(047) A Systematic Review of Partner Satisfaction after Penile Prosthesis and Review of Patient Satisfaction in LGBTQ+ Men after Penile Prosthesis
Authors: Singh A , Cooper C A , Hou S , Raheem O A 
Published: May 2023

Abstract

Introduction
Erectile dysfunction (ED), known to negatively affect both patient and partner quality-of-life (QoL), is estimated to affect more than 30 million men in the United States. Penile prosthesis (PP) implantation has been shown to be a successful surgical option for men with erectile dysfunction refractory to medical treatment. Several recent studies have demonstrated post-surgical patient satisfaction rates of &gt;90% using validated, non-specific tools such as the International Index of Erectile Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS).

Objective
Despite the progress in examining the satisfaction of heterosexual male patients with PP implantation, there has been no thorough review of partner satisfaction and QoL. Our objective was to summarize the current literature around partner satisfaction for heterosexual patients and patient satisfaction for LGBQT+ patients, respectively. We specifically conducted a systematic review according to the Cochrane and preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards and stratified studies into three tiers by methodological rigor.

Methods
A PRISMA systematic literature review was performed using the PubMed database in March 2022. For the heterosexual partner review, a search was conducted to find all relevant abstracts regarding ‘penile prosthesis’, ‘partner satisfaction’, and ‘partner quality of life’. For the LGBQT+ review, ‘MSM’, ‘gay’, ‘homosexual’, ‘queer’, and ‘heterosexual’ were used as additional search terms. The research was limited to English-language articles from January 2000 to March 2022. The list of studies generated by the search was screened to identify eligible studies. Inclusion criteria included a clinical outcome study with primary outcomes related to penile prosthesis, and partner satisfaction was included as an outcome measure. Exclusion criteria included case reports, review articles, animal studies, and patient satisfaction studies that did not include partner satisfaction. Studies for the partner satisfaction review were sorted into three tiers based on the accuracy and external validity of each study’s methods.

Results
After an initial search of 172 articles, 30 studies met the inclusion criteria for the partner satisfaction review (Table 1). For our LGBTQ review, three studies consisting of 129 patients met the inclusion criteria from an initial search of 13 records (Table 2). For our partner satisfaction review, 10 studies were classified as Tier 1, 11 studies were classified as Tier 2, and 9 studies were classified as Tier 3. Across all the tiers, studies noted partner satisfaction rates between 50%-90% and improved satisfaction and sexual QoL metrics compared to pre-surgery rates. Overall, although partner satisfaction rates were high after PP implantation, many studies noted slightly lower partner satisfaction rates than patient satisfaction rates. Satisfaction rates among LGBTQ patients after PP implantation varied greatly between studies, ranging from 11% to 93% satisfaction.

Conclusions
Although the quality of evidence varies, the available literature suggests relatively high rates of partner satisfaction after PP implantation, in addition to varying rates of patient satisfaction after PP implantation in LGBTQ patients. Given the diversity of study designs and widespread use of non-validated or non-specific questionnaires in the current literature, future research should focus on prospective studies and/or data collection using validated, PP-specific questionnaires.

Disclosure
No