Erectile dysfunction patients are more satisfied with penile prosthesis implantation compared with tadalafil and intracavernosal injection treatments

There are various treatment modalities for erectile dysfunction with different success and satisfaction rates. We aim to compare patient satisfaction with tadalafil, intracavernosal injection, and penile prosthesis implantation in patients with erectile dysfunction. The records of 3448 men with erectile dysfunction were evaluated retrospectively. A total of 356 men with organic erectile dysfunction were enrolled into this study. Of these patients, 132 (37%) received tadalafil 20 mg twice a week for 12 weeks, 106 (30%) patients received tadalafil 5 mg once-daily for 12 weeks, 96 (27%) patients used intracavernosal injection therapy (Bi-mix; papaverine and phentolamine). Moreover, 22 patients underwent penile prosthesis implantation. Patient and partner satisfaction were assessed with International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Patients' mean age was 52.4 +/- 25.76 (32-71). The etiology of erectile dysfunction was chronic systemic diseases in 133 (44%) and radical prostatectomy in 121 patients (40%). The mean IIEF-5 scores improvement after the treatment was higher in penile prosthesis implantation group (12.4 +/- 1.3) compared with tadalafil 5 mg (6.7 +/- 1.5) (p < 0.01), tadalafil 20 mg (6.2 +/- 1.5) (p < 0.01), and intracavernosal injection group (8.4 +/- 3.2) (p < 0.05). The EDITS score was significantly higher in penile prosthesis implantation group (78.2 +/- 11.3) compared with intracavernosal injection (60.3 +/- 6.3), tadalafil 5 mg (72.5 +/- 4.5), and tadalafil 20 mg 70.7 +/- 3.4 groups (p < 0.05). Partners' EDITS scores were 70.1 +/- 10 in penile prosthesis implantation group, 50.2 +/- 1.5 in intracavernosal injection group, 62.9 +/- 7.8 in tadalafil 5 mg, and 61.3 +/- 5.3 in tadalafil 20 mg group (p < 0.05). Erectile dysfunction patients who underwent penile prosthesis implantation seem to be more satisfied compared with tadalafil treatment and intracavernosal injection. Future clinical trials are warranted to confirm our results.