A Questionnaire for the Evaluation of Quality of Life after Penile Prosthesis Implant : The Quality of Life and Sexuality in Penile Prosthesis ( QoL SPP).

Enrico Caraceni1, Lilia Utizi2
  • 1 ASUR Marche, Zona Vasta 3 - U.O. Urologia (Civitanova Marche)
  • 2 ASUR Marche, Zona Vasta 3 - U.O. Urologia Psicologo Clinico (Civitanova Marche)


Erectyle dysfunction (ED) raises important issue relating to the identity of man: virility, and manhood, as well as the symbolic meaning of the penis. Severe ED can " wound the self image" of men, and most likely also affected couples.
Penile prosthesis implantation is considered to be a satisfactory treatment for ED; Previous studies have assessed only prosthesis function and perioperative complications, and have measured satisfaction only with regard to sexual performance. Very little or nothing has been reported on the most relevant question: to what extent does the implant affect the patient's life?
Our aim was to develop and validate the pathology-specific QoLSPP, which evaluates patients’ quality of life after penile prosthesis implantation.

Methods and results

Sixty-nine patients aged 32–82 years participated in the study received a three-component hydraulic prosthesis between 1997 and 2009, 47 participated in the re-test of the instrument. The QoLSPP questionnaire was developed to examine general and sexual quality of life in four domains: functional, personal, relational, and social individuals.
All psychometric properties of the QoLSPP were validated. Internal validity was assessed by means of exploratory factor analysis. Crombach’s alfa was used to evaluate the internal consistency of the items within each factor. Paired-sample t-tests were used to investigate metric stability.
Independent-samples t-tests and nonparametric test was used to evaluate the sensitivity .
Main Outcome Measures: Quality of Life as biological and psycho-social-relational well-being. Internal validity, metric stability and sensitivity of the QoLSPP.
The QoLSPP met the psychometric requirements of internal validity and reliability. Metric stability and sensitivity was tested and confirmed.
Respondents reported high satisfaction levels in all quality of life domains. All domains were significantly and positively correlated, the functional domain was most predictive. More than half of respondents perceived that their partners were very satisfied.


The instrument used (QoLSPP) reveals, in our study, that the hydraulic three-component prosthesis improves the quality of life in all the domains studied.
To our knowledge, the QoLSPP is the only tool that correlates prosthesis function with perceived sexual and general QoL. No other available tool provides this range of information; existing instruments are thus insufficient for the full evaluation of penile prosthesis recipients.
For this reason, it should prove to be the most suitable tool for the evaluation of penile prosthesis recipients.
Prosthesis implantation was correlated with high quality of life in recipients and high perceived quality of couples’ relationships; partners’ satisfaction affected patients’ quality of life, self-image, relation to the outside world and satisfaction with implant function.


Kempeneers P, Andrianne R, Mormont C. Penile prosthesis, sexual satisfaction and representation of male erotic value. Sexual and Relationship Therapy 2004;19(4):379–92.

Tefilli MV, Dubocq F, Rajpurkar A, Gheiler EL, Tiguert R, Barton C, Li H, Dhabuwala CB Assessment of psychosexual adjustment after insertion of inflatable penile prosthesis. Urology 1998;52(6):1106–12.

Montague DK, Angermeier KW. Contemporary aspects of penile prosthesis implantation. Urol Int 2003;70(2):141–6.

Carson CC, Mulcahy JJ, Govier FE, Ams 700 CX Study Group. Efficacy, safety and patient satisfaction outcomes of the AMS 700 CX inflatable penile prosthesis: results of a long term multicenter study. J Urol 2000;164:376–80

Montorsi F, Rigatti P, Carmignani G, Corbu C, Campo B, Ordesi G, Breda G, Silvestre P, Giammusso B., Morgia G, Graziottin A. AMS three-piece inflatable implants for erectile dysfunction: a long-term multi-institutional study in 200 consecutive patients. Eur Urol 2000;37:50–5.