Nwaha Makon AS1,2, Mekeme Mekeme JB1, Badjam Hadjidjatou Djingui Ngetiko1, Nzati3, Tazemda Kuitsouc GB5, Ngandeu JM2, Biyouma MDC2, Etobe CMT2, Mbassi AA3, Ngowe Ngowe M2,4.
1- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé 1.
2- Hôpital Laquintinie de Douala (Cameroun).
3- Institut Supérieur de Technologie Médicale, Université de Douala.
4- Faculté de Médecine et des sciences Pharmaceutiques, Université de Douala.
5- Institut de Management et d’Ingénierie de la Santé, Université de Lille.
Correspondance: Dr Axel Stéphane NWAHA MAKON, Hôpital Laquintinie de Douala, Cameroun.
Tél : + 237 699236640. E-mail : [email protected].
SUMMARY
Introduction: erectile dysfunction (ED) is a common issue among aging men, often tied to health
conditions like prostate cancer or diabetes. When medications and other conservative treatments don’t work, penile prosthesis implantation becomes the go-to option. In settings where resources are limited, semi-rigid implants stand out as the most practical and accessible solution. This study set out to examine how semi-rigid penile prostheses perform in real-life conditions in Cameroon—looking at who receives them, why, how the surgeries are done, and how patients fare afterward in terms of function, satisfaction, and complications.
Material and Methods: we followed 30 patients over a 4.5-year period (January 2020 to July 2024) who had severe ED that didn’t respond to medical treatment. Each underwent implantation of a semi-rigid penile prosthesis. Erectile function was measured using the IIEF-5 before and after surgery, and satisfaction was assessed at six months using the EDITS questionnaire. We also tracked surgical details and any complications.
Results: patients had a mean age of 63.7 years. Some were living with prostate cancer (53.3%) or diabetes (70%), and 80% had ED of organic origin. All surgeries were performed under spinal anesthesia, mostly via a longitudinal penoscrotal approach. Erectile function improved significantly post-surgery, with median IIEF-5 scores rising from 5 to 15 (p < 0.0001). By six months, 83.3% of patients had resumed sexual activity. Satisfaction was generally high, with a median EDITS score of 93.1, though six patients reported moderate to low satisfaction (≤65). The overall complication rate was 16.7%, including manageable cases of hematoma, infection, erosion, and mechanical issues.
Conclusion: semi-rigid penile prosthesis implantation proves to be a solid and effective solution for severe ED in low-resource environments. It delivers strong functional outcomes and high patient satisfaction, with a safety profile that remains acceptable. Future studies should also include a direct assessment of partner satisfaction to provide a more complete picture of postoperative outcomes.
Key words: erectile dysfunction, penile prosthesis, semi-rigid implant, patient satisfaction, IIEF-5, EDITS, low-resource setting.