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Delayed postoperative hematoma formation after inflatable penile prosthesis implantation
Bruce B Garber1, Michael Bickell
1Department of Urology, Drexel University College of Medicine, Philadelphia, PA, USA.
The Journal of Sexual Medicine
|October 29, 2014
Summary
Delayed bleeding after inflatable penile prosthesis (IPP) insertion is rare, occurring in 0.5% of cases. Prompt treatment involving antibiotics and hematoma evacuation successfully salvaged all IPPs.
Area of Science:
- Urology
- Andrology
- Surgical Complications
Background:
- Serious complications after inflatable penile prosthesis (IPP) insertion include infection, malfunction, and bleeding.
- Limited literature exists on the etiology, diagnosis, and management of delayed bleeding post-IPP insertion.
Observation:
- A retrospective review of 600 inflatable penile prosthesis (IPP) insertions identified 0.5% incidence of delayed postoperative hematoma (>5 days).
- Causes included excessive physical activity and premature anticoagulation with enoxaparin sodium.
- All patients presented with surgical site swelling and underwent pelvic CT scans for hematoma evaluation.
Findings:
- Delayed hematoma occurred in 3 out of 600 patients (0.5%).
- Successful management involved hospital admission, IV antibiotics, wound exploration, hematoma evacuation, and antibiotic washout.
- All three IPPs were salvaged without peri-prosthetic infection.
Implications:
- Delayed bleeding post-IPP is a rare but manageable complication.
- Recommendations include avoiding postoperative anticoagulants for at least 5 days and strenuous physical activity for 3 weeks.
- Further research is needed due to the low incidence.
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