Penile prosthesis implantation (PPI) is the gold standard treatment for patient with refractory erectile dysfunction (ED) and the number of patients underwent PPI due to ED has been increasing in Korea recently. However, few studies have been conducted to assess the patients’ and his partner’s satisfaction after PPI in Korea. Therefore, we retrospectively investigated the surgical outcomes and the couples’ satisfaction after PPI, according to type of penile prosthesis.

This retrospective study included a total of 157 patients with ED who underwent PPI between January 2010 and December 2018. Of the patients, 73 patients had malleable penile prosthesis (AMS 600) and 84 patients had inflatable penile prosthesis (AMS 700). Couples’ satisfaction was evaluated with the modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire within 12 months after surgery through face-to face or telephone interview by single disinterested coordinator. Surgical outcomes and mechanical reliability were assessed according to the type of penile prosthesis.

The mean age of all patients and his partners underwent penile prosthesis were 59.8±14.1 and 47.1±9.5 years, respectively. The mean follow-up period was 98.3±69.8 months. The mean duration of mechanical life-expectancy was 104.8±51.2 and 112.5±64.5 months in inflatable penile prosthesis and malleable penile prosthesis, respectively. The overall patients’ satisfaction after PPI were 78.34%. The postoperative complications such as infection, device malfunction, and corporal perforation were higher in the inflatable penile prosthesis than in the malleable penile prosthesis (6.8% vs 3.1%, p=0.017). However, couples’ satisfaction after PPI was significantly higher in the inflatable penile prosthesis than in the malleable penile prosthesis (p<0.001).

In terms of mechanical function, there was significant difference between inflatable penile prosthesis and malleable penile prosthesis (p=0.017). In group of inflatable penile prosthesis, the postoperative complications rate was higher than malleable penile prosthesis, although the difference of mechanical life-span between inflatable penile prosthesis and malleable penile prosthesis was not significant. In terms of satisfaction, the patient and his partner had high satisfaction after surgery in both group (overall satisfaction rate was 78.34%). Especially, couples' satisfaction in inflatable penile prosthesis was higher than that in malleable penile prosthesis (88.4% vs 72.9%, respectively, p<0.001).

Although overall survival rate was lower in the inflatable penile prosthesis than in the malleable penile prosthesis, the implantation of inflatable penile prosthesis had higher couples’ satisfaction rates than the malleable penile prosthesis after 1 year of surgery. The type of penile prosthesis should be considered according to patient and his partner's expectation and conditions.