Objective: To identify the main prognostic factors influencing the immediate and long-term results of inflatable penile prosthesis implantation.
Patients and methods: Between February 1999 and December 2007, 118 inflatable penile prostheses were implanted, by the same operator, on 96 patients with a mean age of 54.4 years. One third of the implanted patients had had previous penile surgery. Three different penile implants were used: TITAN alpha1 (N = 32), EXCEL (N = 6), and TITAN RESIST (N = 80).
Results: Median follow-up was 25 months [6-114]. One patient with sickle-cell disease died from a massive pulmonary embolism. Seven patients (7.3%) had a postoperative scrotal haematoma. Eleven patients (11.5%) had a postoperative infection. Fourteen patients (14.6%) had a material migration. Sixteen patients (16.7%) had a surgical revision for mechanical dysfunctions after a mean period of 21 months. The rate of postoperative complications was significantly increased in case of prior penile surgery (p = 0.049) or in case of associated surgical procedure (p = 0.0095). The rate of migration was significantly more important in case of postpriapism erectile dysfunction (p = 0.00035). The risk of mechanical dysfunctions was significantly increased in case of Peyronie's disease. In the end of the follow-up, 85% of patients (and 91% of first-time implantations) had a functional prosthesis.
Conclusion: The long-term functional results of inflatable penile prosthesis are suitable but the postoperative complications are frequent in case of prior penile surgery, associated surgical procedure, Peyronie's disease, or postpriapism implantation.