Background: The minimally invasive infrapubic approach (MIIA) for inflatable penile prosthesis (IPP) placement has shown favorable peri-operative safety and efficacy profile, but scarce data exist on long-term follow-up. Objectives: We investigated the safety and efficacy of IPP implantation via the MIIA after a minimum 5-year follow-up. Materials and methods: We identified data of implanted patients prospectively included in our institutional database. Complications and functional outcomes were assessed by using validated tools. Specifically, quality of life and patient satisfaction were evaluated by the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Kaplan-Meier method was used to analyze IPP survival (defined as a working IPP). Results: Overall, 67 patients implanted by MIIA with a median (IQR) age of 64 years (61-70) were included. The median (IQR) follow-up duration was 71 months (63-80). Fifteen (22%) patients experienced complications: minor (Clavien ≤2) events included changes in penile sensitivity (n = 1; 1.5%), orgasmic dysfunction (n = 1; 1.5%), pain (n = 5; 7%), urinary tract infection (n = 2; 3%), and chronic discomfort (n = 1; 1.5%); major (Clavien 3) complications were represented by mechanical failure (n = 3; 4.5%), IPP infection (n = 1; 1.5%), and cylinder protrusion (n = 1; 1.5%). The estimated IPP survival was 94% (95% CI, 91.4-96.6), 92.5% (95% CI, 89.7-95.3), and 92.5% (95% CI, 89.7-95.3) at 3, 5, and 7 years after implantation, respectively. In patients using the device at follow-up (n = 61; 91%), median (IQR) scores for QoLSPP domains demonstrated favorable functional outcomes and patient satisfaction: functional 21 (19-23), personal 16 (15-18), relational 14 (12-15), and social 12 (11-14). Discussion and conclusion: This study represents the longest follow-up using validated tools to assess the outcomes of IPP implantation via MIIA so far. IPP placement via MIIA confirms to be safe and to offer high satisfaction to both patients and partners at mid-term evaluation.

Mid-term outcomes of minimally invasive infrapubic approach for inflatable penile prosthesis implantation: A single-center study and literature review / Di Pierro, Giovanni Battista; Di Lascio, Giovanni; Lemma, Andrea; Grande, Pietro; Frisenda, Marco; Del Giudice, Francesco; Antonini, Gabriele; Nardi, Francesco; De Berardinis, Ettore; Cristini, Cristiano; Franco, Giorgio; Sciarra, Alessandro; Salciccia, Stefano. - In: ANDROLOGY. - ISSN 2047-2919. - (2023). [10.1111/andr.13497]

Mid-term outcomes of minimally invasive infrapubic approach for inflatable penile prosthesis implantation: A single-center study and literature review

Di Pierro, Giovanni Battista;Di Lascio, Giovanni;Lemma, Andrea;Grande, Pietro;Frisenda, Marco;Del Giudice, Francesco;Antonini, Gabriele;De Berardinis, Ettore;Cristini, Cristiano;Franco, Giorgio;Sciarra, Alessandro;Salciccia, Stefano
2023

Abstract

Background: The minimally invasive infrapubic approach (MIIA) for inflatable penile prosthesis (IPP) placement has shown favorable peri-operative safety and efficacy profile, but scarce data exist on long-term follow-up. Objectives: We investigated the safety and efficacy of IPP implantation via the MIIA after a minimum 5-year follow-up. Materials and methods: We identified data of implanted patients prospectively included in our institutional database. Complications and functional outcomes were assessed by using validated tools. Specifically, quality of life and patient satisfaction were evaluated by the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Kaplan-Meier method was used to analyze IPP survival (defined as a working IPP). Results: Overall, 67 patients implanted by MIIA with a median (IQR) age of 64 years (61-70) were included. The median (IQR) follow-up duration was 71 months (63-80). Fifteen (22%) patients experienced complications: minor (Clavien ≤2) events included changes in penile sensitivity (n = 1; 1.5%), orgasmic dysfunction (n = 1; 1.5%), pain (n = 5; 7%), urinary tract infection (n = 2; 3%), and chronic discomfort (n = 1; 1.5%); major (Clavien 3) complications were represented by mechanical failure (n = 3; 4.5%), IPP infection (n = 1; 1.5%), and cylinder protrusion (n = 1; 1.5%). The estimated IPP survival was 94% (95% CI, 91.4-96.6), 92.5% (95% CI, 89.7-95.3), and 92.5% (95% CI, 89.7-95.3) at 3, 5, and 7 years after implantation, respectively. In patients using the device at follow-up (n = 61; 91%), median (IQR) scores for QoLSPP domains demonstrated favorable functional outcomes and patient satisfaction: functional 21 (19-23), personal 16 (15-18), relational 14 (12-15), and social 12 (11-14). Discussion and conclusion: This study represents the longest follow-up using validated tools to assess the outcomes of IPP implantation via MIIA so far. IPP placement via MIIA confirms to be safe and to offer high satisfaction to both patients and partners at mid-term evaluation.
2023
erectile dysfunction; inflatable penile prosthesis; mid-term surgical and functional outcomes; minimally invasive infrapubic approach; validated assessment tools
01 Pubblicazione su rivista::01a Articolo in rivista
Mid-term outcomes of minimally invasive infrapubic approach for inflatable penile prosthesis implantation: A single-center study and literature review / Di Pierro, Giovanni Battista; Di Lascio, Giovanni; Lemma, Andrea; Grande, Pietro; Frisenda, Marco; Del Giudice, Francesco; Antonini, Gabriele; Nardi, Francesco; De Berardinis, Ettore; Cristini, Cristiano; Franco, Giorgio; Sciarra, Alessandro; Salciccia, Stefano. - In: ANDROLOGY. - ISSN 2047-2919. - (2023). [10.1111/andr.13497]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1685454
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