[Learning curve for inflatable penile prosthesis]

Inflatable penile prosthesis surgery is relatively rare in France, and around ten surgeons perform most of this surgery. The objective of this study was to define the learning curve concerning this surgery.

This study is a retrospective monocentric cohort of first time implantation of inflatable penile prosthesis between 2008 and 2016 in a university hospital. 68 consecutive patients underwent this procedure performed by a single surgeon. These patients were dispatched into two groups: a group of the first 20 patients and a group of the 48 last patients. For each patient, multiple parameters were measured including: duration of surgery, per operative complications, post operative morbidity according to Clavien classification, length of stay, and functional satisfaction. Parameters were compared using Fisher or Wilcoxon tests.

Patients were on average 58.2 year old and average operating time was 87.7minutes. The average complication rate was 16.2%. Five patients from the first group and 3 patients from the second group presented a grade 3 post operative complication according to Clavien classification. The complications included 5 infections, one erosion, one irreductible paraphimosis and a prosthesis dysfunction. This difference was statistically significative (P=0.043). The average duration of hospitalization was significantly shorter in the second group (P=0.004). There was no significative difference concerning the satisfaction using the EDITS score (P=0.52) or a Likert scale (P=0.72).

In this monocentric and retrospective study, the learning curve for first time implantation of inflatable penile prosthesis is acquired after 20 surgeries. Specific training could lower this number, but needs further evaluation.

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