Introduction and Objective: We assess the subjective satisfaction, operating time, the average postoperative hospital stay and complication rate between patients who received a deferred penile and artificial sphincter implantation and those who had the surgery done at the same time. Materials and Methods: We prospectively evaluated 19 patients, who underwent penile prosthesis and urinary sphincter surgery, between January 2007 and December 2010. Intra and postoperative complications, postoperative pain and patient’s satisfaction were recordedUrinary incontinence was assessed by “ICI questionnaire- Urinary Incontinence Short Form”, IQol and PGI-I; penile prosthesis implantation satisfaction was assessed with the EDITS.Postoperative pain was assessed by VAS at 6, 24 and 72 hours after surgery Results: Eleven patients (group A) underwent simultaneous placement of two implants (2 inflatable penile prosthesis and 9 malleable prosthesis; all had a double cuff sphincter implantation) and 8 patients underwent two operations at two different times: 3 implants with double cuff sphincter in patients already carrying inflatable penile prosthesis (group B) and 5 malleable penile implants in patients already carrying urinary sphincter (group C). No intra-operative complications were recorded. The subjective assessment of pain by VAS between the 3 groups was not statistically significant (mean VAS values Group A 5, 3, 2; Group B 4,3,1; Group C 4.3, 1 - p 0.1). No serious postoperative complications or malfunction of the devices were recorded at the median follow up of 1 year. All patients are continent. The average score of preoperative ICI questionnaire is 18 in A and C patients. The mean pre-operative Qol was 40, the post-operative 3 months after surgery 83. At the PGI-I patients answered to have experienced a great improvement in 5% and be much improved in 5% 3 months after surgery No statistically significant differences in average scores to EDITS between groups A and C (6.5 SD 6.6 SD 0.65 and 0.8 respectively - p 0.05). Conclusion: Penile and urinary sphincter prosthesis surgery undoubtedly improves patient’s QoL. The single surgery for both prosthesis, in our experience, is a viable surgery, without higher complications and good, satisfactory rate.
Urinary Incontinence and ErectileDysfunction Post-Prostatectomy:Simultaneous or Delayed SurgicalCorrection?
DE MARIA, CLAUDIA;ROLLE, Luigi;CERUTI, Carlo;FALCONE, MARCO;FONTANA, Dario
2011-01-01
Abstract
Introduction and Objective: We assess the subjective satisfaction, operating time, the average postoperative hospital stay and complication rate between patients who received a deferred penile and artificial sphincter implantation and those who had the surgery done at the same time. Materials and Methods: We prospectively evaluated 19 patients, who underwent penile prosthesis and urinary sphincter surgery, between January 2007 and December 2010. Intra and postoperative complications, postoperative pain and patient’s satisfaction were recordedUrinary incontinence was assessed by “ICI questionnaire- Urinary Incontinence Short Form”, IQol and PGI-I; penile prosthesis implantation satisfaction was assessed with the EDITS.Postoperative pain was assessed by VAS at 6, 24 and 72 hours after surgery Results: Eleven patients (group A) underwent simultaneous placement of two implants (2 inflatable penile prosthesis and 9 malleable prosthesis; all had a double cuff sphincter implantation) and 8 patients underwent two operations at two different times: 3 implants with double cuff sphincter in patients already carrying inflatable penile prosthesis (group B) and 5 malleable penile implants in patients already carrying urinary sphincter (group C). No intra-operative complications were recorded. The subjective assessment of pain by VAS between the 3 groups was not statistically significant (mean VAS values Group A 5, 3, 2; Group B 4,3,1; Group C 4.3, 1 - p 0.1). No serious postoperative complications or malfunction of the devices were recorded at the median follow up of 1 year. All patients are continent. The average score of preoperative ICI questionnaire is 18 in A and C patients. The mean pre-operative Qol was 40, the post-operative 3 months after surgery 83. At the PGI-I patients answered to have experienced a great improvement in 5% and be much improved in 5% 3 months after surgery No statistically significant differences in average scores to EDITS between groups A and C (6.5 SD 6.6 SD 0.65 and 0.8 respectively - p 0.05). Conclusion: Penile and urinary sphincter prosthesis surgery undoubtedly improves patient’s QoL. The single surgery for both prosthesis, in our experience, is a viable surgery, without higher complications and good, satisfactory rate.
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