Satisfaction and quality of life among men undergoing penile prosthesis implantation for erectile dysfunction

Resumo

INTRODUCTION: Erectile dysfunction (ED) is the persistent inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual activity and affects approximately 52% of men aged 40 to 70 years. Penile prosthesis implantation (PPI) is the definitive treatment for ED of organic origin. The literature on satisfaction and quality of life after PPI is based on studies of inflatable prostheses, with limited high-quality information on semirigid prostheses, which are used in the Brazilian public healthcare system. OBJECTIVE: To assess quality of life among patients undergoing semirigid penile prosthesis implantation. METHODS: This cross-sectional study included patients who underwent semirigid PPI at Hospital de Clínicas de São Bernardo do Campo between 2014 and 2024. Participants were assessed with validated questionnaires addressing quality of life and erectile function: translated versions of the Quality of Life and Sexuality with Penile Prosthesis (QOLSPP) and the International Index of Erectile Function (IIEF-15). Overall satisfaction was also measured on a Likert scale (0–100). Clinical and epidemiologic data were collected to analyze possible sources of bias and confounding. RESULTS: Forty-one patients agreed to participate and signed the informed consent form. Overall satisfaction was 92% on the QOLSPP, and mean sexual function was 64 of 75 possible points on the IIEF-15. When asked about overall satisfaction with the procedure, approximately 90.4% of participants assigned scores above 75 on the Likert scale; the mean was 87.8. Likert-scale responses differed significantly between patients with and without type 2 diabetes (p=0.0367; Mann–Whitney test) and according to the year of PPI (q=0.0250; Dunn’s test with the Benjamini–Krieger–Yekutieli correction). DISCUSSION: QOLSPP and IIEF-15 results showed satisfaction levels similar to or higher than those reported in previous studies of inflatable prostheses. The Likert scale was excluded from inferential analysis because response bias was identified. CONCLUSION: Semirigid penile prostheses provide satisfaction levels similar to those of inflatable prostheses and improve quality of life and patient satisfaction, representing a viable therapeutic alternative for refractory ED.