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Published on: June 16, 2022
Concurrent Penile Prosthesis and Artificial Urinary Sphincter versus Penile Prosthesis and Male Sling: A National
Mahmoud I Khalil1,2, Austin K Bramwell1, Naleen Raj Bhandari3
1Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Insights
The study found that combining penile prosthesis (PP) with a male sling (MS) resulted in lower 30-day morbidity compared to combining PP with an artificial urinary sphincter (AUS). No complications were reported with the PP+MS approach.
Area of Science:
- Urology
- Surgical Outcomes
- Medical Device Implantation
Background:
- Urinary incontinence and erectile dysfunction often require combined treatment.
- Penile prosthesis (PP) combined with artificial urinary sphincter (AUS) or male sling (MS) are surgical options.
- Comparative data on the morbidity of these combined procedures is limited.
Purpose of the Study:
- To compare the 30-day postoperative morbidity of combined penile prosthesis (PP) and artificial urinary sphincter (AUS) insertion versus PP and male sling (MS) insertion.
- To evaluate complication, readmission, and reoperation rates for these combined procedures.
Main Methods:
- Retrospective analysis of the National Surgical Quality Improvement Program database (2010-2016).
- Identified patients who underwent combined PP+AUS or PP+MS placement.
- Compared patient demographics, postoperative complications, readmissions, and reoperations using statistical tests.
Main Results:
- Forty-one patients were included: 26 in the PP+AUS group and 15 in the PP+MS group.
- The PP+AUS group had higher average length of stay (2.2 vs. 1.8 days) and reported postoperative morbidity in 4 patients (UTI, SSI, readmission for infection, reoperation).
- No complications were reported in the PP+MS group. Diabetes mellitus was more prevalent in the PP+MS group.
Conclusions:
- Combined penile prosthesis and male sling insertion demonstrated lower 30-day morbidity compared to penile prosthesis and artificial urinary sphincter insertion.
- Complication and readmission rates for both combined procedures were comparable to existing literature.
- The male sling may offer a potentially safer alternative when combined with penile prosthesis implantation.
Purpose:
We aimed to assess the 30-day morbidity in patients undergoing combined insertion of penile prosthesis (PP) and artificial urinary sphincter (AUS) vs. PP and male sling (MS).
Materials And Methods:
The National Surgical Quality Improvement Program database was queried to identify patients who underwent placement of AUS or MS combined with PP. Patient demographics, postoperative morbidity including complications, readmission and reoperation rates were recorded. Student t-test and chi-square or Fischer's exact test were used as appropriate.
Results:
Forty-one patients met selection criteria between 2010 and 2016. Overall, 26 patients received PP and AUS vs. 15 that received PP and MS. Average age was similar in both groups (64.8±6.6 years vs. 62.3±6.3 years, p=0.254). Diabetes mellitus was more prevalent in PP+MS group compared to AUS+PP group (46.7% vs. 11.5%, p=0.022). Average length of stay was higher in PP+AUS group compared to PP+MS group (2.2±0.6 days vs. 1.8±0.4 days, p=0.017). Postoperative morbidity was reported in four patients in PP+AUS group. No reported complications in PP+MS group. In PP+AUS group, complications included one patient who developed urinary tract infection, one developed surgical site infection, readmission in two for postoperative infection, and one return to the operating room. No reported prosthesis explantation or revision in either groups.
Conclusions:
Our results showed that 30-day morbidity was recorded in the PP+AUS group and none in the PP+MS group. The complication and readmission rates remain comparable to the previous reports in both groups.
