Introduction: Autoinflation is a troublesome complication following penile prosthesis placement that may be potentiated by prevesical scarring following radical prostatectomy. We evaluated the frequency of autoinflation and other complications following penile prosthesis placement in radical prostatectomy patients and controls as a surrogate to establishing the utility of lockout reservoirs in preventing autoinflation.
Methods: 139 prostheses (including 14 with lockout reservoirs) were placed in 132 men (including 35 post-prostatectomy patients) over a 5(1/2) year period at our institution. Outcomes assessed include postoperative complications and the need for revision or replacement of the prosthesis. Multivariable regression analysis was used to determine the association of patient, device-specific, and perioperative characteristics with these outcomes.
Results: There was no difference in the postoperative complication and re-operation rates between post-prostatectomy patients and controls (both p > 0.77). The incidence of autoinflation in post-prostatectomy patients and controls was 3% and 5%, respectively (p > 0.99). Patients with prior prostheses were 3 times as likely to develop a postoperative complication or require prosthesis revision (p = 0.02).
Conclusion: Penile prostheses are well tolerated in post-prostatectomy patients with comparable outcomes to those men with organic erectile dysfunction. The frequency of autoinflation does not appear to be increased in post-prostatectomy patients. Initial results with the lockout valve reservoir in preventing autoinflation are encouraging though additional study is warranted to justify their routine use.