Frailty in Surgical Patients: Is it Relevant to Sexual Medicine?

Abstract

Background As the age of our surgical population continues to rise, there is an increased need for adequate preoperative evaluation and risk stratification to ensure the best possible surgical outcomes for patients. Aim We sought to describe the 3 main models currently used to evaluate patient frailty and explore how they are being utilized in the field of surgery and sexual medicine. Methods We reviewed online resources including Pubmed with relevant search criteria centered around frailty, surgery, sexual medicine, and prosthetics. Outcomes/Results All relevant studies were reviewed and several models for patient frailty emerged; the Phenotype Model, the Frailty Index, the Clinical Frailty Scale, and the modified Frailty Index. Worse frailty indices were seen to be linked to higher rates of complications and mortalities postoperatively. Clinical Implications Although the adoption of patient frailty in the field of sexual medicine has been sluggish, few studies have shown that its use could help predict which patients are at increased risk of complications and may require more support when it comes to postoperative care and teaching. Strength & Limitations Overall there is a paucity of literature as it relates to sexual medicine and patient frailty and this paper provides a limited look at the usage of patient frailty in sexual medicine. Conclusion We implore all sexual health providers to begin to incorporate frailty metrics when caring for this population to help reduce postoperative complications and help better predict surgical success.

Inflatable penile prosthesis placement in Peyronie’s disease: a review of surgical considerations, approaches, and maneuvers

“…In addition, there are numerous methods to prognosticate patient outcomes prior to surgical intervention, specifically looking at frailty. While there remains a lack of utilization of patient frailty in sexual medicine, at a minimum, the application of patient grip strength prior to prosthetic procedures could significantly improve patient outcomes and help predict which patients may be at increased risk of prolonged recovery with pain or have more challenges with device manipulation/instruction postoperatively, and whom may be better candidates for MPP ( 11 ). Habous et al found no significant difference in satisfaction rates between patients receiving an MPP or IPP for the treatment of PD ( 9 ).…”