Comparative insights into patient satisfaction and its determinants in malleable and inflatable penile prostheses

Background: Penile prosthesis implantation is a well-established surgical treatment for erectile dysfunction. Both malleable and inflatable penile prostheses offer effective solutions, each with distinct advantages and disadvantages. However, treatment satisfaction reflects a person’s subjective evaluation of the treatment experience, beyond clinical effectiveness. This study aimed to compare patient satisfaction between malleable and inflatable penile prostheses and examines factors influencing satisfaction. Methods: A retrospective cohort study was conducted on patients who underwent penile prosthesis implantation at a single tertiary referral center between January 2021 and September 2023. Patient satisfaction was assessed six months after penile implantation using the modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire along demographics and clinical data. Results: Among 130 participants, 71 (54.6%) received a malleable penile prosthesis and 59 (45.4%) an inflatable one. Both groups reported overall high satisfaction, with significantly higher satisfaction in the inflatable group regarding penile prosthesis, expectation fulfillment and continued use (p = 0.029, 0.008, and 0.019, respectively). Dissatisfaction with device configuration was reported by 15.5% of malleable recipients, while none was reported in the inflatable group. Perceived change in length was noted by 21.1% of malleable and 13.6%of inflatable recipients. In the malleable group only, Body Mass Index (BMI), comorbidities, and past surgical history were associated with satisfaction. Those with BMI under 30 reported greater satisfaction in expectation and partner-related domains, and no dissatisfaction was reported by individuals without comorbidities or with prior surgical history. Conclusions: Both prosthesis types yielded high satisfaction, inflatable implants showing superior outcomes. Patient factors such as BMI, comorbidities and surgical history influenced satisfaction in malleable prosthesis recipients.

Penile implant; Satisfaction; Erectile dysfunction; Impotence

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