Intracavernosal injection history is associated with increased intra- and postoperative inflatable penile prosthesis complications: a multi-institutional analysis

You have accessJournal of UrologyCME1 Apr 2023PD42-09 INTRACAVERNOSAL INJECTION HISTORY IS ASSOCIATED WITH INCREASED INTRA- AND POSTOPERATIVE INFLATABLE PENILE PROSTHESIS COMPLICATIONS: A MULTI-INSTITUTIONAL ANALYSIS James Jones, Martin Gross, David Barham, Muhammed Hammad, Daniel Swerdloff, Jake Miller, Robert Andrianne, Arthur Burnett, Kelli Gross, Georgios Hatzichristodoulou, James Hotaling, Tung-Chin Hsieh, Adam Jones, Aaron Lentz, Jason Levy, Vaibhav Modgil, Daniar Osmonov, Sung Hun Park, Ian Pierce, Paul Perito, Hossein Sadeghi-Nejad, Maxime Sempels, Alfredo Suarez-Sarmiento, Simham Jay, Koenraad van Renterghem, J. Nicholas Warner, Matthew Ziegelmann, and Faysal Yafi James JonesJames Jones More articles by this author , Martin GrossMartin Gross More articles by this author , David BarhamDavid Barham More articles by this author , Muhammed HammadMuhammed Hammad More articles by this author , Daniel SwerdloffDaniel Swerdloff More articles by this author , Jake MillerJake Miller More articles by this author , Robert AndrianneRobert Andrianne More articles by this author , Arthur BurnettArthur Burnett More articles by this author , Kelli GrossKelli Gross More articles by this author , Georgios HatzichristodoulouGeorgios Hatzichristodoulou More articles by this author , James HotalingJames Hotaling More articles by this author , Tung-Chin HsiehTung-Chin Hsieh More articles by this author , Adam JonesAdam Jones More articles by this author , Aaron LentzAaron Lentz More articles by this author , Jason LevyJason Levy More articles by this author , Vaibhav ModgilVaibhav Modgil More articles by this author , Daniar OsmonovDaniar Osmonov More articles by this author , Sung Hun ParkSung Hun Park More articles by this author , Ian PierceIan Pierce More articles by this author , Paul PeritoPaul Perito More articles by this author , Hossein Sadeghi-NejadHossein Sadeghi-Nejad More articles by this author , Maxime SempelsMaxime Sempels More articles by this author , Alfredo Suarez-SarmientoAlfredo Suarez-Sarmiento More articles by this author , Simham JaySimham Jay More articles by this author , Koenraad van RenterghemKoenraad van Renterghem More articles by this author , J. Nicholas WarnerJ. Nicholas Warner More articles by this author , Matthew ZiegelmannMatthew Ziegelmann More articles by this author , and Faysal YafiFaysal Yafi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003352.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intracavernosal injection (ICI) is a standard treatment for men with refractory erectile dysfunction (ED). ICI can create corporal scarring which could make insertion of inflatable penile prosthesis (IPP) more difficult. Associations between ICI use and complications from IPP surgery were assessed using a large multi-institutional database. METHODS: All primary and revision IPP cases from 2016-2021 were included from an international retrospective database of IPP surgeries of 16 expert implanters at 16 institutions. Patients with indeterminate history of ICI or covariates were excluded. Covariates investigated included age, BMI, diabetes, hypertension, vasculopathy, smoking, history of pelvic radiation and/or radical prostatectomy. Outcomes included intraoperative complications (perforation, crossover, urethral injury), postoperative non-infectious complications (healing, device malfunction, etc.) and postoperative infection. Patients were stratified by history of ICI and between-group differences in risk factors were assessed with serial t-test or Fisher’s test as appropriate. Multivariate logistic regression was used to assess for predictors of intraoperative complications, postoperative non-infectious complications and postoperative infection. RESULTS: A total of 3110 patients met inclusion criteria of which 914 (29.4%) had a history of ICI. On average, patients with a history of ICI tended to be older (62 vs 63) and were more likely to have vasculopathy, as well as prior radical prostatectomy and/or radiation. On regression, a history of ICI, smoking and radiation were all significant predictors of intraoperative complications (OR 2.08, p=0.007, OR 2.02. p=0.014, OR 2.27, p=0.035 respectively). A history of ICI and patient age were both significant predictors of non-infectious postoperative complications (OR 1.37, p=0.018, OR 1.02, p=0.017 respectively). None of the variables were significant predictors of infection. CONCLUSIONS: This investigation supports the hypothesis that a history of ICI may increase the risks of IPP surgery. Patients with ICI history experienced intraoperative complications at over twice the expected rate, similar to smokers and patients with a history of pelvic radiation. This is the largest study to date investigating the relationship between ICI and complications with IPP placement. These results may aid Urologists and patients in approaching treatment for ED. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1114 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Jones More articles by this author Martin Gross More articles by this author David Barham More articles by this author Muhammed Hammad More articles by this author Daniel Swerdloff More articles by this author Jake Miller More articles by this author Robert Andrianne More articles by this author Arthur Burnett More articles by this author Kelli Gross More articles by this author Georgios Hatzichristodoulou More articles by this author James Hotaling More articles by this author Tung-Chin Hsieh More articles by this author Adam Jones More articles by this author Aaron Lentz More articles by this author Jason Levy More articles by this author Vaibhav Modgil More articles by this author Daniar Osmonov More articles by this author Sung Hun Park More articles by this author Ian Pierce More articles by this author Paul Perito More articles by this author Hossein Sadeghi-Nejad More articles by this author Maxime Sempels More articles by this author Alfredo Suarez-Sarmiento More articles by this author Simham Jay More articles by this author Koenraad van Renterghem More articles by this author J. Nicholas Warner More articles by this author Matthew Ziegelmann More articles by this author Faysal Yafi More articles by this author Expand All Advertisement PDF downloadLoading ...