There is limited scientific literature regarding the management outcomes for end-stage erectile dysfunction (ED) following radical cystoprostatectomy (RCP). This study aims to evaluate the surgical outcomes of penile prosthesis (PP) implantation. A retrospective analysis over 17 years (2004-2017) was performed from the clinical records of patients in four tertiary referral centres, whom previously had undergone RCP, followed by PP implantation for end-stage ED. Outcome measures include both intra and postoperative complications, operative duration, a 5-point Likert hematoma scale as well as length of hospital stay. Additionally, a matched-pair cohort analysis was performed, dividing patients in 2 groups according to the type of urinary diversion (neobladder versus ileal conduit/cutaneous ureterostomy). The median time elapsed between RCP and PP implantation was 38 months (IQR 20-56). The median follow-up was 18 months (IQR 12-156). A 3-piece inflatable PP was implanted in 43 patients (91.5%) whereas a semirigid device was implanted in the remainder. Reservoir position was extra-peritoneal (utilising a separate abdominal incision) in 24 patients (54.8%), while an ectopic high-submuscular placement was preferred in the remainder. PP infection and mechanical failure occurred in 1 (2.1%) and 3 cases (6.3%) respectively. The comparative analysis of surgical outcomes did not show any statistically significant difference between the two groups. Our evidence suggests that PP implantation in patients with refractory ED following RCP may represent a safe and effective procedure associated with a low incidence of complications. The main limitation of this study is represented by the non-randomised, retrospective nature as well as the lack of patients' functional outcomes and the limited follow-up.

中文翻译：

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根治性膀胱前列腺切除术和尿流改道后阴茎假体植入的结果分析：一项多中心回顾性队列研究。

关于根治性膀胱前列腺切除术（RCP）后终末期勃起功能障碍（ED）的治疗结果的科学文献有限。本研究旨在评估阴茎假体（PP）植入的手术效果。回顾性分析了17个年（2004-2017年）在四个大三级转诊中心的患者的临床记录，这些患者先前曾接受过RCP，随后进行了PP植入以进行末期ED。结果指标包括术中和术后并发症，手术时间，5点李克特血肿量表以及住院时间。此外，进行配对配对队列分析，根据尿流改道的类型（膀胱与回肠导管/皮肤输尿管造口术）将患者分为两组。RCP和PP植入之间的中位时间为38个月（IQR 20-56）。中位随访时间为18个月（IQR 12-156）。3例可充气PP植入了43例患者（占91.5％），而其余部分则植入了半刚性装置。24例患者（54.8％）的腹膜位置为腹膜外（采用单独的腹部切口），其余患者则首选异位高肌肉下放置。PP感染和机械衰竭分别发生1例（2.1％）和3例（6.3％）。手术结局的比较分析未显示两组之间的统计学差异。我们的证据表明，RCP后难治性ED患者PP植入可能代表一种安全有效的方法，并发症发生率低。