Psychosexual Adjustment After Penile Prothesis Surgery

Technical advances in genitourinary surgery and the recent development of an inflatable penile prosthesis have led to an increased frequency of penile prosthesis surgery being used to correct male erectile disturbance. 1 In spite of the frequency with which such surgery is performed, very little is known about the psychosexual adjustment of patients and their spouses post-surgeryY The majority of the reports by genitourinary surgeons indicate that most men are satisfied with the surgical results2 ,4,5 Precise data on the frequency of intercourse post-surgery and the effect of surgery on the marital relationship is lacking in these clinical series. 6 Isolated reports in the literature suggest that penile prosthesis surgery may be followed by sexual refusal ~ or divorce2 Kramarsky-Binkhorst 9 reported the largest study by a non-genitourinary surgeon of the effect of penile prosthesis implantation on the marital relationship. She at tempted to interview This article was read in part at the American Psychiatric Association Annual Meeting Toronto, 1982. R. Taylor Segraves is Associate Professor of Psychiatry, Harry W. Schoenberg is Professor of Surgery, {Urology), Christopher K. Zarins is Associate of Surgery (Vasular), at the Department of Psychiatry and Surgery, University of Chicago. Send requests for reprints to Dr. Segraves at Department of Psychiatry, University of Chicago, 950 East 59th Street, Chicago, IL 60637. Sexuality and Disability, Volume 5, Number 4, Winter 1982 222 0146-1044/82/1600-0222502.7501982 Human Sciences Press R. Taylor Segraves, Harry W. Schoenberg, and Christopher K. Zarins 223 60 men and their wives after Small-Carrion prosthesis surgery. Almost half of the men refused to allow her to interview their wives, saying that the prosthesis had not been used or had been used solely in extramari tal relationships. Of the wives interviewed, less than half were satisfied with the results of the surgery. Information concerning the psychological and interpersonal effects of penile prosthesis is important as some urologists 1° have recently indicated an increased willingness to consider surgical interventions for psychogenic impotence. Approximately, one-half of the reported cases of penile prosthesis surgery concern men diagnosed as being psychogenically impotent. The purpose of this report is to evaluate the psychological, interpersonal and sexual impact of penile prosthesis implantation on a small group of men studied intensively at the Universi ty of Chicago.