Abstract
Introduction. In patients with erectile dysfunction (ED), inflatable penile prosthesis (IPP) surgery is regarded as the gold standard treatment in medically refractory cases or where its conservative treatment options are contraindicated. Despite improvements in surgical technique and implanted materials, IPP surgery retains a substantial complication rate. The aim of the study was to record and grade the postoperative complications of IPP implantation according to a modified Clavien system. Methods. A total of 60 three-piece IPP implantations were performed between 2007 and 2013 by a single surgeon. The primary outcome was to stratify the early (first 30 days) complications into five categories using the modified Clavien-Dindo classification system. A secondary aim was to record the long-term adverse events and to identify possible factors related to complication occurrence. Results. Overall, there were 21 (35%) postoperative complications in 17 of 60 men (28.3%), with 15 adverse events occurring early after surgery. In terms of late complications, there were six (10%) major complications managed by either revision surgery or removal of the prosthesis. Conclusion. This study utilizes a validated morbidity scale thus overcoming problems of previous studies reporting IPP surgery complications. The modified Clavien classification system easily aids in assessing and comparing accurately patients’ postoperative complications, thus improving management and prevention.
Highlights
In patients with erectile dysfunction (ED), inflatable penile prosthesis (IPP) surgery is regarded as the gold standard treatment in medically refractory cases or where its conservative treatment options are contraindicated
Penile prosthesis implantation is the gold standard in treatment of ED when medical therapy either fails or is contraindicated or unwanted by the patient
The Clavien-Dindo classification distinguishes surgery complications based on the type of therapy needed to correct the complication, distinguishing postoperative complications that may appear similar but are quite different in terms of postoperative morbidity, costs, and patient satisfaction
Summary
In patients with erectile dysfunction (ED), inflatable penile prosthesis (IPP) surgery is regarded as the gold standard treatment in medically refractory cases or where its conservative treatment options are contraindicated. Surgical techniques and antibiotic coverage of the newer implants have improved safety and both patient and partner satisfaction. In spite of these improvements, operative complications remain that can be severe and include increasing morbidity and hospitalization cost. The Clavien-Dindo classification distinguishes surgery complications based on the type of therapy needed to correct the complication, distinguishing postoperative complications that may appear similar but are quite different in terms of postoperative morbidity, costs, and patient satisfaction. Grade I includes any deviation from the normal postoperative course without need for special treatment except general therapeutic regimens like antiemetics, antipyretics, analgesics, diuretics, and electrolytes and physiotherapy.
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