Management of the dissatisfied patient

Penile prostheses are a successful treatment solution for men presenting with organic erectile dysfunction, resulting in high satisfaction rates. However, erectile function and satisfaction with erectile performance strongly depend on psychological and cultural factors shaping men’s sexuality. Therefore, some men may be at risk of dissatisfaction after penile prosthetic surgery. This chapter approaches factors predicting satisfaction in the context of penile prosthesis surgery, as well as biopsychosocial dimensions associated with dissatisfaction. Strategies aimed at preventing dissatisfaction are presented and discussed, with a focus on the patient’s partner and the biopsychosocial determinants of men’s sexual functioning. Research limitations are further presented. Given that no longitudinal evidence exists on how dissatisfaction is maintained over a substantial period of time, it is recommended to regard the prevention of dissatisfaction as a key step during the treatment process.