Bilali Habeş GÜMÜŞ, Ali Can ALBAZ

4425

Erektil disfonksiyon tedavisinde penil protez implantasyonunun uzun dönem klinik sonuçları

AMAÇ: Bu çalışmanın amacı, organik nedenli erektil disfonksiyon (ED) tanılı hastaların tedavisi için kliniğimizde uygulanan penil protez implantasyonun uzun dönem klinik sonuçlarını değerlendirmektir.GEREÇ ve YÖNTEMLER: Kliniğimizde organik ED tanısı ile penil protez implantasyonu yapılan ve üzerinden 60 ay ve üzeri süre geçmiş olan, ulaşılabilen 52 hasta içerisinden çalışmaya katılmayı kabul eden 34 hastaya ait veriler retrospektif olarak incelendi. Hastaların demografik verileri, uygulanan protez tipleri, peroperatif ve postoperatif komplikasyonları, post operatif dönemde kendisinin ve eşinin memnuniyet durumu değerlendirildi.BULGULAR: Penil protez implantasyonu yapılan 34 olgunun yaş ortalaması 61,97±10,55 yıl ve ortalama vücut kitle indeksleri 27,55±4,33 kg/m2 olarak saptandı. Hastaların 23'ünde (%69,6) sigara kullanım öyküsü mevcuttu. Malleable protez konulan 15 (%44,1) hasta iken, 14 (%41,1) hastaya iki parçalı penil protez, geri kalan beş (%14,7) hastaya da üç parçalı protez yerleştirildi. Penil protez cerrahisi sefazolin ve gentamisin profilaksisi ile 34 hastada penoskrotal insizyonla gerçekleştirildi. Hiçbir hastada peroperatif komplikasyon yaşanmadı. Bir hastada penil gerginlik/ağrı, iki hastada insizyon yerinde antibiyoterapi ile düzelen lokalize enfeksiyon ve bir hastada mekanik problem nedeniyle re-implantasyon gerçekleştirildi. İki hastada protez enfeksiyonu nedeniyle penil protez çıkartıldı. Ortalama takip süresi 86,47±31,78 ay olan hastaların %82,4'ü, eşlerinin %70,5'i penil protezden memnun olduğunu belirtti.SONUÇ: Penil protez implantasyonu, erektil disfonksiyon tedavisinde 3. basamak tedavi olarak başvurulan invazif ve etkili bir tedavi biçimidir. Yüksek oranlarda hasta ve eş memnuniyeti sağlayan bu yöntemde, uygun cerrahi prosedürlere rağmen enfeksiyon en sık görülen ciddi bir komplikasyondur

The long term clinical results of penile prosthesis implantation in the treatment of erectile dysfunction

INTRODUCTION: The aim of this study is to evaluate the long-term clinical outcomes of penile prosthesis implantation in our clinic for the treatment of patients with organic erectile dysfunction (ED).MATERIAL and METHODS: We retrospectively analyzed the data of 34 patients who agreed to participate in the study from 52 accessible patients who were diagnosed with organic ED in our clinic and who had undergone the penile prosthesis implantation for 60 months or more. Patient demographic data, the type of prostheses, peroperative and postoperative complications, postoperative couples’ satisfaction were evaluated.RESULTS: The mean age of the 34 patients with penile prosthesis implantation was 61.97±10.55 years and the mean body mass index was 27.55±4.33 kg/m2. 23 of the patients (69.6%) had a history of smoking. The malleable prosthesis was implanted to 15 patients (44.1%), the 2-piece penile prosthesis to 14 (41.1%) patients and the 3-piece prosthesis to the remaining 5 (14.7%) patients. Penile prosthesis was performed with cefazolin and gentamicin prophylaxis in 34 patients by penoscrotal incision. There were no peroperative complications in any patient. Penile tension/pain in one patient, localized infection in 2 patients with an on site antibiotherapy and re-implantation due to a mechanical problem in 1 patient. Penile prosthesis was removed due to prosthetic infection in two patients. The mean follow-up was 86.47±31.78 months and approximately 82.4% of patients and 70.5% of their partners were satisfied with the surgical results of the penile prosthesis operation.CONCLUSION: Penile prosthesis implantation is an invasive and effective form of treatment as a third-line treatment in the treatment of erectile dysfunction. In this method of providing patient and co-satisfaction at high rates, infection is the most common serious complication, despite appropriate surgical procedures
PDF

