Ten-year experience with penile prosthetic surgery for the treatment of erectile dysfunction: outcomes of a tertiary referral center and predictors of early prosthetic infection
Por:
Palmisano, F, Boeri, L, Ievoli, R, Sanchez-Curbelo, J, Spinelli, MG, Gregori, A, Granata, AM, Ruiz-Castane, E, Montanari, E, Sarquella-Geli, J
Publicada:
1 ene 2022
Resumen:
We aimed to evaluate ten-year outcomes of penile prosthesis (PP) implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection (EPI). We identified 549 men who underwent 576 PP placements between 2008 and 2018. Univariate and multivariate analyses were used to identify potential predictors of EPI. An EPI predictive nomogram was developed. Thirty-five (6.1%) cases of EPI were recorded with an explant rate of 3.1%. In terms of satisfaction, 82.0% of the patients defined themselves as "satisfied," while partner's satisfaction was 88.3%. Diabetes (P = 0.012), longer operative time (P = 0.032), and reinterventions (P = 0.048) were associated with EPI risk, while postoperative ciprofloxacin was inversely associated with EPI (P = 0.014). Rifampin/gentamicin-coated 3-piece inflatable PP (r/g-c 3IPP) showed a higher EPI risk (P = 0.019). Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients, redo surgeries, or when a r/g-c 3IPP was used (all P < 0.03). We showed that diabetes, longer operative time, and secondary surgeries were the risk factors for EPI. Postoperative ciprofloxacin was associated with a reduced risk of EPI, while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant. After further validation, the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.
Filiaciones:
Palmisano, F:
Luigi Sacco Univ Hosp, Dept Urol, ASST Fatebenefratelli Sacco, I-20157 Milan, Italy
Boeri, L:
Univ Milan, IRCCS Fdn Ca Granda Osped Maggiore Policlin, Dept Urol, I-20122 Milan, Italy
Ievoli, R:
Univ Ferrara, Dept Econ & Management, I-44121 Ferrara, Italy
Sanchez-Curbelo, J:
Univ Barcelona, Dept Androl, Fundacio Puigvert, Barcelona 08025, Spain
Spinelli, MG:
Univ Milan, IRCCS Fdn Ca Granda Osped Maggiore Policlin, Dept Urol, I-20122 Milan, Italy
Gregori, A:
Luigi Sacco Univ Hosp, Dept Urol, ASST Fatebenefratelli Sacco, I-20157 Milan, Italy
Granata, AM:
Luigi Sacco Univ Hosp, Dept Urol, ASST Fatebenefratelli Sacco, I-20157 Milan, Italy
Ruiz-Castane, E:
Univ Barcelona, Dept Androl, Fundacio Puigvert, Barcelona 08025, Spain
Montanari, E:
Univ Milan, IRCCS Fdn Ca Granda Osped Maggiore Policlin, Dept Urol, I-20122 Milan, Italy
Sarquella-Geli, J:
Univ Barcelona, Dept Androl, Fundacio Puigvert, Barcelona 08025, Spain
Green Submitted, Green Published, gold
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