Delayed closed-suction drain removal after inflatable penile prosthesis: a multi-institutional experience

You have accessJournal of UrologyCME1 Apr 2023PD42-12 DELAYED CLOSED-SUCTION DRAIN REMOVAL AFTER INFLATABLE PENILE PROSTHESIS: A MULTI-INSTITUTIONAL EXPERIENCE Luke Shumaker, Nicholas Zulia, Jonathan Beilan, Emmett Kennady, Nicolas Ortiz, and Adam Baumgarten Luke ShumakerLuke Shumaker More articles by this author , Nicholas ZuliaNicholas Zulia More articles by this author , Jonathan BeilanJonathan Beilan More articles by this author , Emmett KennadyEmmett Kennady More articles by this author , Nicolas OrtizNicolas Ortiz More articles by this author , and Adam BaumgartenAdam Baumgarten More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003352.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is little published data regarding percutaneous drain (PD) duration after inflatable penile prosthesis (IPP) placement. The dissection associated makes scrotal hematomas common in the first 72 hours. Maintaining a percutaneous drain represents a strategy to reduce scrotal hematoma formation. However, a percutaneous tract also represents a feasible path for seeding of a new prosthesis. Given the severe consequences of infection, establishing comparable outcomes for delayed drain removal patients is necessary. Here we detail rates of infection, hematoma, device explantation and other standard post IPP metrics in a multi-institutional cohort with delayed PD removal (48-hours or greater). METHODS: Data was collected retrospectively for 224 patients undergoing virgin IPP placement with delayed PD removal. Cases were performed by three surgeons at three high-volume centers between 01/01/2020 and 3/31/2022. It was the practice of these surgeons to leave PDs 48 hours or greater. 15 patients had PDs removed before 48 hours due to scheduling, patient preference, or inadvertent removal. These patients were excluded leaving 209. R for Statistical Computing was used to generate statistics and data visualization. RESULTS: Mean drain duration was 2.8 days. Mean follow-up interval was 170 days. 84 patients (40%) carried the diagnosis of diabetes mellitus with a mean hemoglobin A1c of 7.2. Penoscrotal and infrapubic approaches were employed (114 versus 95). Reservoir location was split between space of Retzius (SOR) and high submuscular with SOR being more common (164 versus 45). 7 discrete hematomas were observed. Despite this small number, Fisher’s exact testing demonstrated significant association between hematoma formation and both anticoagulation and antiplatelet therapy (p<0.01 in both cases). There were 3 device infections (1.4%). 9 patients (4.3%) required revision for non-infectious causes. CONCLUSIONS: Rates of infection and explantation observed in virgin IPP implantation with delayed PD removal are similar to other modern virgin cohorts where drains were not employed. Additional prospective research would be useful to characterize effect of delayed drain removal on hematoma formation, postoperative pain, and interval to device use. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1115 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luke Shumaker More articles by this author Nicholas Zulia More articles by this author Jonathan Beilan More articles by this author Emmett Kennady More articles by this author Nicolas Ortiz More articles by this author Adam Baumgarten More articles by this author Expand All Advertisement PDF downloadLoading ...