PD20-05 COST EFFECTIVENESS OF ACUTE INSERTION OF MALLEABLE PENILE PROSTHESIS FOR REFRACTORY ISCHEMIC PRIAPISM IN PUBLIC HOSPITAL SETTING

Abstract

METHODS: At eight centers a total of fifteen patients with locally positive, but no systemic signs and symptoms of wound / IPP infection were reviewed. If the patient had systemic / septic symptoms, immediate surgical treatment was performed. Basic patient demographics and post-operative data were acquired. All patients were carefully and frequently followed on one to two oral antibiotics. RESULTS: Fifteen patients were retrospectively reviewed. Demographics reveal age of 47 to 70 (mean 59.4), 7 of 15 (47%) being diabetic, 12 Titans / 1 700 / 1 Genesis / 1 Ambicor [has no infection retardant coating] and 11 (73%) were primary implantation with 3 (20%) being replacements and 1 (6.7%) into previous infected IPP scarred corporal bodies. Time to local wound / IPP infection after implantation was 7 to 40 days (mean 20.4 days), 14 (93 %) had incisional wound drainage with some described as large quality of fluid, 3 (20%) had significant swelling, 1 (6.7%) had device skin fixation and 4 (27%) of the 15 patients had significant increase in IPP pain / tenderness. 9 different bacteria isolates were cultured out of the incisional drainage of 7 patients with 3 Staph Epi, 2 pseudomonas, 1 enterococcus, 2 E. coli, 1 staph aurerus, 1 alpha streptococcus and 1 proteus growths. Time to total resolution of symptoms was 21 to 141 (mean 76.2) days with 13 patients having total resolution of symptoms and two currently under observation. CONCLUSIONS: Observation maybe an option for patients with local signs / symptoms of IPP infection, even with incisional drainage of culture positive bacteria, that traditionally indicated immediate surgical intervention. The authors strongly feel that from a medical legal issue this information is important to get into the literature.