The woman and the penile prosthetic implant. Primary or secondary role? Personal experiences on 355 implanted patients

Objective: We evaluated the role of women (wife, partner, girlfriend, lover) in the decision and the results of Penile Prostheses Implants (PPI). Material and methods: In a group of 355 pts (21-82 years, average age 50.3 years) submitted to PPI since 2007, we recorded data concerning the relationships with their partner and their role in the surgical decision. We implanted 97 Semirigid (SPP), 136 Malleable (MPP) and 122 Inflatable (IPP) Prostheses. We collected data regarding some aspects of the sexual life of patients. We asked them if they were married, divorced or widowed; if they had a lover; if they go regularly to brothels; if they were satisfied of their actual couple's life. After surgery we recorded data concerning their difficulties in utilizing the PPI and their level of satisfaction. Results: Most patients (93%) confirmed their satisfaction after PPI. Relational aspects: 44 out of 46 unmarried patients with difficult sexual intercourses managed to have regular sex and decided to marry after PPI, including 5 younger patients (21- 30 years old) who were not able to penetrate their girlfriends. In the group of married patients 5 pts were not able to penetrate their wives; after PPI they managed to have regular intercourses and pregnancies. Fifteen widowers and 22 divorced patients decided to have a PPI for possible sexual dating or stable relationships. Ninety-six out of 271 (28.2%) married patients declared a stable extramarital relationship that represented the main reason for having a PPI. Conclusions: In our opinion the simple act of penetrate and ejaculate in vagina, without considering the importance of personal, relational, emotional factors, often well linked to a specific woman, cannot be considered the ideal target of PPI.