247 Comparison of Complication Rates Related to Penile Prosthesis and Advance™ Male Slings Versus Penile Prosthesis and Artificial Urinary Sphincters: National Multi-Institutional Analysis of NSQIP Database

Abstract

Studies comparing early postoperative morbidity of combined penile prosthesis (PP) and male sling (MS) versus PP and artificial urinary sphincter (AUS) for stress urinary incontinence and erectile dysfunction are lacking. We aim to assess the 30-day postoperative morbidity in patients undergoing combined insertion of PP and MS vs. PP and AUS utilizing the National Surgical Quality Improvement Program (NSQIP). NSQIP database was queried to identify males who underwent simultaneous MS or AUS combined with PP for stress urinary incontinence and erectile dysfunction. Patient demographics, postoperative morbidity including complications, readmission and reoperation rates were recorded. Student t test and Chi-square or Fischer’s exact test were used as appropriate. 41 patients were identified meeting selection criteria (combined AUS with PP or MS with PP) between 2010 and 2016 reported by NSQIP database. Overall, there was 26 (63%) received AUS and PP versus 15 (37%) received MS and PP. Average age were similar in both groups (65 ± 6.6 vs. 62 ± 6.3, p=0.254). Diabetes Mellitus was the most prevalent co-morbid disease in MS and PP group compared to AUS and PP group (47% vs. 12%, p=0.022). Average length of stay (days) was higher in AUS and PP group compared to PP and MS group (2.2 ± 0.6 vs. 1.8 ± 0.4, p=0.017). Postoperative morbidity occurred in 4 patients (15%) in AUS and PP group. No reported complication in MS and PP group. In the AUS and PP group, complications included 1 (4%) patient developed urinary tract infection, 1 (4%) developed surgical site infection, readmission in 2 (7%) and return to the operating room for incision and drainage of fluid collection in 1 (4%). No reported prothesis explanation, erosion or revision in either groups.