The penile prosthesis implantation: the current experience of surgical treatment for erectile dysfunction.

Abstract

Objective. The purpose of this work was to describe the Russian experience in applying European clinical recommendations, as well as a statistical description of a group of patients with erectile dysfunction who received surgical treatment. Methods. A retrospective study was conducted on a group of patients with primary implantation and re-implantation of a penile prosthesis. The inclusion criteria for the study were: a completed patient medical record; including anthropometric parameters of the patient; diabetic status; characteristics of penile prostheses; type of surgical intervention and the availability of a full set of laboratory tests. Results. With strict adherence to European clinical guidelines, no cases of breakage or development of prosthetic infection were identified in patients after primary implantation of a penile prosthesis (314 people). About half of the patients (144 people) with ED who underwent primary penile replacement had a BMI <27.14. Three-piece penile prostheses were most commonly implanted in patients ≤52 years of age. A prognostic model for assessing the risk of developing diabetes has been proposed, taking into account the parameters of BMI, blood glucose and HbAc1. Conclusions. The strict sequence of actions of the operating team and their compliance with European clinical recommendations allows us to minimize the occurrence of prosthetic infections during the primary implantation of a penile prosthesis. Predisposition to diabetes, which can be assessed using a prognostic model, is recommended to be taken into account when developing a strategy for surgical treatment of patients with erectile dysfunction.