To drain or not to drain an inflatable penile prosthesis implantation? A multi-institutional experience tracking scrotal hematoma and infection occurrence

Ragheb, Ahmed M.; Otero, Jorge Pombo; Bettocchi, Carlo; Renterghem, Katrien Van; Kp, Jünemann; Wilson, Stelios C.

doi:10.1016/s0302-2838(21)00880-0

Cited by 2 publications

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“…Serious adverse events can occur during or following inflatable penile prosthesis (IPP) surgery [ 5 , 6 ]. Scrotal hematoma formation after IPP surgery is a serious adverse event that remains relatively underexplored in the literature [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Hematoma formation is an unfavorable complication with a wide variation in incidence, ranging from 0.2% to 22.2% in primary implant recipients [ 9 – 13 ]. Prevention of postoperative IPP bleeding complications correlates with shorter recovery time and decreased risk of device infection [ 7 , 8 ]. Numerous strategies have been developed to help mitigate postoperative IPP scrotal bleeding, including running corporotomy closures, use of clotting agents at corporotomies, penoscrotal pressure dressing (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Numerous strategies have been developed to help mitigate postoperative IPP scrotal bleeding, including running corporotomy closures, use of clotting agents at corporotomies, penoscrotal pressure dressing (e.g. “Mummy wrap”), complete or partial device inflation to minimize bleeding from the corporotomy, and/or closed suction device placement [ 8 , 14 ]. Inconsistent adoption and reporting of these strategies limits evaluation of their efficacy.…”

Section: Introductionmentioning

confidence: 99%

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Defining the incidence and management of postoperative scrotal hematoma after primary and complex three-piece inflatable penile prosthesis surgery

et al. 2023

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Scrotal hematoma is a challenging complication of penile prosthesis surgery. We characterize the risk of hematoma formation with implementation of standardized techniques to mitigate hematomas and assess for any associated factors in a large multi-institutional penile implant cohort. This was a retrospective review from February 2018 to December 2020 of all patients who underwent inflatable penile prosthesis implantation at 2 high volume implant centers. Cases were defined as “complex” if they involved revision, salvage with removal/replacement, or were performed with concurrent penile, scrotal or intra-abdominal surgeries. The incidence of scrotal hematoma among primary and complex IPP recipients was measured and modifiable and innate risk factors associated with hematoma formation within the two cohorts were tracked. Of 246 men who underwent penile prosthesis surgery, 194 (78.9%) patients underwent primary implantation and 52 (21.1%) were complex. Although hematoma formers in the complex group had comparable drain outputs to primary patients on postoperative day 0 (66.8cc ± 32.5 vs 48.4 ± 27.7, p = 0.470) and postoperative day 1 (40.3cc ± 20.8vs 21.8 ± 11.3 p = 0.125), hematomas in the complex group had a higher propensity for OR evacuation ( p = 0.03). Difference in duration of temporary device inflation between 2 (64, 26%) and 4 weeks (182, 74%) did not contribute to hematoma formation ( p = 0.562). The incidence of postoperative hematoma formation in complex cases was 9.6% (5/52) and 3.6% in primary cases (7/194) (HR = 2.61, p = 0.072). Complex IPP surgery performed for revision or with ancillary procedures are more likely to result in clinically significant hematomas that require surgical management, suggesting a need for heightened caution in managing these individuals.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Defining the incidence and management of postoperative scrotal hematoma after primary and complex three-piece inflatable penile prosthesis surgery

et al. 2023

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Defining the Incidence and Management of Postoperative Scrotal Hematoma after Primary and Complex Three-piece Inflatable Penile Prosthesis Surgery

Simhan

Braun

Swerdloff³

et al. 2022

Preprint

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Background: Scrotal hematoma is a challenging complication of penile prosthesis surgery. We characterize the risk of hematoma formation with implementation of standardized techniques to mitigate hematomas and assess for any associated factors in a large multi-institutional penile implant cohort. Materials and Methods: A retrospective review from February 2018 to December 2020 of all patients who underwent inflatable penile prosthesis (IPP)implantation at 2 high volume implant centers was conducted. Cases were defined as ‘complex’ if they involved revision, salvage with removal/replacement, or were performed with concurrent penile, scrotal or intra-abdominal surgeries. The incidence of scrotal hematoma among primary and complex IPP recipients was measured and modifiable and innate risk factors associated with hematoma formation within the two cohorts were tracked. Results: Of 246 men who underwent IPP, 194 (78.9%) patients underwent primary implantation and 52 (21.1%) were complex. Although patients in the complex group had comparable drain outputs to non-hematoma patients on POD0 (66.8cc vs 49.6, p=0.488) and POD1 (20.0cc vs 40.3, p=0.114), hematomas in the complex group had a higher propensity for OR evacuation (p=0.03). Difference in duration of temporary device inflation between 2 and 4 weeks did not contribute to hematoma formation. Postoperative hematoma formation in complex cases (5/52, 9.6%) trended towards a higher incidence than primary cases (7/194, 3.1%) (HR=2.61, p=0.072). Conclusions: Complex IPP surgery performed for revision or with ancillary procedures are more likely to result in clinically significant hematomas that require surgical management, suggesting a need for heightened caution in managing these individuals.

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To drain or not to drain an inflatable penile prosthesis implantation? A multi-institutional experience tracking scrotal hematoma and infection occurrence

Cited by 2 publications

References 0 publications

Defining the incidence and management of postoperative scrotal hematoma after primary and complex three-piece inflatable penile prosthesis surgery

Defining the incidence and management of postoperative scrotal hematoma after primary and complex three-piece inflatable penile prosthesis surgery

Defining the Incidence and Management of Postoperative Scrotal Hematoma after Primary and Complex Three-piece Inflatable Penile Prosthesis Surgery

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