Prognostic value of doppler ultrasound prior to penile prosthesis implantation

Abstract Objectives Penile Doppler ultrasound prior to penile prosthesis implantation is useful for aetiological diagnosis and to assess the response to intracavernous injections. The objective of our study was to analyze the relationship between the parameters collected in the preoperative Doppler ultrasound of the penis, performed per protocol, and postoperative complications and patient satisfaction. Methods We conducted a retrospective observational study, selecting patients undergoing penile prosthesis implantation in our center from 2017 to 2020, with at least 1 year of follow-up after surgery. The baseline characteristics of the cohort, basic parameters of penile Doppler ultrasound, surgical aspects, postoperative complications according to the Clavien-Dindo classification, and postoperative pain were collected. In addition, satisfaction was assessed by telephone interview. Results A total of 36 patients were selected, of whom 28 participated in the study (77.8% response rate). The mean age was 64.6 years and the mean time of evolution of erectile dysfunction prior to surgery was 5.7 years. Using Doppler ultrasound, 36.1% were diagnosed with arterial insufficiency and 22.2% with failure of the venocorpo-occlusive mechanism. Neither the maximum peak systolic velocity (p 0.58), nor the minimum end-diastolic velocity (p 0.99), nor the maximum resistance index (p 0.41), were related to the rate of complications or the level of satisfaction after surgery. Using linear regression, it was found that the shorter the corporotomy time (p 0.0001) and the shorter the surgical time (p 0.0001), the greater the satisfaction with the implant. Conclusions Doppler ultrasound prior to penile prosthesis implantation does not seem to have any prognostic value after surgery, neither in relation to the rate of complications nor in relation to satisfaction. A shorter surgical time, possibly reflecting a simpler surgery and a lighter postoperative period, seems to be related to greater satisfaction after implantation. Conflicts of Interest No conflict of interest with this presentation.