(489) Comparison of Penile Prostheses Outcomes in Veterans with Peyronie’s Disease: A Single-Center Analysis

Abstract

Abstract Introduction Peyronie’s disease (PD) causes erectile dysfunction (ED) in at least 40% of cases. ED refractory to medical and injection therapy can be treated with implantable penile prosthesis, which may also address the penile deformities. However, prosthesis surgery has significant associated morbidity-including erosive disease and infection-and frequently requires explant or revision. Data for Veterans Affairs (VA) patients with PD is limited, especially with respect to penile prosthesis placement. More information is needed for proper counseling and perioperative planning in this high-risk population. Objective The aim of this study is to compare outcomes and revision rates in Veteran patients with and without PD after primary penile prosthesis implantation. Methods A retrospective cohort study of the xxx VA Medical Center Informatics and Computing Infrastructure database was performed. Veterans who underwent penile prosthesis surgery between January 2013 and February 2022 were identified and included in the study. Patient factors including age, race, procedure type, and relevant comorbidities were collected. Patients with and without history of PD were identified and separated into two cohorts and patient factors of these two groups were compared using chi-square and Fisher’s exact tests. Freedom from revision was analyzed using Cox regression and hazard ratios. Results A total of 229 patients underwent penile prosthesis placement with at least 4 months follow-up. 24 patients (10.48%) with history of PD were identified. The mean age at prosthesis placement of PD patients was younger than that of non-PD patients (61.3 vs 65.0 respectively, p=0.0358). Rear tip extender length was longer in the PD cohort than the non-PD cohort (3.02 cm vs 2.32 cm respectively, p=0.0313). Operative time was shorter in patients with PD than in patients without PD (91 minutes vs 111 minutes respectively, p=0.0409). Prosthesis type, hospital stay, and post-operative complication rates were not significantly different between groups. PD was not associated with significantly increased risk of prosthesis revision or removal (p>0.05). No patients in the PD cohort experienced infection or erosion; two explants were performed for component migration and supersonic transporter deformity respectively. Conclusions Veterans with PD undergoing prosthesis placement have similar revision rates and explant rates as compared to veterans without PD. Additionally, penile prosthesis implantation for men with PD is associated with low morbidity and similar complication rates compared to men without PD undergoing prosthesis placement for erectile dysfunction. Disclosure No