Surgery Clinical Trial
Official title:
Inflatable Penile Prostheses : Predicting Factors of Pump Misuse and Unsatisfaction
Sexual health and satisfaction are well know as critical critera to assess quality of life,
at any age. Among the multiple aspects of sexual health, erectile dysfunction (ED) is not
anymore a fate, mainly thanks to the advent of phosphodiesterase type 5 (PDE5) inhibitors in
1998. Nevertheless, a significant part of patients are intolerant or does not respond to PDE5
inhibitors and thus are looking for other treatment options.
Since the first implantation of foreign material intracarvernosally in 1966 by Beheri,
multiple modifications and enhancements were achieved in order to produce devices more
reliable with a more natural appearance. First introduced in 1973 by Scott et al., inflatable
prosthesis provides now high general satisfaction rates (69-94%), better than in malleable
prostheses, except for few authors.
In addition to changes in materials and construction, the two main manufacturers of IPP,
Boston scientific AMS (Marlborough, MA, USA) and Coloplast (Minneapolis, MN, USA), modernized
the pump mechanism of their devices. Since the introduction of AMS IPP, three main pump
formats have been used : the standard pump has been replaced in 2004 by the " Tactile " pump
and then the " Momentary Squeeze " (MS) pump in 2006, smaller and easier to deflate by not
requiring the patient to hold the deflation button throughout deflation. Coloplast also
replaced in 2008 their " Genesis " pump by a " One Touch Release " (OTR) pump, and finally in
2014 by the current " Touch " pump, smaller, and presenting a biconcave deflation button,
easier to find.
Despite all technological advances, appropriate pre-operative counselling and careful
post-operative teachning, a significant part of patients has still difficulties to handle the
pump and thus, does not use their IPP, regardless of any material malfunction. That situation
obviously leads to patient's dissatisfaction and highlights the operating risks of a useless
surgical procedure.
The purposes of this study were:to identify the risks factors, modifiable and non-modifiable,
for patients' difficulty to inflate and/or deflate their device after IPP implantation, then
to show a correlation between easy handling and post-operative satisfaction. And last but not
least, to show an association between pre-operative pump pattern viewing and handling and
post-operative easy handling. That information could help the physicians to improve the
pre-operative selection of patients and to adapt the peri-operative care in order to improve
patients satisfaction.
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