Are We Having The Same Indications For Penile Prosthesis Implantation After Phosphodiesterase 5 Inhibitors Era?

Cortés-González, JR⁽¹⁾; Glina, S⁽²⁾

⁽¹⁾Hospital Universitario "Dr. José E. González" UANL ⁽²⁾Instituto H. Ellis

Objetive: The objective with this article is to describe modifications on indications for penile prosthesis implantation in the treatment of Erectile Dysfunction (ED) before and after Sildenafil Era.
Patients and Methods: Penile prosthesis implantation was indicated in 144 men with ED at our institution between 1992 and 2007. Fifty-seven point six percent (83) accepted the procedure, 38.2% (55) refused it and 4.2%(6) accepted but eventually haven’t undergone to surgery. Forty five of them were operated before the launch of Sildenafil (BS) and 38 after (AS)
Results: On BS group, after surgical revision on previous implanted prostheses elsewhere, the most frequent etiology was vascular disease with 24.4%(11) compared to the 2.6%(1) on the AS group. The most frequent etiology on the AS group was previous radical pelvic surgery (radical prostatectomy, sigmoidectomy, etc) with 42.1%(16) compared to 0% of the BS group. There weren’t significant differences on complications rate in both groups. Satisfaction in patients with malleable and inflatable devices was 75%(42) and 77.3%(17) respectively.
Conclusions: After the new era of oral therapy for ED, some changes in the etiology of refractory ED has been observed. ED post radical prostatectomy is gaining space as the main reason for penile implant.