TY - JOUR
T1 - Predictors of intraoperative complications in men undergoing inflatable penile prosthesis placement
AU - PUMP Prosthetic Urology Multiinst Partnership Collaborators
AU - Jones, James M.
AU - Barham, David W.
AU - Gross, Martin S.
AU - Chang, Chrystal
AU - Hammad, Muhammed
AU - Swerdloff, Daniel
AU - Miller, Jake
AU - Loeb, Charles
AU - Andrianne, Robert
AU - Burnett, Arthur L.
AU - Gross, Kelli
AU - Hatzichristodoulou, Georgios
AU - Hotaling, James M.
AU - Hsieh, Tung-Chin
AU - Jenkins, Lawrence C.
AU - Jones, Adam
AU - Lentz, Aaron C.
AU - Modgil, Vaibhav
AU - Osmonov, Daniar
AU - Park, Sung H.
AU - Pearce, Ian
AU - Perito, Paul
AU - Sadeghi-Nejad, Hossein
AU - Sempels, Maxime
AU - Suarez-Sarmiento Jr, Alfredo
AU - Simhan, Jay
AU - van Renterghem, Koenraad
AU - Warner, Jonathan Nicholas
AU - Ziegelmann, Matthew
AU - Yafi, Faysal A.
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved.
PY - 2025/11/1
Y1 - 2025/11/1
N2 - BACKGROUND: Intracavernosal injection (ICI) therapy for erectile dysfunction (ED) and prostate cancer treatments all carry a risk of corporal fibrosis, potentially making placement of an inflatable penile prosthesis more difficult.AIM: To evaluate the association between history of ICI, history of prostate cancer treatment (prostatectomy, radiation) and complications of inflatable penile prosthesis (IPP) placement.METHODS: A retrospective cohort study was performed of primary IPP cases from 2016 to 2021 across 16 institutions. Patients were stratified by development of intraoperative complications (crossover, corporal perforation, or urethral injury) and between-group differences in risk factors were assessed. Multivariable logistic regression was used to assess for predictors of intraoperative complications and postoperative infection.OUTCOMES: The primary outcome was intraoperative complications, and secondary outcome was implant infection.RESULTS: A total of 2540 patients met inclusion criteria. Intraoperative complications occurred in 36 (1.4%) patients. On multivariable regression, a history of ICI, prostatectomy, and radiation were all significant predictors of intraoperative complications (OR 2.11, P = 0.03; OR 2.27, P = 0.03; OR 2.40, P = 0.04, respectively). Age, body mass index, diabetes, hypertension, vascular disease, smoking, and Peyronie's disease were not predictors of intraoperative complications. None of the variables were significant predictors of infection.CLINICAL IMPLICATIONS: Prosthetic urologists should counsel patients that a history of ICI or prostate cancer treatment with radical prostatectomy and/or radiation are associated with an increased risk of intraoperative complications.STRENGTHS AND LIMITATIONS: Strengths of this study include the utilization of a large, multicenter, international dataset. The study is limited by retrospective nature, a lack of granular data as to the type and duration of ICI therapy, and inherent selection bias in that all cases were performed by dedicated implant surgeons.CONCLUSION: In men undergoing IPP placement, a history of ICI, a history of radical prostatectomy, and a history of radiation are all independently associated with increased risk of intraoperative complications.
AB - BACKGROUND: Intracavernosal injection (ICI) therapy for erectile dysfunction (ED) and prostate cancer treatments all carry a risk of corporal fibrosis, potentially making placement of an inflatable penile prosthesis more difficult.AIM: To evaluate the association between history of ICI, history of prostate cancer treatment (prostatectomy, radiation) and complications of inflatable penile prosthesis (IPP) placement.METHODS: A retrospective cohort study was performed of primary IPP cases from 2016 to 2021 across 16 institutions. Patients were stratified by development of intraoperative complications (crossover, corporal perforation, or urethral injury) and between-group differences in risk factors were assessed. Multivariable logistic regression was used to assess for predictors of intraoperative complications and postoperative infection.OUTCOMES: The primary outcome was intraoperative complications, and secondary outcome was implant infection.RESULTS: A total of 2540 patients met inclusion criteria. Intraoperative complications occurred in 36 (1.4%) patients. On multivariable regression, a history of ICI, prostatectomy, and radiation were all significant predictors of intraoperative complications (OR 2.11, P = 0.03; OR 2.27, P = 0.03; OR 2.40, P = 0.04, respectively). Age, body mass index, diabetes, hypertension, vascular disease, smoking, and Peyronie's disease were not predictors of intraoperative complications. None of the variables were significant predictors of infection.CLINICAL IMPLICATIONS: Prosthetic urologists should counsel patients that a history of ICI or prostate cancer treatment with radical prostatectomy and/or radiation are associated with an increased risk of intraoperative complications.STRENGTHS AND LIMITATIONS: Strengths of this study include the utilization of a large, multicenter, international dataset. The study is limited by retrospective nature, a lack of granular data as to the type and duration of ICI therapy, and inherent selection bias in that all cases were performed by dedicated implant surgeons.CONCLUSION: In men undergoing IPP placement, a history of ICI, a history of radical prostatectomy, and a history of radiation are all independently associated with increased risk of intraoperative complications.
KW - Aged
KW - Erectile Dysfunction/surgery
KW - Humans
KW - Intraoperative Complications/etiology
KW - Male
KW - Middle Aged
KW - Penile Implantation/adverse effects
KW - Penile Prosthesis/adverse effects
KW - Prostatectomy/adverse effects
KW - Prostatic Neoplasms/radiotherapy
KW - Retrospective Studies
KW - Risk Factors
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:001579802900001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1093/jsxmed/qdaf136
DO - 10.1093/jsxmed/qdaf136
M3 - Article
C2 - 41003539
SN - 1743-6095
VL - 22
SP - 2116
EP - 2122
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 11
ER -