Клінічна та профілактична медицина (Dec 2023)
HISTORICAL AND PSYCHOTHERAPEUTIC ASPECTS OF PENILE IMPLANTATION
Abstract
Introduction. To date, despite significant progress in the field of erectile dysfunction (ED) pharmacotherapy, for a certain group of patients, the implantation of a penile prosthesis is the only possible way to return them to an active sexual life. To increase the satisfaction with the sexual life of men and their partners, the improvement of models of penile prostheses, which has its own history, is being carried out. In addition, in andrology, methods of psychotherapeutic correction of ED are introduced for both men and their partners. The aim. To determine the influence of the type of penile implant and psychotherapeutic correction on the frequency of satisfaction of sexual partners. Materials and methods. Out of 354 patients operated on by us, 80 men with severe organic ED and their sexual partners consented to participate in the study. Men underwent penile implantation. Participants were divided into two groups: 1st group – 40 couples in which men had a plastic implant installed; The 2nd group – 40 couples in which men had a hydraulic implant installed. Each group was divided into two subgroups. In subgroups 1a (20 couples) and 2a (20 couples), psychological counseling was given to both partners before and after the operation, in subgroups 1b and 2b no psychological counseling was given. Results: Between subgroups 1b and 2b, patients whose psychological counseling was not performed, differences in the general satisfaction with sexual life in women were not observed, and it was observed in both subgroups in 65% of the patients' partners. Men of these subgroups were satisfied with their sex life after implantation in 80% and 85%, respectively. In 95% of women after psychotherapeutic support (subgroups 1a and 2a), satisfaction with sexual life was noted, which was statistically significantly higher (Fisher's exact test, p < 0.05) than in women of subgroups 1b and 2b. In men of subgroups 1a and 2a, this indicator corresponded to 90% and 95%, respectively. Dissatisfaction among partners in subgroups 1b, 2b, respectively, was 35%, among women after psychotherapeutic correction (subgroups 1a, 2a), 10% and 5%, respectively. Conclusions. The obtained data show that satisfaction with sexual life in men does not depend on the implant model and psychological counseling. Unlike men, the frequency of satisfaction with sexual life in female partners after psychotherapeutic correction reaches 95%, which is statistically significant more than without it (р˂0.05).
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