Men who receive penile implants after radical prostatectomy are generally satisfied with their sexual function, according to a new study of Australian men.
More men are surviving prostate cancer in Australia, but treatments can leave patients with sexual and urinary problems. Men who undergo radical prostatectomy, the surgical removal of the prostate gland, often face erectile dysfunction (ED), sensory changes in the penis, loss of penile length, and trouble with orgasm.
Penile prostheses (implants) are one way to help men with ED. The process involves placement of an internal rod or inflatable device that allows a man the ability to have a firm erection when he wishes one. Past studies have shown high satisfaction rates for men with implants, but such research had not been published for men in Australia.
This study focused on the sexual and psychosocial experiences for a group of Australian men and their partners.
Seventy-one men (average age 63) and 43 of their partners (average age 59) participated in the study. As appropriate, they completed a series of questionnaires that evaluated quality of life, overall health, anxiety, depression, satisfaction with ED treatment, self-esteem, and relationships. They also provided general feedback on their experiences with the prosthesis.
An average of 31 months had passed since the men’s implant surgery.
Ninety-four percent of the men said they were satisfied with their implants, and 77% said they had good sexual function. Men who were satisfied tended to have less depression and higher sexual confidence. About a quarter of the men said their erections with the implant felt natural to them. Fifty-nine percent said erections felt different, “but not in a positive or negative way.”
Over half the men said they would recommend implants without reservation; almost half said they had a better relationship with their partner since the implant.
Partners reported lower sexual relationship satisfaction than the patients but had similar results for treatment satisfaction.
Depression seemed to influence the results. Patients with less depression tended to have more sexual confidence and intimacy, which was associated with better treatment satisfaction and improved sexual function.
Higher treatment satisfaction was also more frequent in couples with similar results on depression assessments. When patients had more depression than their partners, they were less likely to be satisfied with treatment.
While the results were encouraging, the authors noted that some men did have poor outcomes. In some cases, men’s implants don’t live up to their expectations, malfunction, have complications, or change how the penis looks. It’s possible that these men might have had more depressive symptoms, and more research is needed in this area, the researchers said.
They added that counseling, both before and after implant surgery, could help patients and their partners adjust.
Several limitations were acknowledged, including the lack of information on patients’ comorbid health issues and the partners’ sexual function. In addition, only 43 partners took part in the study and their results might not reflect the outcomes for all partners.
The study was first published online in October in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Pillay, Brindha, et al.
“Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy”
(Full-text. Published online: October 27, 2017)