(470) Malleable Penile Implant Rod Diameter Predicts Complications And Patient Satisfaction

Abstract

Abstract Introduction One of the most common complaints after malleable prosthesis implantation (MPI) is thinning of the penis and decreasing girth. Some surgeons try to insert the largest diameter they can to improve patient satisfaction Objective To investigate if malleable rod diameter (MRD) has an impact on outcome and patient satisfaction Methods Consecutive malleable prosthesis implanation (MPI) was assessed in a high volume center over one year. The same preoperative, intraoperative, and postoperative protocols were used for all patients and one brand of the malleable device was used only. We recorded MRD and length for all patients. All patients had data on comorbidities including glycated hemoglobin (HbA1c) and clinical Peyronie’s disease (PD). Revision cases and those who lost for follow up were excluded from the study. We also excluded patients operated on by low volume surgeons. All complications, minor (edema, ecchymosis, pain), and major (infection and erosion) were recorded. After 1-year, patients were assessed and given a Likert scale from 1-5 where 1 is dissatisfied and 5 is most satisfied with their MPI. We stratified patients according to MRD into two groups: group A for diameter 9.5 and 11 mm and group B for 13 mm. Results 183 patients had full data and filled the questionnaire after 1 year follow up. All patients had Coloplast, Genesis penile implants. Major complications rate (infection, erosion, and removal) was significantly higher in group B 11% versus 1.2% in group A (P=0.016). At 4 weeks postoperative visit, 90 % of group A showed no complications versus 60 % only in group B that was statistically significant (p=0.0003). Satisfaction rate was more in patients in group A (88.6%) compared to patients in group B (75.7%)but this did not reach to be statistically significant (P=0.0519). See Table 1. Conclusions Larger diameter of malleable penile implants are not always associated with higher patient satisfaction as there are other predictors like postoperative complications and concealement. The best implant size for a certain patient is the best fitting, neither the oversize nor the undersize. Disclosure No