Arch Ital Urol Androl. 2026 May 20. doi: 10.4081/aiua.2026.14954. Online ahead of print.
ABSTRACT
BACKGROUND: The aim of this paper was to compare the intraoperative and postoperative outcomes of two similar groups of patients who underwent three-component penile prosthesis implantation under spinal versus local anaesthesia.
MATERIALS AND METHODS: We reviewed retrospectively the medical records of twenty consecutive patients who underwent three-component penile prosthesis implantation for erectile dysfunction under spinal anaesthesia (S-PPI) versus local anaesthesia (L-PPI) in the period between January 2023 and January 2025. As regards the assessment of the pain, the patient’s requests of sedation due to pain complaining during the induction of the anesthesia and the following surgical procedure were assessed. The Visual Analogue Scale (VAS) was also used for pain assessment six hours and one day after the surgical procedure. A modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) validated questionnaire was used to evaluate patient satisfaction after the prosthesis implantation. Perioperative and postoperative complications were also assessed.
RESULTS: There was no statistical difference in terms of age, BMI and etiology of erectile dysfunction among the two groups. As regards the assessment of the pain, a significantly higher request of sedation was assessed in the S-PPI group than in the L-PPI group of patients (10% versus 40%) due to discomfort during the local anaesthesia or the surgical procedure (p < 0.05). On the contrary, mean VAS scores of 6.0 and 6.5, 5.5 and 5 were reported by the S-PPI and L-PPI groups at 6 and 24 hours after surgery respectively, showing a similar degree of postoperative pain among the two groups of patients. The EDITS questionnaire scores showed no significant difference between the two groups in terms of patient satisfaction. As regards the complications, no significant difference was assessed between the two groups of patients.
CONCLUSIONS: Our preliminary outcomes showed that a threecomponent penile prosthesis implantation under local anesthesia can be successfully performed in terms of postoperative pain control, acceptable complication rates and remarkable satisfaction scores with respect to the same procedure under spinal anaesthesia. Concerning the perioperative pain control, a significantly higher request of sedation was reported in the L-PPI group of patients with respect to the S-PPI group due to discomfort during the induction of local anesthesia or the implant procedure. Basing on these aspects, we think that a three-component penile prosthesis implantation in local anaesthesia could be proposed in selected patients with comorbidities which contraindicated spinal or general anesthesia or in patients unwilling to undergo these types of anesthesia after a preoperative counselling regarding the pain control and the possible need of sedation.
PMID:42165155 | DOI:10.4081/aiua.2026.14954
