Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Erektil Disfonksiyon Tedavisinde Üç Parçalı Şişirilebilir Penil Protez Cerrahisinin Uzun Dönem Sonuçları ve Çiftlerin Memnuniyeti
Long Term Outcomes and Couples' Satisfaction with Three-Piece Inflatable Penile Prosthesis Surgery in the Treatment of Erectile Dysfunction
Ozan EFESOYa, Engin ÖZBAYa, Mesut TEKa, Erdem AKBAYa, Selahittin ÇAYANa
aÜroloji AD, Mersin Üniversitesi Tıp Fakültesi, Mersin
Turkiye Klinikleri J Med Sci. 2010;30(6):1965-70
doi: 10.5336/medsci.2009-14125
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızın amacı üç parçalı şişirilebilir penil protez implantasyonunun komplikasyonlarını, uzun dönem mekanik sağ kalım oranı ile hasta ve eşlerinin memnuniyetini irdelemektir. Gereç ve Yöntemler: Temmuz 1999 ile Aralık 2008 tarihleri arasında kliniğimizde organik erektil disfonksiyon tanısıyla üç parçalı şişirilebilir penil protez yerleştirilen 68 hastanın verileri retrospektif olarak değerlendirildi ve penil protez tipleri ile istenmeyen yan etkiler kaydedildi. Daha sonra hasta ve eş memnuniyeti telefon görüşmeleri ya da yüz yüze görüşmelerde modifiye EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction) sorgulama formu kullanılarak değerlendirildi. Bulgular: Hastaların ortalama yaşı 55 ± 10.75 (25-76) yıl ve izlem süreleri 54.72 ± 35.53 (6-116) aydır. Olguların 10'unda (%14.7) konservatif yöntemlerle kontrol edilebilen penoskrotal ödem veya hematom, üç olguda (%4.4) antibiyoterapi ile baskılanan ve protezin çıkarılmasını gerektirmeyen enfeksiyon gelişirken, altı olguya (%8,8) revizyon cerrahisi yapılmıştır. Bu olgulardan 5'ine mekanik cihaz hasarı, 1'ine ise protez erozyonu nedeniyle protez revizyonu yapılmıştır. Olguların tamamı, eşlerin ise 52'sinin memnuniyet düzeyleri değerlendirilebilmiştir. Olguların 61'inin (%89.7) oldukça memnun, altısının (%8.8) kısmen memnun ve yalnız birinin (%1.5) hiç memnun olmadığı saptanırken eşlerin 48'inin (%92.3) oldukça memnun, dördünün (%7.7) ise kısmen memnun olduğu saptandı. Sonuç: Üç parçalı şişirilebilir penil protez implantasyonu organik erektil disfonksiyonlu erkeklerin tedavisinde, uygun hasta seçimi ve ameliyat öncesi yeterli bilgilendirme yapıldığı takdirde, kabul edilebilir komplikasyon ve revizyon oranları; yüksek başarı ve hasta/eş memnuniyeti ile etkin ve güvenilir bir tedavi seçeneğidir.

Anahtar Kelimeler: Sertleşme bozukluğu; penis protezi; komplikasyonlar; kişisel memnuniyet
ABSTRACT
 Objective: The aim of this study was to assess the complications, long-term mechanical reliability and couples' satisfaction with three-piece inflatable penile implantations. Material and Methods: A total of 68 organic erectile dysfunction patients treated in our clinic with three-piece inflatable penile implantations between July 1999 and December 2008 were retrospectively evaluated and the adverse events observed with each type of penile prosthesis were recorded. Couples' satisfactions after treatment were evaluated by the modified EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction) questionnaire administered through telephone or face-to-face interviews. Results: The mean age of the patients was 55 ± 10.75 years (range 25-76), and the mean follow-up period was 54.72 ± 35.53 months (range 6-116). Penoscrotal edema/hematoma manageable by conservative methods was observed in 10 (14.7%) cases. Infection was observed in three (4.4%) cases which could be suppressed by antibiotics and did not require removal of the device. Six cases (8.8%) underwent revision surgery because of mechanical device failure in five, and spontaneous urethral prosthesis erosion in one patient. Evaluation of the couples' satisfaction revealed that 89.7% (61/68) of the patients were very/extremely satisfied, 8.8% (6/68) were somewhat satisfied and one patient (1.5%) was not satisfied at all. Partners satisfaction rate of very/extremely satisfied was 92.3% (48/52), and somewhat satisfied was 7.7% (4/52). Conclusion: Three-piece inflatable penile prosthesis implants, with high levels of treatment success and patient and partner satisfaction, are effective and safe options for treatment of organic erectile dysfunction with acceptable complication and revision rates if performed by appropriate patient selection and adequate preoperative information.

Keywords: Erectile dysfunction; penile prosthesis; complications; personal satisfaction

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30.03.2014

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