Concomitant Procedures During Inflatable Penile Prosthesis Placement

Abstract

Abstract Introduction and Objectives: There is substantial literature demonstrating minimal to no increased risk of 3-piece penile prosthesis (PP) complications for patients undergoing PP placement with concomitant reconstructive urologic procedures. However, there is a paucity of research investigating outcomes for patients suffering from erectile dysfuncton(ED) who undergo concomitant non-reconstructive urologic procedures at the time of PP placement. Methods: A retrospective IRB-approved (IRB00205900) review of patients undergoing PP placement at Johns Hopkins from January 2007-July 2021 was conducted. We identified 330 patients who underwent PP placement and a second urologic procedure during this time. Of the 330 identified, 48 had a non-reconstructive urologic procedure done concurrently. A control group involving 127 patients (with etiology of ED from previous prostatectomy) who underwent PP placement after 2015 with no concomitant procedure was utilized. Results: Concomitant procedure type was divided into: endoscopic n=24 (53.3%), penile n=9 (20.0%), scrotal n=10 (22.2%), neuromodulation n=1 (2.2%), and oncologic n=1 (2.2%). Median age and body mass index (BMI); while, overall infection and erosion rates were low between both cohorts (Table 1). Patients in the concomitant group were generally unhealthier with 49.7% having more than 2 co-morbidities vs only 37.2% in the control p=0.03. Device infections were similar between the two groups: control n=2 (1.6%) vs concomitant n=1 (2.2%); though, not statistically significant p=0.78. Device erosions were also similar: control n=4(3.2%) vs concomitant n=2(4.4%); again, not statistically significant p=0.68. Patients who underwent future revision similar were also similar: control n=13(10.2%) vs. concomitant n=6 (13.3%) p=0.50. Conclusions: To date, this retrospective analysis demonstrates the largest cohort of patients undergoing non-reconstructive urologic procedures at the time of PP placement. Our results demonstrate that concomitant (non-reconstructive) procedures do not increase the likelihood of prosthetic adverse events, regardless of concomitant procedure type.