Objective: This study aims to evaluate the feasibility and safety of penile prosthesis implantation (PPI) revision surgery in a high-volume center.
Materials and Methods: We retrospectively analyzed data from 30 patients undergoing PPI revision between January 2021 and September 2024, performed by two experienced andrology-trained surgeons at two centers. Patient demographics, comorbidities, surgical details, and complications were recorded. Quality of life was assessed at three months using the Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Complications were classified using the Clavien-Dindo system.
Results: Revision indications included non-functioning prostheses (33.3%), visible deformity (16.7%), inadequate inflation (20%), conversion from malleable to inflatable penile prosthesis (IPP) (13.3%), and infection (16.7%). Infrapubic (40%) or penoscrotal (60%) approaches were used. Mean operative time was 101.8 minutes, hospital stay was 2.1 days, and follow-up was 9 months. Complications (Clavien-Dindo Grade I-II) included orchitis (10%), wound infection (6.7%), and scrotal/perineal ecchymosis (13.3%), all resolved conservatively. Staphylococcus epidermidis was the most common pathogen in infections. Patients transitioning to IPPs reported high QoLSPP scores.
Conclusion: PPI revision surgery, when performed by skilled surgeons, is safe and effective, with high patient satisfaction, particularly for IPP transitions. Larger studies with longer follow-up are needed to assess long-term outcomes.