1868 EXPLANTATION COMPARED TO WASHOUT AND REIMPLANTATION OF INFECTED PENILE PROSTHESES: A NATIONAL COMPARISION (2012)

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Peyronie's Disease/Surgical Therapy II1 Apr 20121868 EXPLANTATION COMPARED TO WASHOUT AND REIMPLANTATION OF INFECTED PENILE PROSTHESES: A NATIONAL COMPARISION Sherwin Zargaroff, Joshua Meeks, Brian Le, James M. Dupree, Vidit Sharma, Kunj R. Sheth, and Kevin McVary Sherwin ZargaroffSherwin Zargaroff Chicago, IL More articles by this author , Joshua MeeksJoshua Meeks Chicago, IL More articles by this author , Brian LeBrian Le Chicago, IL More articles by this author , James M. DupreeJames M. Dupree Chicago, IL More articles by this author , Vidit SharmaVidit Sharma Chicago, IL More articles by this author , Kunj R. ShethKunj R. Sheth Chicago, IL More articles by this author , and Kevin McVaryKevin McVary Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1980AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Implantation of a penile prosthesis (PP) is an effective procedure for men with erectile dysfunction (ED). Although infrequent, the most devastating complication is penile prosthesis infection (PPI). When patients initially present with PPI, the prostheses can be explanted (EX) with a possible delayed reimplant or immediately reimplanted after washout (R−EX). We evaluated some of the factors associated with R−EX compared to EX in men with a PPI using a large, all-payer national database. METHODS Men were identified from the National Inpatient Sample (NIS) from 2000 to 2008 by ICD-9 codes for ED, PPI, and procedures codes for either EX or R−EX. All patient refined diagnosis related groups (APRDRG) were used to evaluate patient's severity of illness. All events were single patients for one admission. Chi-square and Fisher's test were used for categorical variables. Wilcoxon tests were used to compare medians of two groups for continuous variables. RESULTS 1044 men were identified with PPI that underwent EX (891, 85.3%) or R-EX (153, 15.7%). The percentage of patients that had R-EX has remained stable from 2000-2008. EX is more likely when presentation is to the ER or urgent care facility, 94.2% and 86.7% respectively, compared to 78.1% for elective presentation (p<0.001). EX was also more common in diabetic vs. non-diabetics patients (89% vs. 83% p=.02), patients greater than 75 years old (p=0.002), and patients with greater severity of illness on presentation (APRDRG 1-2: 82% vs. 3-4: 96%; p<0.0001). We found EX is more likely in Medicaid patients (92%) as opposed to Medicare (88%) or private insurance (77.5%; p<0.001). It should be noted however that Medicaid patients typically presented with greater severity of illness and usually presented to the ER or urgent care centers. There was no association in technique by hospital location or teaching status, patient race, or day of week of presentation. When compared to R-EX, patients undergoing EX had a lower average cost of admission ($21,322 vs. $33,212; p<0.001), yet a longer hospital stay (4 vs. 3 days; p<0.001) and a greater discharge with home health assistance (39% vs. 12%; p<0.001). CONCLUSIONS Reimplantation after washout of an infected penile prosthesis was a less common event than explantation and yearly R-EX utilization remained steady during the course of the study. Explantation without immediate reimplant was more likely if the presentation was via ER /urgent care centers, patients had a greater severity of illness, were greater than 75 years old, diabetic, or had non-privatized insurance. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e755 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sherwin Zargaroff Chicago, IL More articles by this author Joshua Meeks Chicago, IL More articles by this author Brian Le Chicago, IL More articles by this author James M. Dupree Chicago, IL More articles by this author Vidit Sharma Chicago, IL More articles by this author Kunj R. Sheth Chicago, IL More articles by this author Kevin McVary Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...