implantation via PSA(n=21) or MIIA(n=21) between 2011 and 2016. Excluded from the study were those patients with urinary incontinence, simultaneous surgery for congenital or acquired recurvatum, previous urethral or penile surgery and lack of follow-up data. All patients were invited to fill in validated self-administered questionnaires to evaluate various aspects of post-prosthesis sexual life. Specifically, questionnaires included: the International Index of Erectile Function(IIEF), Erectile Dysfunction Inventory of Treatment Satisfaction(EDITS) and Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaires. Results Mean(SD) operative time was 128(40.6) min in group PSA and 91(43.0) min in group MIIA(p=0.041). Complications occurred in 3 (14%) and 2 (10%) patients in groups PSA and MIIA(p=0.832). Overall, no differences were observed concerning the device utilization (p=0.275). However, in group MIIA 4 (19%) patients were able to resume sexual activity prior to 4 postoperative weeks, while in group PSA no patient was (p=0.012). Mean(SD) scores for questionnaires were similar between groups PSA and MIIA: IIEF [20.9(7.3) vs 20.7(4.8); p=0.132], patient EDITS [76.0(25.6) vs 74.7(20.8); p=0.256] and partner EDITS [72.5(29.1) vs 73.1(21.4); p=0.114]. Similarly, QoLSPP showed comparable results among the groups PSA and MIIA: functional domain [3.9(1.4) vs 4.0(1.2); p=0.390], personal [4.0(1.2) vs 4.1(1.0); p=0.512], relational [3.7(1.5) vs 3.9(1.2); p=0.462] and social [4.0 (1.2) vs 3.9 (1.2); p=0.766]. Conclusions Penoscrotal and minimally invasive infrapubic approaches demonstrated to be safe and efficient techniques for IPP implantation, leading to high level of both patients and partners satisfaction. Additionally, the minimally invasive infrapubic approach showed a shorter operative time and a tendency for a faster return to sexual activity.
2018
Annual Meeting of the American Urological Association 2018
04 Pubblicazione in atti di convegno::04d Abstract in atti di convegno
Prospective trial comparing penoscrotal versus minimally invasive infrapubic approach for inflatable penile prosthesis placement: a single-centre matched paired analysis / Grande, Pietro; Antonini, Gabriele; Cristini, Cristiano; DE BERARDINIS, Ettore; Gentile, Giuseppe; DI LASCIO, Giovanni; Lemma, Andrea; DI PIERRO, GIOVANNI BATTISTA. - In: THE JOURNAL OF UROLOGY. - ISSN 0022-5347. - ELETTRONICO. - (2018), pp. ?-?. (Intervento presentato al convegno Annual Meeting of the American Urological Association 2018 tenutosi a San Francisco, USA nel 18-21 Maggio).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1084756
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