Outcome of Malleable Penile Implant and End Stage of Erectile Dysfunction Single Centre Experience

Background: The inflatable penile prosthesis (IPP) is typically the preferred implant for Peronei’s disease (PD) and malleable penile prostheses (MPPs) have been discouraged. Objective: To share experience of malleable penile implant in younger patients at institute of kidney disease Peshawar in a developing country. Materials and Methods: Total of 24 Patients were included in this study who underwent malleable penile prosthesis surgery from July 2017 till June 2020 were included. They all counseled thoroughly regarding procedure, success statistics, possible complications and post-operative follow up. During follow up any problem if occurred and satisfaction documented. Data analysis done with SPSS version 22. Results: mean age of 31.7 (27-65) years were included. The most common etiology of ED was vasculogenic (n=10, 41.7%). The comorbidities found were diabetes mellitus and hypertension in 12.5% each (n=3), these patients had no comorbidities (n=18, 75%). The mean size of penile prosthesis was 11.79mm (ranged from 9.5-13mm). We had four patients (16.7%) with unconsummated marriage due to ED. The post-operative problems noted were penile numbness (n=4, 16.7%), retarded ejaculation (n=4, 16.7%), penile pain (n=3, 12.55), hematoma (n=1, 4.2%) and lower urinary tract symptoms (n=1, 4.2%). Most of these patients were fully satisfied (n=15, 62.5%), some were partially satisfied (n=7, 29.2%), only two patients were not satisfied (8.3%) while all patients had their partner satisfaction with malleable penile prosthesis. Inappropriately, patients had presented initially to urologist, rest of all 24 patients were initially treated by quacks, general practitioners, homeopaths, spiritual healers, dermatologists, gynecologists and psychiatrists. All patients had no sense about erectile dysfunction. Patients have idea about discussion of specific field consultant. Their doctor only deal with urology, kidney and bladder pathologies. Conclusion: Malleable penile prosthesis has great success rate in end point erectile dysfunction with acceptable complication rate. E.D is a global problem. There has been an incredible ignorance in the public about proper referral and management of Sexual dysfunction. Herbal medications are marginally effective and management of erectile dysfunction.