396 The Use of Oxidized Cellulose and Fibrin Sealant to Prevent Infection Following Penile Prosthesis Insertion

Abstract

Penile prosthesis insertion is the definitive management of erectile dysfunction in patients who fail conservative therapy. Infection rates vary from 1-18%. Oxidized cellulose is a widely used hemostatic agent, with known bactericidal properties. The aim of this study is to evaluate the effect of hemostatic agents on infection rates, following penile prosthesis insertion in an ambulatory setting. We retrospectively reviewed our database of 136 patients who underwent outpatient penile prosthesis insertion, by a single surgeon between January 2015 and February 2017. Individuals operated on after March 2016 received coverage of their corporal incisions with both Surgicel SNoW and Evicel. This cohort was compared to the previous subset of patients who did not undergo coverage with hemostatic agents. 136 patients underwent penile prosthesis insertion at our ambulatory surgery center between January 2015 and February 2017. 48% of our patients had pre-existing diabetes, and 22.8% had post-prostatectomy ED. 59 patients (43.4%) had placement of a penile prosthesis without the use of hemostatic agents. The post-operative infection rate in this cohort was 13.6%. 77 patients received coverage with both oxidized cellulose and fibrin sealant after corporotomy closure. 3.9% of patients within this cohort presented with a post-operative infection. Diabetes Mellitus and use of hemostatic agents were both significant predictors of post-operative infection on logistic regression analysis (p=0.01 and 0.03).