Abstract Introduction Surgeon-reported outcomes following inflatable penile prosthesis (IPP) procedures historically demonstrate high levels of satisfaction. However, patient-reported outcomes provide a more accurate reflection of real-world experience. The Satisfaction Survey for Inflatable Penile Implant (SSIPI) is the only validated English-language instrument designed to assess patient outcomes across four domains of IPP function and satisfaction. With increasing longevity, improved medical care, and implantation in younger populations, the number of patients requiring IPP revision surgery has risen. Objective This study aimed to evaluate patient satisfaction following revision IPP using the SSIPI questionnaire. Methods Study population consisted of men at 4 high-volume centres who had IPP revision surgery and completed the SSIPI. SSIPI was administered at least 6 months postoperatively. Patients with primary IPP were excluded. SSIPI: 16 questions across 4 domains including, satisfaction (S, 4Q/score range 4-20), pain (P, 2Q/2-10), appearance (A, 5Q/6-30) and function (F, 4Q/4–20), each composed of questions scored on a 1–5-point Likert scale, where higher scores indicate more favourable outcomes. We selected an endpoint of scoring ≥4 (most of the time) on all 16 questions to define overall high satisfaction (high satisfaction, low pain, high comfort with appearance, excellent function). Results To date, complete data exist for 66 patients. Mean age at SSIPI completion was 63 (SD 13) years. 83% were in a relationship (62% married, 21% partnered). 44 (66%) had 1 revision, 16 (25%) 2 revisions and 6 patients (9%) 3 revisions. Mean duration post-initial IPP at completion of SSIPI was 8.2 (7.7) years. 27% had a history of radical prostatectomy, 11% prostate radiation therapy, 9% diabetic, and 15% a history of priapism. 35% had revision for mechanical failure, 27% infection, 8% for erosion. At the time of SSIPI completion, 85% of patients were sexually active. Mean total IPP use over the 3 months prior to SSIPI completion was 7.6 (10). Mean total SSIPI score was 56 (18). 61% of men met our definition of high satisfaction, the scores meeting the high satisfaction criterion for each of the 4 domains being: P (72%) F (63%), S (58%) and A (57%). Subgroup analysis of those with 1, 2 and 3 revisions showed a total mean score of 58, 53 and 52 respectively highlighting decreasing satisfaction with subsequent operations. Additionally, those with mechanical failure reported higher mean total score (60) than those with infection (55) and this was also apparent in each specific domain. Conclusions Using a validated instrument, two thirds of men after IPP revision surgery meet our a priori definition of high satisfaction. Those with who had revision for mechanical failure have higher satisfaction than those with revision for infection. Disclosure No
Al-Mitwalli et al. (Mon,) studied this question.