Background: Inflatable penile prosthesis (IPP) is typically the preferred
implant in Peyronie’s disease (PD) and malleable penile implants (MPP)
have been discouraged.
Objectives: We aimed to evaluate the effectiveness and patient satisfaction
of MPP compared to IPP in patients with PD.
Design, Setting, and Participants: Men with PD and erectile
dysfunction(ED) who elected for penile implant surgery constituted the
study population. Preoperatively, demographic and comorbidity parameters
were recorded. Curvature was measured with a goniometer at maximum
rigidity after intracavernosal vasoactive agent
injection(ICI). Postoperatively, overall satisfaction was measured at 3,6,12
and 24 months on 5-point Likert scale from 1(dissatisfied) to 5 (very
satisfied).
Outcome Measurements and Statistical Analysis : 166 men with a mean
age of 59±10 years were analyzed. The mean preoperative curvature in
the entire cohort was 65 (30-130) degrees. 94% of MPP patients had total
resolution of their curvature at end of operation, while 8 patients (6%) had
residual curvature (25-40 degrees).In IPP group(25/30; 83.3%) had
straight penis at the end of surgery while (5/30; 16.7%) still have residual
curvature, with the mean magnitude being 33 degrees in MPP and 30
degrees in IPP groups.
Results:86% of all patients were diabetic. There were no differences
between the 2 implant groups in age, HbA1c, BMI or smoking status.The
mean patient satisfaction was 4.42±0.70 (range = 2-5) and there was no
difference between the two groups. The mean follow up period was 23.4
months (6-29 months).
Limitations: Relatively small number IPP and non-randomized study.
Conclusion: We have shown that MPP is as effective as IPP in curvature
correction in PD patients with similar patient satisfaction for both groups. |