Mp57-06 the Urethral Microbiome During Inflatable Penile Prosthesis Placement

Abstract

METHODS: A single institution retrospective review of patients undergoing primary IPP placement between 7/2019-9/2020 was performed. Baseline patient characteristics, intraoperative details, and postoperative course were recorded. Regression analysis was conducted to determine factors associated with ACM.RESULTS: A total of 130 patients underwent primary placement of penile prosthesis during this time. Median age was 67 years (IQR 13). Comorbidities included diabetes mellitus in 22.3%, CAD in 22.3%, history of prostatectomy or cystectomy in 33.8%, history of pelvic radiation in 7.7%, and Peyronie's disease in 21.5%. The median corporal measurement was 21 (IQR 2) bilaterally and median cylinder size 20 cm (IQR 4) bilaterally with 1cm rear tip extenders. Of the 18.5% (24/130) of patients with ACM, asymmetry was as follows: 20.8% (5/24) had a less than 1 cm, 70.8% (17/24) had 1 cm but less than 2 cm, and 8.3% (2/24) had 2 cm or greater. Of these patients 87.5% (21/24) underwent placement of an asymmetric device, only 5% (1/21) of which had residual curvature less than 30 degrees. Despite ACMs, 12.5% (3/ 24) of patients had a symmetric device placed, one of which had residual curvature. Only 2 patients underwent additional straightening procedures including plication and incision/grafting. Univariate regression did not reveal an association between ACM and residual curvature, adjunctive measures for correction, or postoperative pain or device issues (p >0.05 for all).CONCLUSIONS: Almost 1 in 5 patients undergoing primary placement of penile prosthesis for ED had ACM. However this did not correspond to residual curvature following placement of prosthesis cylinders or requirement for adjunctive straightening techniques. These findings may provide intraoperative reassurance to urologists when noting asymmetric measurements during corporal dilation in penile prosthesis placement.