Manual Dexterity Predictors of Inflatable Penile Prosthesis Success

Objective: To investigate the ability of preoperative dexterity assessments to predict postoperative success of inflatable penile prosthesis (IPP) placement for erectile dysfunction. Materials: A timed 9-hole peg test, pinch and grip strength assessment, and Disabilities of the Arm Shoulder and Hand questionnaire were administered during the preoperative visit before IPP placement. In addition to standard preoperative workup, subjective handshake strength was recorded. Initial device-cycling and assessment of pump placement occurred 3-4 weeks after surgery. Three months postoperatively, a survey measuring satisfaction, difficulty of use, confidence, and erectile change was administered. Correlation between preoperative assessment variables and the postoperative questionnaire was assessed. Results: Twenty-nine patients were included. Mean age and BMI were 63.0 years and 30.7 kg/m², respectively. Postoperatively, 65.5% of patients were satisfied; 41.4% reported no difficulty of use; and 75.8% were confident in device use by 1 month. 68.9% rated their erection as much improved or very much improved. Grip strength was inversely associated with difficulty of use (P = 0.037). There was an association between increased age and decreased confidence of device use (P = 0.068). Peg test, pinch strength, and handshake were not statistically significant. Conclusion: Grip strength is a useful adjunct to assess manual functional status during preoperative IPP evaluation for patients whose manual functional status is unclear. These tests are inexpensive and easy to perform in the clinic.