(339) SURGICAL OUTCOMES FOLLOWING OUTPATIENT INFLATABLE PENILE PROSTHESIS IMPLANTATION
Authors: Fidel M , Shah J , Bal D , Roque C , Ko Y , Dhillon H , Chung D , Pandian A , Nayak J , Patel P 
Published: December 2024

Introduction

Inflatable penile prosthesis (IPP) implantation is commonly performed in a hospital or ambulatory setting which accommodates overnight stay. Recent literature has demonstrated that IPP surgery is increasingly being performed as same-day procedures in outpatient settings, not requiring an overnight stay. The implementation of outpatient IPP surgeries aligns with trends in patient-centered care, efficiency, and optimal resource use, encouraging flexible and efficient healthcare delivery.

Objective

We sought to investigate the rate of complications amongst patients following day surgery insertion of an IPP. The following was collected within 6 weeks of their procedure, 1. infection, 2. hospital admission, 3. emergency/urgent care visit, and 4. additional prescription for analgesia.

Methods

A mixed-methods study has been performed since February 2023 of all patients undergoing day surgery insertion of an IPP at an outpatient ambulatory surgical centre. Only patients who are classified as ASA 1 or 2 and suitable for day surgery are deemed eligible for outpatient surgery. Patients were enrolled and consented on the day of the procedure. Patients were prescribed trimethoprim/sulfamethoxazole BID 2 days before surgery along with a Dexedin/Hibiclens wash. Vancomycin and gentamycin were given pre-operatively. Intraoperative Irrisept wash was used during the case for irrigation and implant preparation. All procedures involved the use of a 3-piece prosthetic device and were performed under spinal anesthesia or deep intravenous sedation with local anesthesia using an infra pubic approach. Patients were discharged with a catheter and a drain. Post-operatively, gabapentin, celecoxib and acetaminophen were given for analgesia.

Results

Currently, 52 patients are enrolled in this study with a mean patient age of 62.5 ± 3.1 years. All procedures were performed successfully with no intra-operative complications. The mean procedure length defined as the time from incision to dressing time was 65.2 ± 17.9 minutes. The mean postoperative duration of stay defined as patient entry into the post-operative recovery room to the time they left the clinic was 115.85 ± 58.2 minutes. Patients were cleared to use the device after 6 weeks. One patient (1.9%) developed a wound infection treated with oral antibiotics, another presented to the emergency department for an untreated pneumonia and 4 patients (7.7%) required additional post-operative analgesia. No patients required hospital admission.

Conclusions

Our preliminary results demonstrate the safety and feasibility of performing an IPP in the outpatient setting, with rates of complications reflecting those reported in the literature. Safely performing these procedures in an outpatient setting can increase accessibility and reduce wait times while utilizing overnight facilities more effectively.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.