MP62-01 MULTICENTER EVALUATION OF INFLATABLE PENILE PROSTHESIS (IPP) PLACEMENT IN MEN WITH A HISTORY OF PRIAPISM

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP62-01 MULTICENTER EVALUATION OF INFLATABLE PENILE PROSTHESIS (IPP) PLACEMENT IN MEN WITH A HISTORY OF PRIAPISM David Barham, Muhammed Hammad, Daniel Swerdloff, Kelli Gross, Georgios Hatzichirstodoulou, James Hotaling, Tung-Chin Hsieh, James Jones, Ian Pearce, Hossein Sadeghi-Nejad, Maxime Sempels, C Austin Service, Jay Simhan, Faysal Yafi, and Martin Gross David BarhamDavid Barham More articles by this author , Muhammed HammadMuhammed Hammad More articles by this author , Daniel SwerdloffDaniel Swerdloff More articles by this author , Kelli GrossKelli Gross More articles by this author , Georgios HatzichirstodoulouGeorgios Hatzichirstodoulou More articles by this author , James HotalingJames Hotaling More articles by this author , Tung-Chin HsiehTung-Chin Hsieh More articles by this author , James JonesJames Jones More articles by this author , Ian PearceIan Pearce More articles by this author , Hossein Sadeghi-NejadHossein Sadeghi-Nejad More articles by this author , Maxime SempelsMaxime Sempels More articles by this author , C Austin ServiceC Austin Service More articles by this author , Jay SimhanJay Simhan More articles by this author , Faysal YafiFaysal Yafi More articles by this author , and Martin GrossMartin Gross More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prolonged priapism can result in corporal fibrosis which may make IPP placement more difficult. The current literature on IPP placement in men with a history of priapism is limited to small and often single-center experiences. We sought to evaluate a multicenter experience of IPP placement in men with a history of priapism. METHODS: We performed a multicenter, retrospective cohort study of patients with a history of priapism undergoing IPP placement by 9 experienced implant surgeons. We excluded patients who underwent IPP in the acute priapism event. Demographic, intraoperative, and postoperative variables were collected. Descriptive statistics were performed using mean and standard deviation for continuous variables, whereas frequencies and percentages were used for categorical variables. We evaluated differences in complication rates in those undergoing early or delayed IPP placement. We defined early placement as ≤4 months from priapism to IPP. RESULTS: 53 patients underwent IPP placement at a median of 29.5 months following ischemic priapism. The mean duration of priapism was 42.6±14.1 hours. The mean age of the cohort was 51.5±1.4 years with a mean follow-up of 16.4±9.5 mo. Overall, 19 patients (36%) had a prior shunt for priapism and 7 (13%) had penoscrotal decompression. Only 5 (9%) patients underwent early placement (≤4 mo) whereas 48 (91%) underwent late placement. No complications occurred in those undergoing early IPP placement. Complications occurred in 19 (39%) of patients undergoing delayed placement. Intraoperative urethral injury and proximal perforation occurred in 1 patient each. Infection occurred in 3 (6%) men. Postoperative complications occurred in 17 (35%). Cylinder related complications accounted for 8 (47%) (3 displacements of a cylinder through the corporotomy, 1 lateral displacement of the distal cylinders requiring revision, 2 proximal cylinder migration, 2 cylinder leaks). Fifteen (22.5%) implants were revised or removed for infectious or non-infectious complications. Full-sized cylinders were used in all cases that resulted in cylinder related complications. CONCLUSIONS: IPP placement in men with a history of priapism carries a notable incidence of complications, especially in men undergoing delayed placement or when full-sized cylinders are used. Few IPPs in this series were placed early after the priapism episode, as our surgeons are predominantly tertiary referral centers. Priapism patients should be referred to prosthetic experts early to decrease future morbidity. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e861 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Barham More articles by this author Muhammed Hammad More articles by this author Daniel Swerdloff More articles by this author Kelli Gross More articles by this author Georgios Hatzichirstodoulou More articles by this author James Hotaling More articles by this author Tung-Chin Hsieh More articles by this author James Jones More articles by this author Ian Pearce More articles by this author Hossein Sadeghi-Nejad More articles by this author Maxime Sempels More articles by this author C Austin Service More articles by this author Jay Simhan More articles by this author Faysal Yafi More articles by this author Martin Gross More articles by this author Expand All Advertisement PDF downloadLoading ...