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Reoperation Rates for Penile Prosthetic Surgery
Hossein Mirheydar1, Tianzan Zhou2, David C Chang3
1Department of Urology, University California-San Diego Health, San Diego, CA, USA.
The Journal of Sexual Medicine
|January 13, 2016
Summary
Penile prosthesis reoperation rates are highest in the first year after surgery, particularly for younger, African-American, and Hispanic men. Malfunction and infection are leading causes, with many reoperations occurring at different hospitals.
Area of Science:
- Urology
- Surgical Outcomes
- Prosthetic Devices
Background:
- Penile prosthesis implantation is a treatment for erectile dysfunction refractory to medical therapies.
- Despite improvements, penile prostheses can lead to complications requiring reoperation.
Purpose of the Study:
- To determine the long-term reoperation rate following penile prosthesis implantation.
- To identify risk factors associated with reoperation for penile prostheses.
Main Methods:
- Longitudinal analysis of the California Office of Statewide Health Planning and Development database (1995-2010).
- Inclusion of men undergoing their first penile prosthetic surgery.
- Kaplan-Meier plots, hazard curves, and multivariate analysis were used to assess reoperation rates, adjusting for demographic and hospital factors.
Main Results:
- The 5- and 10-year cumulative reoperation rates were 11.2% and 15.7%, respectively.
- Prosthetic malfunction (57%) and infection (27%) were the primary reasons for reoperation.
- Higher reoperation rates were observed in younger men, African-American men, and Hispanic men.
- Reoperation rates peaked within the first postoperative year and decreased thereafter.
Conclusions:
- The incidence of penile prosthesis reoperation is highest within the first postoperative year.
- Younger age, African-American race, and Hispanic race are associated with increased reoperation risk.
- A significant proportion of reoperations occur at facilities different from the primary implantation site, potentially underestimating complication rates in existing literature.
