Mp62-16 factors associated with virgin inflatable penile prosthesis infection: 10 years of data in a large health care system

You have accessJournal of UrologyCME1 Apr 2023MP62-16 FACTORS ASSOCIATED WITH VIRGIN INFLATABLE PENILE PROSTHESIS INFECTION: 10 YEARS OF DATA IN A LARGE HEALTH CARE SYSTEM Nancy Ye, Joanie Chung, Polina Reyblat, Irene Chen, Eugene Rhee, and George Abdelsayed Nancy YeNancy Ye More articles by this author , Joanie ChungJoanie Chung More articles by this author , Polina ReyblatPolina Reyblat More articles by this author , Irene ChenIrene Chen More articles by this author , Eugene RheeEugene Rhee More articles by this author , and George AbdelsayedGeorge Abdelsayed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Inflatable penile prosthesis (IPP) is the recommended treatment for erectile dysfunction refractory to medical management. Device infection is a dreaded complication leading to significant patient morbidity and increased healthcare costs. This study aims to determine factors associated with device infection in a large fully integrated healthcare system. METHODS: IPPs implanted between 2009 and 2019 at Kaiser Permanente Southern California were retrospectively reviewed. Perioperative and intra-operative variables were assessed to identify factors associated with device infection. Particular attention was paid to patient demographics, co-morbid conditions, surgeon volume, intra-operative antibiotics, operative time, and concurrent procedures. Univariate and multivariable logistic regression analyses were performed. RESULTS: 978 virgin IPPs were implanted in the study period by 66 different implanters. Overall device infection rate was 4.5% (44/978). We identified four surgeons, who performed >100 IPP surgeries within the study period, as high-volume implanters (HVI). They collectively implanted 441 IPPs (45%). Patients who had IPPs placed by HVI were significantly less likely to develop a device infection compared to other surgeons (OR 0.49, p<0.05). On multivariable logistic regression analysis, hemoglobin A1c, body mass index, operative time, anti-coagulation, prior pelvic surgery, radiation, or spinal cord injury were not associated with device infection. Yet, patients who received prophylactic intravenous (IV) antibiotics per American Urological Association (AUA) Best Practice Statement were less likely to have a device infection than patients who received other antibiotics (OR 0.35, p<0.05). Additionally, IPP placement via penoscrotal approach was associated with greater likelihood of device infection compared to infrapubic approach (OR 4.67, p<0.05). Mean follow-up was 4.9 years. CONCLUSIONS: Device infection was associated with non-high-volume implanters as well as prophylactic IV antibiotics outside of AUA recommendations. Operative time, long considered to be associated with device infections, was not associated with device infection on either univariate or multivariable logistic regression analysis in this large cohort with long term follow up. Greater understanding of patient and surgeon factors associated with device infection may help decrease patient morbidity and better prepare implanters. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e868 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nancy Ye More articles by this author Joanie Chung More articles by this author Polina Reyblat More articles by this author Irene Chen More articles by this author Eugene Rhee More articles by this author George Abdelsayed More articles by this author Expand All Advertisement PDF downloadLoading ...