(153) Laparoscopic Radical Prostatectomy with the Simultaneous Implant of a Penile Prosthesis: Penile Length Preservation After 10 years Follow Up

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Abstract Introduction The preservation of the full dimensions of the penis is an important consideration for improving patients' compliance for the treatment after prostatectomy. We performed twenty laparoscopic extraperitoneal RP and simultaneous penile prosthesis implantation (PPI) in order to preserve the full length of the penis and to improve patients' satisfaction in 2013. Objective Objective of the study is to evaluate the ten years follow up of this unique series in the world. Oncological and functional results were analyzed. Methods From June 2013 to June 2014, 20 patients underwent simultaneous PPI (with an AMS InhibiZone prosthesis) and RP laparoscopic. Patients were evaluated by means of urological visits, questionnaires, and objective measurements before surgery, at discharge from the hospital, on postoperative days 21 to 28, each 3 months for the first year, and each 1 year thereafter. The main outcome measures were biochemical recurrence-free rate, penile length, and quality of life. Results 15 patients mean age 71 range 66–75 were reached at the 10-year follow-up-1 died of acute infarction 10 years after surgery, 1 died of disease 7 years after surgery; 3 lost to followup. Partners had mean age 60 with range 37–71 years. Mean preoperative PSA 9.3 (6.3–13.7) at 10 years 0.08 (range 0.01–1.2); Pre-surgical IIEF 11 (range 9–14) to 10 years 23 (range 22–25). 10-year partner satisfaction rating had increased from 8 post-surgical to 7. Penis size unchanged after 10 years: surgery day 9 cm (range: 8.5–9.5) at 10 years 8.8 range (8–9.5). Conclusions In our cases, the simultaneous extraperitoneal laparoscopic surgery of radical prostatectomy and penile prosthesis implantation is an interesting option to offer to selected and highly motivated patients. Preservation of the size of the penis, the possibility of resuming normal sexual activity 21 days after surgery, partner satisfaction and oncological safety with a 10-year follow-up make it a surgical technique to be proposed in clinical practice if performed by a team with experience in prosthetic surgery. Disclosure No.

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