MP62-18 NEW FINDINGS REGARDING INDEPENDENT PREDICTORS OF POOR CORPORAL INTEGRITY IN A LARGE SERIES OF PENILE IMPLANT RECIPIENTS: A MULTICENTER INTERNATIONAL INVESTIGATION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP62-18 NEW FINDINGS REGARDING INDEPENDENT PREDICTORS OF POOR CORPORAL INTEGRITY IN A LARGE SERIES OF PENILE IMPLANT RECIPIENTS: A MULTICENTER INTERNATIONAL INVESTIGATION Chrystal Chang, Zafardjan Dalimov, David Barham, Daniel Swerdloff, Hossein Sadeghi-Nejad, Robert Andrianne, Mike Hsieh, Martin Gross, Georgios Hatzichristodolou, Maxime Sempels, Daniar Osmonov, Aaron Lentz, Paul Perito, James Hotaling, Koenraad Van Renterghem, Sung Hun Park, Jonathan N. Warner, Faysal A. Yafi, and Jay Simhan Chrystal ChangChrystal Chang More articles by this author , Zafardjan DalimovZafardjan Dalimov More articles by this author , David BarhamDavid Barham More articles by this author , Daniel SwerdloffDaniel Swerdloff More articles by this author , Hossein Sadeghi-NejadHossein Sadeghi-Nejad More articles by this author , Robert AndrianneRobert Andrianne More articles by this author , Mike HsiehMike Hsieh More articles by this author , Martin GrossMartin Gross More articles by this author , Georgios HatzichristodolouGeorgios Hatzichristodolou More articles by this author , Maxime SempelsMaxime Sempels More articles by this author , Daniar OsmonovDaniar Osmonov More articles by this author , Aaron LentzAaron Lentz More articles by this author , Paul PeritoPaul Perito More articles by this author , James HotalingJames Hotaling More articles by this author , Koenraad Van RenterghemKoenraad Van Renterghem More articles by this author , Sung Hun ParkSung Hun Park More articles by this author , Jonathan N. WarnerJonathan N. Warner More articles by this author , Faysal A. YafiFaysal A. Yafi More articles by this author , and Jay SimhanJay Simhan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Inflatable penile prosthesis (IPP) offers high satisfaction rates for patients, but this procedure is not without complications that can be encountered either intraoperatively or postoperatively. Particularly, predictors of intraoperative corporal perforation and delayed cylinder complications in IPP placement have not been well-delineated. We hypothesize that preoperative and intraoperative variables may impact the integrity of the corporal bodies long-term and thus implant viability. METHODS: We retrospectively reviewed a large, multi-institutional collaborative study of IPP surgeries performed by expert implanters from 2016-2021. All primary and revision cases were included. Salvage cases for infection were excluded. Demographic characteristics, intraoperative variables, and postoperative outcomes were assessed. PCI was defined as intraoperative corporal complications (proximal and/or distal perforation of the corpora, corporal crossover) or postoperative corporal complications (cylinder erosion, extrusion, impending erosion, or deformity). Risk factor analysis and multivariate analysis were performed to identify independent predictors of PCI. RESULTS: After excluding salvage cases for infection, we identified 5,153 patients undergoing IPPs, of which 149 were diagnosed with PCI. The rates of diabetes (p=0.19), immunosuppression (p=0.79), priapism (p=0.06), history of radiation (p=0.29), and prior use of intracavernosal injections (p=0.19) all had no significant effect on corporal integrity. Patients with PCI were more likely to have active coronary artery disease (CAD) or peripheral vascular disease (PVD) (p=0.02), be current smokers (p=0.003), and have a history of IPP infection (p<0.001). On multivariate analysis, predictors of PCI included older age (OR 1.02 (1.00-1.04), p=0.03), CAD/PVD (OR 1.58 (1.06-2.35), p=0.025) and history of IPP infection (OR 5.82 (3.27-10.34), p<0.001). Obesity (OR 0.582 (0.40-0.86), p=.006) and non-Caucasian race (OR 0.60 (0.41-0.88), p=0.01) were found to be protective. CONCLUSIONS: Our multicenter analysis found that CAD/PVD, current smoking, and history of IPP infection were risk factors for complications associated with poor corporal integrity. Recognizing these risk factors preoperatively can allow for improved patient-specific counseling and changes in surgical strategy to potentially promote longer term device viability. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e869 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chrystal Chang More articles by this author Zafardjan Dalimov More articles by this author David Barham More articles by this author Daniel Swerdloff More articles by this author Hossein Sadeghi-Nejad More articles by this author Robert Andrianne More articles by this author Mike Hsieh More articles by this author Martin Gross More articles by this author Georgios Hatzichristodolou More articles by this author Maxime Sempels More articles by this author Daniar Osmonov More articles by this author Aaron Lentz More articles by this author Paul Perito More articles by this author James Hotaling More articles by this author Koenraad Van Renterghem More articles by this author Sung Hun Park More articles by this author Jonathan N. Warner More articles by this author Faysal A. Yafi More articles by this author Jay Simhan More articles by this author Expand All Advertisement PDF downloadLoading ...