REVIEW   Free access

Minerva Urology and Nephrology 2024 April;76(2):166-75

DOI: 10.23736/S2724-6051.23.05466-6

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Quality of life and sexuality with penile prosthesis: a systematic review and pooled analysis

Celeste MANFREDI ^{1, 2} ✉, Giorgio I. RUSSO ³, Paolo CAPOGROSSO ⁴, Marco FALCONE ⁵, Marco CAPECE ⁶, Ioannis SOKOLAKIS ⁷, Paolo VERZE ⁸, Andrea SALONIA ⁹, Peter TSAMBARLIS ², Leonardo SELIGRA LOPES ¹⁰, Javier ROMERO-OTERO ¹¹, Marco DE SIO ¹, Laurence LEVINE ² on behalf of YAU Working Group Sexual and Reproductive Health 

¹ Unit of Urology, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy; ² Department of Urology, Rush University Medical Center, Chicago, IL, USA; ³ Urology Section, Department of Surgery, University of Catania, Catania, Italy; ⁴ Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy; ⁵ Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy; ⁶ Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy; ⁷ Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece; ⁸ Scuola Medica Salernitana, Department of Medicine, Surgery, Dentistry, University of Salerno, Salerno, Italy; ⁹ Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy; ¹⁰ Department of Urology, Centro Universitário FMABC, Santo André, Brazil; ¹¹ Department of Urology, HM Hospitales, Madrid, Spain

INTRODUCTION: Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) is the first validated questionnaire to specifically evaluate the satisfaction of patients undergoing penile prosthesis implantation. Our primary aim was to conduct a systematic review and pooled analysis of articles reporting QoLSPP.
EVIDENCE ACQUISITION: A comprehensive bibliographic search on the MEDLINE, Scopus, Web of Science, and Cochrane Library databases was performed in April 2023. Studies were selected if they assessed male subjects (P) undergoing penile prosthesis implantation (I) with or without comparison with other treatments (C), reporting the patient satisfaction according to QoLSPP (O). Prospective and retrospective original studies were included (S). The risk of bias was assessed using the ROBINS-I tool and the Knoll method. Means and standard deviations (SDs) of QoLSPP scores were included in the pooled analysis. PROSPERO ID: “CRD42023427261.”
EVIDENCE SYNTHESIS: A total of 10 studies investigating 1105 patients were included in the systematic review; of these, eight articles describing the outcomes of 693 subjects were eligible for the pooled analysis. Overall serious risk of bias was found in 2/3 of nonrandomized comparative studies (66%), while seven single-arm studies (100%) were classified as having a high risk of bias. Pooled analysis of the QoLSPP-Functional domain revealed an overall effect size (ES) of 4.22 points (95% CI 4.04-4.40; P<0.001). The QoLSPP-Relational pooled score was 4.17 points (95% CI 4.03-4.31; P<0.001). The QoLSPP-Social pooled score corresponded to 4.21 points (95% CI 4.02-4.40; P<0.001). Pooled analysis of the QoLSPP-Personal domain showed an overall ES of 3.97 points (95% CI 3.61-4.32; P<0.001). There was insufficient data to pool QoLSPP total scores.
CONCLUSIONS: Patients undergoing penile prosthesis implantation report positive scores in all QoLSPP domains, demonstrating high satisfaction levels. Future studies are needed to improve the evidence on the topic.

KEY WORDS: Erectile dysfunction; Penile prosthesis; Quality of life; Patient satisfaction