Perioperative Morbidity of Penile Prosthesis Placement with Concurrent Surgery: Analysis of the National Surgical Quality Improvement Program Database

Abstract

ABSTRACT Introduction There is always a concern whether performing concurrent surgery along with penile prosthesis (PP) placement may increase the risk of complications, specifically postoperative infection. Contemporary reports on perioperative morbidity of PP placement with concurrent surgery are scarce. Objective To assess the 30-day postoperative morbidity in patients undergoing insertion of PP with concurrent surgery utilizing the National Surgical Quality Improvement Program (NSQIP). Methods From 2005-2016, the NSQIP database was queried to identify males who underwent placement of PP combined with other procedure. Patient demographics, postoperative morbidity including complications, readmission and re-operation rates were recorded and compared between the two groups. Student t test and Chi-square or Fischer's exact test were used as appropriate. Results 142 patients were identified and included in the study. The most prevalent concurrent procedures were surgical correction of Peyronie's disease (n=54, 38%), insertion of artificial urinary sphincter (n=27, 19%), and repair of inguinal or abdominal hernia (n=25, 17.6%). A majority of patients were white (65.5%), aged 60-69 (42.9%) and received the combined procedure in 2016 (30.3%). Fifty percent of patients were ASA class I/II and 50% were class III-V. Mean body mass index (±SD) was 30.1±4.8. Mean operating time (±SD) and length of stay (±SD) were 139.4±62.7 minutes and 2.0±1.0 days, respectively. Overall, postoperative complications occurred in 7 patients (4.9%) only. Specifically, there were urinary tract infection (n=4, 2.8%), superficial surgical site infection (n=2, 1.4%) and unplanned intubation (n=1, 0.7%). Similarly, reoperation and readmission rates were low (0.7% and 2.8%, respectively). Conclusions Overall the 30-day postoperative morbidity, reoperation and readmission rates of PP insertion with concurrent surgery were low. The majority of the reported complications were minor. Concurrent surgery with PP insertion does not seem to significantly increase the risk of postoperative morbidity. Disclosure No