A Review of Factors Affecting Patient Satisfaction With Inflatable Penile Prosthesis.

Introduction: A variety of factors that can influence patient satisfaction after inflatable penile prosthesis (IPP) surgery, including patient expectations before surgery, intraoperative complications, and perceived penile shortening and partner satisfaction after surgery. While patient satisfaction rates with IPP are high, there are several reported methods to further improve patient satisfaction with IPP.

Objective: Identifying factors responsible for patient satisfaction after IPP surgery from preoperative counseling, intraoperative techniques, and postoperative care and identifying ways to improve overall patient satisfaction.

Methods: A PubMed search was performed of all articles available on the database relating to penile prosthesis and patient satisfaction.

Results: The main outcome measure is patient satisfaction after IPP surgery. Patient satisfaction has been reported to be as high as 90%. Factors affecting postoperative satisfaction include preoperative counseling and expectations, patient comorbidities, partner satisfaction, and postoperative complications. One of the most common complaints is decreased penile length postoperatively. It is critical to accurately measure penile length before surgical intervention. Preoperative strategies to improve penile length with IPP include the use of penile traction therapy and vacuum erection device (VED). Several adjuvant procedures have been described and shown to safely increase penile length with concomitant IPP surgery, including ventral phalloplasty, suprapubic fat pad excision, and modified sliding technique-multiple slice technique. Postoperative penile rehabilitation program has been shown to improve penile length. The use of phosphodiesterase type 5 inhibitors in the postoperative period leads to increased glans engorgement and improved patient satisfaction.

Conclusion: Patient satisfaction with IPP is influenced by many factors, which can be categorized into 3 distinct patient care stages: preoperative, intraoperative, and postoperative. There are several techniques described in each patient care stage to improve perceived penile length including preoperative counseling and correct penile length measuring, preoperative penile stretching, the use of adjuvant surgical procedures, and postoperative penile rehabilitation. Shah T, Wang R, A Review of Factors Affecting Patient Satisfaction With Inflatable Penile Prosthesis. Sex Med 2021;9:350-357.