PD42-02 PARTIAL COMPONENT EXCHANGE OF A NON-INFECTED IPP IS ASSOCIATED WITH A HIGHER COMPLICATION RATE

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD42-02 PARTIAL COMPONENT EXCHANGE OF A NON-INFECTED IPP IS ASSOCIATED WITH A HIGHER COMPLICATION RATE David Barham, Muhammed Hammad, Edward Choi, Daniel Swerdloff, Brittany Berk, Eric Chung, Jonathan Clavell-Hernandez, Martin Gross, Tung-Chin Hsieh, James Jones, Martin Kathrins, Aaron Lentz, Patrick Selph, Jay Simhan, Robert Welliver, and Faysal Yafi David BarhamDavid Barham More articles by this author , Muhammed HammadMuhammed Hammad More articles by this author , Edward ChoiEdward Choi More articles by this author , Daniel SwerdloffDaniel Swerdloff More articles by this author , Brittany BerkBrittany Berk More articles by this author , Eric ChungEric Chung More articles by this author , Jonathan Clavell-HernandezJonathan Clavell-Hernandez More articles by this author , Martin GrossMartin Gross More articles by this author , Tung-Chin HsiehTung-Chin Hsieh More articles by this author , James JonesJames Jones More articles by this author , Martin KathrinsMartin Kathrins More articles by this author , Aaron LentzAaron Lentz More articles by this author , Patrick SelphPatrick Selph More articles by this author , Jay SimhanJay Simhan More articles by this author , Robert WelliverRobert Welliver More articles by this author , and Faysal YafiFaysal Yafi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003352.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management of malfunctioning inflatable penile prostheses (IPPs) is varied. The impact of partial component exchange versus complete device exchange on complications is unknown. We sought to describe the infectious and non-infectious complications in men undergoing IPP revision with partial and complete component exchange for device malfunction. METHODS: We performed a multicenter retrospective cohort study of patients who underwent IPP revision. Men undergoing procedures for implant infection were excluded. Patients were divided into two groups based on whether they had complete exchange of the entire device or partial exchange of only one or two components (i.e. pump revision only, or pump and reservoir exchanged but cylinders left in situ). Differences between baseline demographics were assessed with two tailed student t-tests and Fisher’s exact tests. Multivariable analysis was performed controlling for significant covariates and clinically relevant variables. A descriptive analysis was performed of non-infectious complications. RESULTS: 453 men underwent IPP revision. 368 had complete exchange of the entire device and 85 had partial component exchange. Men undergoing partial exchange had a significantly higher infection rate (7.1% vs 2.2%, p=0.031). The partial exchange group also was more likely to receive antifungals (51.8 vs 16.8%, p<0.001), have a modified salvage washout (77.4 vs 60.2%, p=0.004), and less likely to receive vancomycin and gentamicin (63.5 vs 83.7%, p<0.001). Time to revision was significantly shorter in the partial exchange group (44.9 vs 168.2 months, p<0.001). In multivariable analysis, partial exchange surgery (OR 2.6, 95% CI 0.7-9.3, p=0.17), vancomycin and gentamicin prophylaxis (OR 0.3, 95% CI 0.1-1.2, p=0.11), modified salvage washout (OR 1.8, 95% CI 0.3-9.2, p=0.48), and antifungal prophylaxis (OR 2.7, 95% CI 0.7-10.3, p=0.13) were no longer associated with postoperative infections. The partial exchange group had greater rates of non-infectious complications (21.2% vs 9.5%, p=0.005) such as pump malfunction and tubing breakage. CONCLUSIONS: While patients undergoing partial component revision were more likely to receive non-standard antibiotics, antifungal prophylaxis, and undergo a modified salvage washout, they had more infectious and mechanical/non-infectious complications. These findings suggest that partial component exchange increases risks in men undergoing IPP revision for non-infectious indications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1111 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 Edward Choi More articles by this author Daniel Swerdloff More articles by this author Brittany Berk More articles by this author Eric Chung More articles by this author Jonathan Clavell-Hernandez More articles by this author Martin Gross More articles by this author Tung-Chin Hsieh More articles by this author James Jones More articles by this author Martin Kathrins More articles by this author Aaron Lentz More articles by this author Patrick Selph More articles by this author Jay Simhan More articles by this author Robert Welliver More articles by this author Faysal Yafi More articles by this author Expand All Advertisement PDF downloadLoading ...