___

  • 1. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357:762–74. doi: 10.1056/NEJMoa067423
  • 2. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993;270:83–90.
  • 3. Nehra A, Barret DM, Morelan RB. Pharmacotherapeutic advances in the treatment of erectile dysfunction. Mayo Clin Proc 1999;74:709–21. doi: 10.4065/74.7.709
  • 5. Akkus E, Kadioglu A, Esen A, Doran S, Ergen A, Anafarta K, et al. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol 2002;41:298–304.
  • 6. Mulhall JP, Bella AJ, Briganti A, McCullough A, Brock G. Erectile function rehabilitation in the radical prostatectomy patient. J Sex Med 2010;7:1687–98. doi: 10.1111/j.1743-6109.2010.01804.x
  • 7. Gontero P, Fontana F, Zitella A, Montorsi F, Frea B. A prospective evaluation of efficacy and compliance with a multistep treatment approach for erectile dysfunction in patients after non-nerve sparing radical prostatectomy. BJU Int 2005;95:359–65. doi: 10.1111/j.1464-410X.2005.05300.x
  • 8. Evans C. The use of penile prostheses in the treatment of impotence. Br J Urol 1998;81:591–8.
  • 9. Minervini A, Ralph DJ, Pryor JP. Outcome of penile prosthesis implantation for treating erectile dysfunction: experience with 504 procedures. BJU Int 2006;97:129–33. doi: 10.1111/j.1464- 410X.2005.05907.x
  • 10. Anafarta K. Surgical treatment of erectile dysfunction. Türkiye Klinikleri J Surg Med Sci 2007;3:38–44.
  • 11. Aytac IA. McKinlay JB. Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999;84:50–6.
  • 12. Hatzimouratidis K, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010;57:804–14. doi: 10.1016/j.eururo.2010.02.020
  • 13. Rajpurkar A, Dhabuwala CB. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice. J Urol 2003;170:159–63. doi: 10.1097/01.ju.0000072524.82345.6d
  • 14. Anafarta K, Safak M, Bedük Y, Baltaci S, Aydos K. Clinical experience with inflatable and malleable penile implants in 104 patients. Urol Int 1996;56:100–4.
  • 15. Turna B, Umul M, Altay B, Apaydın E, Semerci B, Çıkılı N. Penil protez yerleştirilmesi cerrahisinde klinik deneyimlerimiz. Türk Ürol Der 2007;33:151–5.
  • 16. Wilson SK, Delk JR, Salem EA, Cleves MA. Long-term survival of inflatable penile prostheses: single surgical group experience with 2384 first-time implants spanning two decades. J Sex Med 2007;4:1074–9. doi: 10.1111/j.1743-6109.2007.00540.x
  • 17. Selph JP, Carson CC 3rd. Penile prosthesis infection: approaches to prevention and treatment. Urol Clin North Am 2011;38:227–35. doi: 10.1016/j.ucl.2011.02.007
  • 18. Carson CC. Penile prosthesis implantation and infection for Sexual Medicine Society of North America. Int J Impot Res 2001;13:S35–8. doi: 10.1038/sj.ijir.3900775
  • 19. Carson CC. Diagnosis, treatment and prevention of penile prosthesis infection. Int J Impot Res 2003;15:S139–46. doi: 10.1038/sj.ijir.3901091
  • 20. Mould JW, Carson CC. Infectious complications of penile prostheses. Infect Urol 1989;139:50–2.
  • 21. Falcone M, Garaffa G, Gillo A, Dente D, Christopher AN, Ralph DJ. Outcomes of inflatable penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery. BJU Int 2017. doi: 10.1111/bju.14027. [Epub ahead of print]
  • 22. Goldstein I, Newman L, Baum N, Brooks M, Chaikin L, Goldberg K, et al. Safety and efficacy outcome of mentor alpha-1 inflatable penile prosthesis implantation for impotence treatment. J Urol 1997;157:833–9.
  • 23. Montague DK, Angermeier KW. Penile prosthesis implantation. Urol Clin North Am 2001;28:355–61.
  • 24. Mulhall JP, Ahmed A, Branch J, Parker M. Serial assessment of efficacy and satisfaction profiles following penile prosthesis surgery. J Urol 2003;169:1429–33. doi: 10.1097/01. ju.0000056047.74268.9c
  • 25. Montague DK, Angermeier KW. Current status of penile prosthesis implantation. Curr Urol Rep 2000;1:291–6.
  • 26. Levine LA, Estrada CR, Morgentaler A. Mechanical reliability and safety of and patient satisfaction with the Ambicor inflatable penile prosthesis: results of a 2 center study. J Urol 2001;166:932–7.
Androloji Bülteni-Cover
  • ISSN: 2587-2524
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1999
  • Yayıncı: Turgay Arık
Arşiv
Sayıdaki Diğer Makaleler

İzogenol tabanlı etkili yeni bir antioksidanın testis torsiyonu oluşturulan ratlarda testis dokuları üzerine olan etkilerinin melatoninle karşılaştırılması

FİKRET ERDEMİR, Esra FINDIK, MUSTAFA CEYLAN, Erkan SÖĞÜT, Sevil ÇAYLİ, Hakan KESİCİ

Prostatik kalsifikasyonun alt üriner sistem yakınmalarına etkisi

EYÜP VELİ KÜÇÜK, Ahmet TAHRA, Ahmet BİNDAYI, Ümit YILDIRIM, Resul SOBAY, Uğur Tolga ŞEN

Seminal sıvının fertilizasyondaki rolü

MURAT SERKANT ÜNAL, Mehmet Caner ÖZER, Ferhan Hacioğlu SÖNMEZ, GÜLSEN BAYRAK, Hatice Oruç DEMİRBAĞ

Gecikmiş orgazm ve anorgazmi

Serdar AYKAN, Serkan GÖNÜLTAŞ, Mehmet YILMAZ, Muhammet Murat DİNÇER

Testosteron replasmanı ve kardiyovasküler yan etkileri

Ali ATAN, Süleyman YEŞİL, Fazlı POLAT

Erektil disfonksiyon tedavisinde penil protez implantasyonunun uzun dönem klinik sonuçları

Bilali Habeş GÜMÜŞ, Ali Can ALBAZ