Introduction The spouses and partners of patients undergoing implantation of an inflatable penile prosthesis (IPP) are often active participants in the perioperative process. Many urologists encourage partner involvement for penile implant patients, but there is little information on whether this influences their post-operative course. Objective This study seeks to determine whether preoperative partner attendance at clinic appointments is associated with deviation from a standard postoperative care pathway for patients undergoing primary IPP placement. Methods This is a retrospective study conducted using data obtained from primary IPPs performed by a single surgeon between October 2016 and January 2021. A standardized postoperative course was used, including planned follow-up visits at 2 weeks (for wound check and device deflation) and 6 weeks (for device teaching). Patient characteristics, including demographics, partner involvement, and the number of follow-up visits were obtained from the medical record. Logistic regression modeling was performed to determine the influence of partner involvement on planned postoperative scheduled visits. Results During the study period, n = 170 primary IPP patients were identified and 147 (67%) of these patients had partners. Partners were involved in all perioperative visits for 92 patients (54%). Unplanned follow up visits were seen for 58 patients (34%) between 0-6 weeks and for 28 patients (17%) after 6 weeks postoperatively. Partner involvement was associated with a reduced odds of additional follow up visits, both at 0-6 weeks (unadj: OR 0.43, 95% CI 0.23-0.83; adj: OR 0.40, 95% CI 0.20-0.79) and after 6 weeks (unadj: OR 0.32, 95% CI 0.13-0.76; adj: OR 0.33, 95% CI 0.13-0.81), both in unadjusted analysis and when adjusted for obesity and presence of complications. Clavien-Dindo complications were identified in 29 patients (17%) intraoperatively or postoperatively. Mean surgical time was 69 minutes (SD = 19). Mean patient age was 62 years (SD = 9). Comorbidities included obesity (52%), diabetes (37%), hyperlipidemia (72%), and hypertension (84%). Conclusions Partner involvement equated to a 2.5 fold decrease in the odds of unplanned postoperative visits among primary IPP patients. Though the mechanism of this reduction is unclear, having partners attend perioperative visits is easily implemented, low cost, and minimal risk. We would recommend that urologists routinely encourage patients considering insertion of a penile prosthesis involve their partners in perioperative visits. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast

Introduction Inflatable penile prosthesis (IPP) placement is a critical component of urology residency education. Resident trainees are useful in IPP cases, but resident assistance is not always available to prosthetic urologists. Registered Nurse First Assistants (RNFAs) can also serve as capable assistants during IPP procedures. We reviewed our data to compare intraoperative and postoperative complications in IPP cases with residents or RNFAs as assistants. We also compared the differences in the surgical procedures with either type of assistant. Objective Comparing the influence of different assistants on perioperative complications of Inflatable Penile Prosthesis Methods Medical records of patients who underwent IPP placement by a single surgeon between 2017 and 2020 were retrospectively reviewed with IRB approval. Baseline patient characteristics, details of surgical procedure, and outcomes were collected. A logistic regression model was used to identify predictors of complications. Student's T test was used to examine for differences in total OR time between different assistants. Results A total of 210 patients who underwent IPP surgery were identified, among which 168 (80%) placements were assisted by RNFAs, and 42 (20%) by urology residents. Complications were reported in 37 (17.6%) patients. Clavien-Dindo complications were grades V (1%, n=2), IIIb (11%, n=23), II (0.5%, n=1), and I (7%, n=14). There was no significant difference in the rate of complications for IPP placement assisted by a resident or RNFA (OR 0.95, CI 0.35 – 2.31) but this was limited by the overall power in assessing complications. Resident-assisted IPP placements were found to be associated with longer operative time than those assisted by RNFAs (86.2 ± 23.1 min vs 72.9 ± 35.5 min, p<0.01). Patient factors including new IPP, BMI>30, DM, and positive urine culture were also not associated with increased complication rate. Current smokers were noted to have more complications (OR 2.51, CI 0.94 – 6.30), although this was not statistically significant. Patients were followed for 12.2 ± 10.8 months postoperatively. Conclusions Resident-assisted IPP placement with a high-volume surgeon is not associated with observable increase rate of complications comparing to those assisted by RNFAs. Moreover, resident involvement is only associated with slight increase in operative time compared to RNFA-assisted IPP placement. Overall complications were low in this series. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast