Long term results and couples’ satisfaction with different penile implant types

This article investigated the long term complications, mechanical reliability (MR) and couples’ satisfaction with different penile implant (PI) types and brands. 

The authors concluded that 3-piece and 2-piece implants had the highest couples' satisfaction rates.

Men with erectile dysfunction (ED) have trouble having an erection firm enough to have sexual intercourse. This leads to a poor quality of life. A solution is penile prosthesis implantation (PPI). There are several different types of penile implants (PI). There are 2 or 3 -piece inflatable devices and semi-rigid (malleable; MPI) devices.

A 2-piece (2P) is a fluid-filled device consisting of a pair of cylinders implanted in the penis and a pump implanted in the scrotum. Squeezing and releasing the pump moves fluid to the cylinders, creating an erection. A 3-piece (3P) works the same as a 2-piece however it has an extra fluid reservoir. A MPI involves a surgeon implanting two flexible rods into the penis. The implants never change in size or stiffness and maintain a semi–rigid state. 

Although PI return erectile function in men, they can be associated with complications and couple dissatisfaction depending on which device is used. It is not known which is the best PI device in terms of couples satisfaction or complications. 

The study involved 883 male patients who underwent PPI. 349 had a MPI, 26 had a 2P and 508 had a 3P. Couples' satisfaction was measured using a questionnaire. Patients were followed up for an average of 67 months after the PPI. 

At follow up, couples' satisfaction was higher in the 3P group (99.2%) vs the MPI group (90.3%). There was no difference between the 3P and the 2P group. In the MPI group, 27 patients switched to the 3P due to couples' dissatisfaction. 1 patient switched from 3PID to the MPI.

Side effects included penile corporal perforation (PCP; the implant pierces the penis tissue) and PI malfunction (PIM; the device did not work properly). 2.6% of PCP occurred in the MPI group and 5.5% of PIM occurred in the 3P group.  

The authors concluded that 3P and 2P PIs had higher couples' satisfaction rates,