Analysis of factors for selection of penal prosthesis in patients with erectile dysfunction

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Aim. To investigate the factors influencing the choice of penile prosthesis and to evaluate the results of surgical treatment of patients suffering from erectile dysfunction (ED).

Materials and methods. Surgical results of penile prosthesis implantation in 348 patients were reviewed. The analysis included such factors as age, weight, height, body mass index (BMI) and the type of prosthesis.

Results. It was found that younger patients who tended to have an active lifestyle preferred three-piece prostheses, while older patients tended to favor one-piece prostheses. Weight, height and BMI do not affect the development of ED. A direct correlation between low patient height and increased risk of prosthesis failure and subsequent complications was found. When the patient was circumcised, there were no infections or mechanical failure after implantation.

Discussion. Our results emphasize the importance of an individual approach to the selection of a penile prosthesis, taking into account the physical characteristics and preferences of each patient. Such a factor as short stature is associated with a more limited space for placing the prosthesis pump, which requires consideration when selecting a prosthesis and preparing it for implantation during procedure. Young patients usually choose three-piece prostheses owing to their ability to enlarge the penis during sexual intercourse and to reduce its rigidity and size after sexual intercourse. For older patients, one-piece prostheses are the primary choice due to the age-related surgical risks and affordability of this type of prosthesis.

Conclusions: Our results show the importance of further investigation and taking into account all the different factors that influence the development of ED and the outcome of penile prosthesis implantation.

Sobre autores

M. Menshchikov

Russian Medical Academy of Continuous Professional Education

Autor responsável pela correspondência
Email: dr.menshchikov.mikhail@gmail.com

Ph.D. student at the Department of Endoscopic Urology

Rússia, Moscow

K. Menshchikov

InterMedicum Plus LLC

Email: dr.menshchikov.konstantin@gmail.com

urologist

Rússia, Khimki

D. Yurasov

InterMedicum Plus LLC

Email: dr.yurasov.dmitry@gmail.com

urologist

Rússia, Khimki

G. Borisenko

Russian Medical Academy of Continuous Professional Education

Email: gborisenko-doc@mail.ru

Ph.D., associate professor at the Department of Endoscopic Urology

Rússia, Moscow

M. Shatokhin

Russian Medical Academy of Continuous Professional Education; Private healthcare institution «Central clinical hospital «RZD-Medicine» (NUZ NKC OAO “RJD”)

Email: sh.77@mail.ru

Ph.D., MD, professor, professor at the Department of Endoscopic Urology

Rússia, Moscow; Moscow

Sh. Abdullaev

Russian Medical Academy of Continuous Professional Education

Email: luon@mail.ru

Ph.D. student at the Department of Endoscopic Urology

Rússia, Moscow

O. Teodorovich

Russian Medical Academy of Continuous Professional Education; Private healthcare institution «Central clinical hospital «RZD-Medicine» (NUZ NKC OAO “RJD”)

Email: teoclinic1@gmail.com

Ph.D., MD, professor, Head of the Department of Endoscopic Urology

Rússia, Moscow; Moscow

Bibliografia

  1. Gamidov S.I., Ovchinnikov R.I., Popova A.Yu., Shatylko T.V. Risk factors for erectile dysfunction: known and unexpected facts (review). Andrologiya i genital’naya khirurgiya = Andrology and Genital Surgery 2021;22(4):13–21. doi: 10.17650/1726-9784-2021-22-4-13-21. Russian (Гамидов С.И., Овчинников Р.И., Попова А.Ю., Шатылко Т.В. Факторы риска развития эректильной дисфункции: известные и неожиданные факты. Андрология и генитальная хирургия. 2021;22(4):13–21. doi: 10.17650/1726-9784-2021-22-4-13-21).
  2. Baas W., O’Connor B., Welliver C., et al. Worldwide trends in penile implantation surgery: data from over 63,000 implants. Transl Androl Urol. 2020;9(1):31–37. doi: 10.21037/tau.2019.09.26
  3. Caraceni E., Utizi L. A questionnaire for the evaluation of quality of life after penile prosthesis implant: quality of life and sexuality with penile prosthesis (QoLSPP): to what extent does the implant affect the patient’s life?. J Sex Med. 2014;11(4):1005–1012. doi: 10.1111/jsm.12453.
  4. Cayetano-Alcaraz A.A., Yassin M., Desai A., et al. Penile implant surgery-managing complications. Fac Rev. 2021;10:73. Published 2021 Sep 24. doi: 10.12703/r/10-73.
  5. Chung E., Bettocchi C., Egydio P., et al. The International Penile Prosthesis Implant Consensus Forum: clinical recommendations and surgical principles on the inflatable 3-piece penile prosthesis implant. Nat Rev Urol. 2022;19(9):534–546. doi: 10.1038/s41585-022-00607-z.
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  7. Goodstein T., Jenkins L.C. A narrative review on malleable and inflatable penile implants: choosing the right implant for the right patient. Int J Impot Res. 2023;35(7):623–628. doi: 10.1038/s41443- 023-00765-7.
  8. Юрасов Д.А., Меньщиков М.К., Меньщиков К.А., Шатохин М.Н. Имплантация протеза полового члена: этиологические особенности пациентов и выводы // Сиб. мед.вестн. 2024. Т. 8, No 1. С. 21–26. doi: 10.31549/2541-8289-2024-8-1-21-26
  9. Menshchikov K., Menshchikov M., Yurasov D., Artamonov A. Risk factors for penile prosthesis infection: An umbrella review and meta-analysis. Arab Journal of Urology. 2023:1–6. doi: 10.1080/2090598X.2023.2242204.

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2. Fig. 1. Weight, height, and BMI according to the type of prosthesis.

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3. Fig. 2. Age index according to type of surgery and presence of prosthetic infection.

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4. Fig. 3. Weight index according to the type of surgery and the presence of prosthetic infection

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