Our armamentarium for the treatment of
erectile dysfunction has recently been expanded by addition of
Viagra and the
MUSE. However, their long-term results are still unknown. The insertion of a
penile prosthesis is invasive, expensive, and irreversible, but under optimal condition provides an acceptable, definitive
solution for
erectile dysfunction. We evaluated our long-term results with
penile prosthesis insertion (PPI). From 1987-1998, 57 patients underwent PPI in our department. Mean age was 55 years and the common causes of
erectile dysfunction were atherosclerotic disease (23), radical pelvic surgery (15), and
diabetes mellitus (14). Semirigid
prostheses were inserted in 12 and inflatable
prostheses in 45, including 42 single-component and 3 multi-component
prostheses. Recently we interviewed these patients by telephone, using a standard questionnaire. Those not satisfied with the surgical results (83% of the living patients) were examined in our clinic. Mean follow-up was 53 months. In 37 (84%) the
prosthesis was mechanically functional (rates after 1, 5 and 10 years were 87.8%, 80%, and 75%, respectively). In only 2 (2.5%) had serious complications led to
prosthesis removal. All mechanical failures had occurred in those with inflatable
prostheses after a mean of 48.5 months (range 4-113). At the time of the survey 68% were sexually active and 64% were satisfied with the surgical result. We conclude that PPI is safe treatment for
erectile dysfunction. Although the rate of mechanically functioning
prostheses decreases with time, modern multi-component
prostheses may lead to better mechanical results.