Assessing psychiatric risk with a focus on optimizing patient satisfaction with penile prosthesis placement-a narrative review.

Autor:	Helo S; Department of Urology, Mayo Clinic, Rochester, MN, USA., Betcher HK; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Ziegelmann M; Department of Urology, Mayo Clinic, Rochester, MN, USA.
Jazyk:	angličtina
Zdroj:	Translational andrology and urology [Transl Androl Urol] 2023 Nov 30; Vol. 12 (11), pp. 1761-1771. Date of Electronic Publication: 2023 Nov 07.
DOI:	10.21037/tau-23-144
Abstrakt:	Background and Objective: Treatment for medication-refractory erectile dysfunction (ED) is based on a shared decision-making model. The gold standard treatment for medication refractory ED is penile prosthesis (PP) placement. Patient satisfaction rates with PP are high with adequate counseling and expectation-setting. However, as with any elective surgery, patient selection is key to minimizing complications and ultimately patient dissatisfaction. Psychological well-being is an important consideration in the preoperative evaluation and postoperative management of patients undergoing PP placement. Methods: We performed a PubMed literature review to identify pertinent studies for this narrative review. Specifically, we sought describe preoperative evaluation including appropriate counseling and patient selection as well relevant intraoperative and postoperative factors for patients undergoing PP placement with a specific focus on optimizing preoperative psychiatric factors and treatment-related patient satisfaction to identify pertinent articles describing ways to optimize patient satisfaction with PP. Key Content and Findings: A patient's psychological state can influence the degree of understanding of their condition, affect perception of their treatment team, and limit their ability to cope with complications. All patients should undergo a thorough medical history and physical examination to screen for psychiatric health disorders, substance abuse, and chronic pain conditions. Establishing patient expectations with regards to treatment-related outcomes during the preoperative consultation will ensure congruency between the patient and performing surgeon. Patients with a more significant psychiatric distress related to their underlying sexual dysfunction may require additional evaluation and counseling preoperatively. Conclusions: PP placement is associated with high levels of overall satisfaction in appropriately screened patients. Specific considerations during preoperative counseling and careful patient selection, intraoperative decision making to avoid or anticipate possible complications, and postoperative cares are necessary to ensure the best result for an individual patient. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-23-144/coif). The series “Complex Penile Prosthesis Surgery” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare. (2023 Translational Andrology and Urology. All rights reserved.)
Databáze:	MEDLINE
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