National Trends in the Treatment of Penile Prosthesis Infections by Explantation Alone vs. Immediate Salvage and Reimplantation. (13th March 2014)

• Record Type: Journal Article
• Authors: Zargaroff, Sherwin; Sharma, Vidit; Berhanu, Daniel; Pearl, Jeff A.; Meeks, Joshua J.; Dupree, James M.; Le, Brian V.; Cashy, John; McVary, Kevin T.
• Is Part Of: Journal of sexual medicine. Volume 11:Number 4(2014:Apr.)
• Page Start: 1078
• Page End: 1085
• Publication Date: 2014-03-13
• Subjects: Sexual disorders -- Periodicals; Sex -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1111/jsm.12446
• Languages: English
• ISSNs: 1743-6095

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jsm12446-sec-0001" sec-type="section"> <title>Introduction</title> <p>A penile prosthesis infection (PPI) is either treated with explantation of the prosthesis with a possible delayed reimplantation or a salvage procedure with an immediate reimplantation of the prosthesis.</p> </sec> <sec id="jsm12446-sec-0002" sec-type="section"> <title>Aim</title> <p>We used a large, all‐payer national database to investigate the use of the salvage procedure in the setting of PPI.</p> </sec> <sec id="jsm12446-sec-0003" sec-type="section"> <title>Methods</title> <p>The study used years 2000–2009 of the Nationwide Inpatient Sample to identify PPIs treated with immediate salvage or explantation alone. Admissions were then stratified by various parameters to compare differences in the salvage rates.</p> </sec> <sec id="jsm12446-sec-0004" sec-type="section"> <title>Main Outcome Measures</title> <p>Salvage Rate of Penile Prosthesis infection.</p> </sec> <sec id="jsm12446-sec-0005" sec-type="section"> <title>Results</title> <p>A total of 1, 557 patients were treated with an explantation only (82.7%) or salvage (17.3%) for PPI, a proportion that remained stable over the study period. The patients treated with salvage were younger (60.4 vs. 65.1 years), more likely to be discharged home (87.3% vs. 61.9%), and were less likely to have a severe presentation (7.2% vs. 31.6%) than those who were explanted only (<italic>P</italic> < 0.001). These factors were confirmed on multivariate regression analysis. The regression also revealed that treatment at rural hospitals had lower odds of salvage than treatment at urban teaching hospitals. Race, comorbid diabetes, and insurance status did not independently affect the salvage rate. There was no significant difference in total hospital charges between groups.</p> </sec> <sec id="jsm12446-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Salvage rates have remained low over the past decade. Our study elucidated several factors decreasing the chances of salvage after PPI including age, severity of presentation, and hospital setting. <bold>Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, Le BV, Cashy J, and McVary KT. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation. J Sex Med 2014;11:1078–1085.</bold></p> </sec> </abstract>