Preoperative counseling for penile implant surgery

madman

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A must read for anyone considering getting a penile implant!

This is gold!




Shared-decision making is crucial in today’s society. Although penile prosthesis surgery has had significant improvements regarding technique and materials over the last few decades - with the highest satisfaction rate in erectile dysfunction treatment at present time -, dissatisfaction can occur because of bad preoperative counseling with the creation of unrealistic expectations. This paper includes a small narrative review regarding the most important preoperative variables to be discussed in the preoperative setting. Literature search was conducted in December 2023 using PubMed. Additionally, our own standardized flowchart for preoperative counseling was added. The most important aspects of preoperative counseling include a description of the pathophysiology of erectile dysfunction as well as alternative treatments. Information should be given about which implant categories exist. Additionally, some information about the procedure itself as well as the financial aspect should be communicated. The most frequent and most important complications should be illustrated. Last but not least, the patient’s expectations should be evaluated. Our added standardized flowchart with figure acts as a practical guideline for professionals as well as for patients. Our standardized approach for preoperative counseling emphasizes reasonable post operative expectations aiming for a well-informed patient with high postoperative satisfaction. Our general strategy is to underpromise and overdeliver.




PATHOPHYSIOLOGY AND ALTERNATIVE TREATMENTS


CHOOSING THE RIGHT IMPLANT


INFORMATION ABOUT THE PROCEDURE ITSELF


FINANCIAL CONSIDERATIONS


COMPLICATIONS


EXPECTATIONS REGARDING SEXUAL FUNCTION


STANDARDIZED APPROACH IN OUR HIGH-VOLUME CENTER OF EXCELLENCE




CONCLUSION

This article demonstrates some of the most crucial aspects for counseling in penile implant surgery. Our overview illustrates some key features that deserve consideration in a preoperative setting. Additionally, our standardized flowchart used in the informative preoperative consultation was added as a practical guide. By using this standardized approach, we try to merge structure and evidence-based data in order to optimize the quality of our counseling which will result in a well-informed and satisfied patient. Our general strategy is to underpromise and overdeliver.
 

Attachments

Fig. 1 Standardized flowchart for preoperative counseling in penile implant surgery.
1720381318860.webp





Screenshot (37783).webp

Screenshot (37784).webp
 
*The most important aspects of preoperative counseling include a description of the pathophysiology of erectile dysfunction as well as alternative treatments. Information should be given about which implant categories exist. Additionally, some information about the procedure itself as well as the financial aspect should be communicated. The most frequent and most important complications should be illustrated. Last but not least, the patient’s expectations should be evaluated.

*Our added standardized flowchart with figure acts as a practical guideline for professionals as well as for patients. Our standardized approach for preoperative counseling emphasizes reasonable post operative expectations aiming for a well-informed patient with high postoperative satisfaction. Our general strategy is to underpromise and overdeliver.
 

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Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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