Patient Satisfaction and Outcomes of Penile Prosthesis Implantation in Psychogenic and Organic Erectile Dysfunction: A Comparative Study

<b>Background</b>: Penile prosthesis implantation (PPI) is an established treatment for erectile dysfunction (ED). Nevertheless, the effectiveness of and satisfaction with PPI in mainly psychogenic ED compared to mainly organic ED patients remain underexplored. <b>Aim</b>: To evaluate patient satisfaction outcomes following PPI in individuals diagnosed as mainly psychogenic ED vs. mainly organic ED. <b>Methods</b>: Twenty-five patients with psychogenic ED who underwent PPI were included. Data were collected from medical records and a follow-up assessment was done using the Quality of Life and Sexuality with Penile Prosthesis (QolSPP) questionnaire. Additionally, the patients filled out an ad hoc questionnaire including self-reported satisfaction rated on a 1-to-10 scale, the Global Assessment Questionnaire-Questions 1 and 2 (GAQ-1, 2), and the Sexual Encounter Profile Questions 2 and 5 (SEP-2, 5). Results were compared with those of 36 patients with mainly organic ED (control) for comparative analysis. <b>Results</b>: In the psychogenic ED group, 96% reported improved erections, 92% felt more confident initiating sex, 92% achieved penetration and 95% had satisfactory sexual encounters. The overall satisfaction score was 8.71 on a 10-point scale. Comparative analysis using the QolSPP questionnaire revealed statistically significant differences favouring the psychogenic group in 8 of 16 questions, regarding prosthesis satisfaction and overall well-being. Surgical complications were noted in 16% of the psychogenic group, compared to a 2.8% complication rate in the organic ED control group. <b>Conclusions</b>: The findings indicate high levels of satisfaction with PPI among patients with psychogenic ED, comparable to those with organic ED. However, an increase in complications in the psychogenic cohort highlights the need for careful consideration of surgical risks in this population.