(106) Concept of Enhanced Recovery Implant Care (ERIC) in Inflatable Penile Prosthesis Surgery: A Double-blind, Randomized, Controlled Trial on Clinical Outcomes and Patient Satisfaction Rate

Abstract

Abstract Introduction ERAS (Enhanced Recovery After Surgery) is considered a standard of care intended to achieve earlier recovery and reduce stress response following surgery. While inflatable penile prosthesis (IPP) surgery is a safe and effective treatment for males with erectile dysfunction, complications such as significant postoperative pain and scrotal hematoma are not uncommon and can result in delayed IPP cycling and lower patient satisfaction rate Objective To evaluate the concept of ERIC (Enhanced Recovery Implant Care) on clinical outcomes and patient satisfaction rate following IPP surgery. Methods This prospective double-blind, randomised, controlled clinical trial received internal ethics approval and 60 males were randomised to receive “normal care” (NC) vs ERIC pathway which consisted of a strict perioperative regime of intra-operative regional nerve block and device analgesia elution, meticulous haemostatic corporotomy closure and multi-layered scrotal closure as well as postoperative 7 days of fitted scrotal support following IPP surgery. An independent third-party survey with objective measurement of pain score (visual analogue scale, VAS), analgesic requirement (conversion to opioid dose equivalence), time to IPP cycling and overall patient satisfaction rates (on a 5-point scale) were collected and compared on Day 1, 7, 14, 28 and 42 postoperatively. Results There was no significant difference in patient demographics between the 2 groups. No intraoperative complication was documented. Males in the ERIC group reported lower VAS scores (p<0.05), less analgesic requirement (p<0.05) and shorter time to IPP cycling (p=0.08). Twelve (40%) patients in NC had a scrotal hematoma (Clavien-Dindo grade 1) compared to 2 (7%) patients in the ERIC group on days 1 and 7 postoperative. The overall patient satisfaction rate (rated 4 or 5) was higher in the ERIC compared to NC groups (93% vs. 70%; p<0.05). Conclusions The ERIC pathway appears to improve clinical outcomes and postoperative recovery following IPP surgery in terms of pain score, the analgesic requirement, and time to IPP cycling, as well as the overall patient satisfaction rate. Disclosure No