OUTCOME ANALYSIS OF PENILE IMPLANT-SURGERY AFTER EXTERNAL-BEAM RADIATION FOR PROSTATE-CANCER

Purpose: We evaluated the success and possible complication rates of p enile implant surgery in patients who underwent external beam radiatio n therapy for prostate cancer. Materials and Methods: We reviewed the charts of 43 patients who underwent penile implant surgery after radia tion therapy for prostate cancer. The type, dose and volume of radiati on were assessed. The types of surgical approach and prosthesis as wel l as complications were recorded. A total of 34 patients was alive and traceable, and 9 were untraceable (7 dead and 2 missing). The 34 trac eable patients were interviewed personally or by telephone to evaluate the function of and satisfaction with the penile implant. Followup of the 9 untraceable patients was assessed through a chart review. Resul ts: A total of 35 patients (81%) received definitive radiation therapy to the prostate and seminal vesicles, and 8 (19%) underwent radical r etropubic prostatectomy followed by radiation therapy to the prostatic bed. Mean age at implant surgery was 67 years (range 36 to 83). In th e 43 men 46 procedures were done and mean followup was 40 months. None of the patients in this series had infection or erosion. Of the men 2 4 (71%) use the prosthesis at least once weekly or more for sexual int ercourse, 6 (17%) use it twice monthly, 4 (12%) are not sexually activ e despite a functioning implant, 2 are not sexually active because of a lack of sexual partners, and 2 are not satisfied with the implant an d would not recommend this device. Discomfort from the penile implant was reported by 2 patients, although they currently use the implant fo r intercourse at least twice weekly. Conclusions: Penile prosthesis su rgery can be safely and effectively performed after radiation therapy with minimal intraoperative and postoperative complications, and an ex cellent patient satisfaction rate.