Open AccessImmediate insertion of a soft penile prosthesis as a new option for a safe and cost-effective treatment of refractory ischemic priapism
Author(s) -
Franco Palmisano,
Valerio Vagi,
Alessandro Franceschelli,
Giorgio Gentile,
Fulvio Colombo
Publication year - 2021
Publication title -
archivio italiano di urologia andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.429
H-Index - 23
eISSN - 2282-4197
pISSN - 1124-3562
DOI - 10.4081/aiua.2021.3.356
Subject(s) - priapism , medicine , penile prosthesis , erectile dysfunction , reimbursement , surgery , erectile function , sexual intercourse , adverse effect , refractory (planetary science) , health care , population , physics , environmental health , astrobiology , economics , economic growth
Objective: The aim of this study is to assess the management of refractory ischemic priapism (IP) by the immediate insertion of a soft penile prosthesis (sPP). Patients and methods: We identified men affected by IP who underwent early sPP placement from May 2017 to October 2019. All patients underwent a detailed medical history review; intraoperative, postoperative features and adverse events were recorded. We evaluated the penile lengthening and bending, presence of complementary erection, ability to have sexual intercourse, postoperative sexual life satisfaction (International Index of Erectile Function [IIEF] questionnaire - question number 5). A cost-analysis was included. Results: A total of six patients were identified. Median time (range) since onset was 78 (48-108) hours with a mean age (SD) of 33 (6.9) years. Median operative time (range) was 82 minutes (62-180). No complications were recorded. Median follow- up was 9 months (range 3-17). No significant loss of penile length, neither penile angulation was recorded. Despite a transient reduction of penile sensitivity, all patients reported satisfactory sexual intercourse (mean score question number 5 from IIEF-5 of 4). The cost of sPP was € 1769,00 with a surgeryrelated reimbursement fee from the National Health System of € 3856,75. Conclusions: The insertion of a sPP for patients with refractory IP results in immediate pain relief, preservation of sexual function and penile size, with a higher surgery reproducibility in an emergency. In addition to this, financial and resource burdens of IP on the health-care system can be potentially reduced.