The importance of psychosexual counselling in the re-establishment of organic and erotic functions after penile prosthesis implantation

Abstract

Although many studies about penile prosthesis implantation (PPI) have been published so far, only a small amount of them take into account patients and partners outcome in terms of satisfaction and erotic function. The aim of this study is to explore the value of psycosexual counselling in and the sexual and erotic function of penile prosthesis recipients. Thirty patients and their partners were randomised into two groups. In arm A (case group) patients and their partners underwent a multistep psychosexual counselling before and after surgery. In arm B (control group) surgery was performed without the specific psychosexual counselling scheme. Specific questionnaires (International Index of Erectile Function (IIEF) and the Sexual Daydreaming Scale (SDS)) were administered before surgery and 12 months afterwards. Twenty-four months postoperatively patients were asked to complete the Global Assessment Questions (GAQ) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), while their partners were asked to answer to the EDITS partner's section. Between January 2009 and October 2011, we enrolled 30 patients undergoing PPI in our institution (15 in each arm). Twenty-four months postoperative follow-up is available for all of them. No significant differences between the two groups in terms of baseline questionnaires scores were observed. Mean IIEF score was significantly higher in case group (arm A 68.3, arm B 53.4, P-value<0.001). At 12 months after PPI the improvement of erotic function according to SDS was significantly higher in the study group for both patients and their partners. Improvement in satisfaction rates were confirmed at 24 months, with statistically significant scores for EDITS in arm A patients and partners as compared with arm B. PPI with a pre- and postoperative psychosexual counselling scheme resulted in better postoperative sexual activity and erotic function for both patients and partners than PPI alone.

Practical Approaches to Treat ED in PDE5i Nonresponders

“…As one type of psychological intervention, sexual counseling can not only improve erectile function and sexual satisfaction but also increase treatment compliance in patients with ED caused by RP and penile prosthesis implantation, extended device application or hypospadias repair performed in childhood [69][70][71][72][73]. A meta-analysis has demonstrated that taking PDE5is to improve erectile function requires other comprehensive management, including sexual counseling, exercise and lifestyle changes [74].…”

De erectieprothese voor de behandeling van erectiele disfunctie: herintroductie in Nederland

“…Uit een recente studie blijkt dat er een sterke positieve correlatie is met de tevredenheid van de man en de seksuele functie van de vrouw (gemeten met de Female Sexual Index scale) [14]. Het is dus belangrijk de partner bij de counseling te betrekken [15].…”

“…Al in de beginjaren van Udo Jonas werden patiënt en partner voor de implantatie uitgebreid seksueel gecounseld [22]. Het belang van seksuologische counseling voor het krijgen van een tevreden patiënt is logisch en aangetoond [14,15]. Onderwerpen die besproken moeten worden zijn: de achtergrond waartegen de wens om een prothese te laten plaatsen zich afspeelt, de motivatie voor een prothese, de medische, psychosociale en sociaal-relationele factoren die een rol spelen, mogelijke alternatieve behandelingen, de verwachtingen en of deze realistisch zijn en, tot slot, het omgaan met tegenslag bij een mechanische of esthetische onvolkomenheid of, in het ergste geval, infectie waarbij de prothese verwijderd moet worden [23].…”

Preoperative counseling and expectation management for inflatable penile prosthesis implantation

“…The modern prosthesis has been around for over 40 years and undergone numerous iterations. For patients refractory to medical therapies, including phosphodiesterase type 5 inhibitors, penile prosthesis placement is widely considered the gold standard surgical therapy ( 1 , 2 ). The IPP has evolved from the semi-rigid implant and two-piece inflatable prosthesis to the modern three-piece inflatable device, the “Cadillac” of available penile implants.…”