600 Clinical indications for penile prosthesis implantation: data from the national prospective registry of penile prosthesis implantation “INSIST-ED”

Abstract

The European Urological Association (EAU) guidelines suggest penile prosthesis implantation (PPI) only as a third line therapy for the treatment of erectile dysfunction (ED). We looked at the current indications for PPI in clinical practice using data from a prospective national registry. Data from a national multi-institutional database of PPI including patients treated in 2014-2017 in Italy (INSIST-ED) were analysed. Data have been prospectively recorded by 45 surgeons on a dedicated website (www.registro.andrologiaitaliana.it) and revised by a single datamanager. According to EAU guidelines, the indication for PPI was considered appropriate when patients have been offered both a first line (e.g. PDE5is and/or vacuum therapy) and a second line (e.g. intracavernous injection) treatment approach before surgical treatment. Patients with penile curvature and ED were considered as properly submitted to PPI when they were previously offered at least with PDE5is. Logistic regression analyses tested the association between clinical characteristics, surgeon experience and ED etiology with the likelihood of a proper indication for PPI.