1222 “DRAIN AND RETAIN” STRATEGY FOR UROGENITAL PROSTHETIC BALLOONS AND RESERVOIRS DURING AUS AND IPP REVISION SURGERY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation (I)1 Apr 20131222 “DRAIN AND RETAIN” STRATEGY FOR UROGENITAL PROSTHETIC BALLOONS AND RESERVOIRS DURING AUS AND IPP REVISION SURGERY Christopher A. Cefalu, Xiangrong Deng, J. Francis Scott, Sandeep Mehta, Lee C. Zhao, and Allen F. Morey Christopher A. CefaluChristopher A. Cefalu Dallas, TX More articles by this author , Xiangrong DengXiangrong Deng Dallas, TX More articles by this author , J. Francis ScottJ. Francis Scott Dallas, TX More articles by this author , Sandeep MehtaSandeep Mehta Dallas, TX More articles by this author , Lee C. ZhaoLee C. Zhao Dallas, TX More articles by this author , and Allen F. MoreyAllen F. Morey Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2576AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Artificial Urinary Sphincter (AUS) and/or Inflatable Penile Prosthesis (IPP) reoperation is not uncommon due to device malfunction or consequent tissue atrophy. Removal of the urogenital prosthetic balloon or reservoir (UPBR) often requires tedious dissection into the retropubic space, a practice we have abandoned in routine uninfected cases at our tertiary center. We present our experience using a “drain and retain” strategy, wherein the UPBR was not removed during routine AUS/IPP re-operative cases. We hypothesize that there is no difference in the infection rates between retained UPBR patients and those receiving their first prosthesis. METHODS A retrospective chart review was performed identifying all patients undergoing genitourinary prosthetics by a single surgeon from July 2007 to September 2012. Patients were included in the “drain and retain” study group if they underwent prosthetic replacement (with contralateral new UPBR placement) or subtotal device removal while having their original UPBR drained and retained. Outcomes were compared to patients receiving their first prosthesis (control group). Complete removals and revision cases utilizing the original UPBR were excluded from this analysis. Post-operative complications with specific attention to infection were reviewed and compared using chi-square analysis. RESULTS A total of 551 urologic prostheses (251 AUS and 300 IPP) were inserted in 433 evaluable patients having complete data during the study period. Among 120 reoperative procedure, UPBR were drained and retained in 55 study group patients (16 with subtotal device removal, 39 with contralateral UPBR placement). A control group of 390 patients having their first AUS and/or IPP placement was identified. No difference in infection rate was identified between the control group (6/390, 1.5%) and the drain and retain study group (1/55, 1.8%, chi-square=0.024, p=0.88). A total of 65 other cases were excluded, including those having complete removal (17 due to infection, 7 UPBR herniation, 2 in conjunction with cystectomy) or revision using the original UPBR (39 cases). CONCLUSIONS The drain and retain strategy for genitourinary prosthetic revisions and/or removals has a low rate of infection similar to routine AUS and/or IPP surgery. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e500-e501 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher A. Cefalu Dallas, TX More articles by this author Xiangrong Deng Dallas, TX More articles by this author J. Francis Scott Dallas, TX More articles by this author Sandeep Mehta Dallas, TX More articles by this author Lee C. Zhao Dallas, TX More articles by this author Allen F. Morey Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...