Delayed closed-suction drain removal following inflatable penile prosthesis placement: a multi-institutional...

Area of Science:

• Urology
• Surgical Outcomes
• Medical Device Technology

Background:

• Limited data exist on prolonged (>48 hours) percutaneous drain use after inflatable penile prosthesis (IPP) placement.
• Concerns include potential retrograde device seeding versus benefits of reduced scrotal hematoma.

Purpose of the Study:

• To quantify outcomes associated with percutaneous drain durations of 48 hours or greater following primary IPP implantation.
• To evaluate the safety and efficacy of extended drain use in a multi-institutional cohort.

Main Methods:

• Retrospective analysis of 209 patients undergoing primary 3-piece IPP placement with drains in place for ≥48 hours.
• Data collected from 3 high-volume centers between January 2020 and March 2022.
• Primary outcomes: infection and hematoma rates; Secondary outcome: device explantation.

Main Results:

• Mean drain duration was 67 ± 24.7 hours.
• Overall infection rate was 1.4% (3 patients).
• Hematoma formation occurred in 7 patients (3.3%), with 2 requiring intervention (both infection cases). Anticoagulation/antiplatelet therapy was significantly associated with hematoma (P=.017).

Conclusions:

• Maintaining closed-suction bulb drains for >48 hours following IPP implantation is safe.
• This practice is associated with infection rates comparable to modern cohorts and a low rate of hematoma formation.
• Extended drain use appears to be a safe and effective component of perioperative care for IPP.