Penile prosthesis implantation surgery: a statewide population based analysis of 2354 patients

Jhaveri, Faiyaaz M.; Rutledge, Robert; Carson, Culley C.

doi:10.1038/sj.ijir.3900359

Cited by 28 publications

(4 citation statements)

References 8 publications

(9 reference statements)

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“…Furthermore, our results mirror those observed by Jhaveri et al. in North Carolina between 1988 and 1993 [11]. In this claims‐based analysis of 151 North Carolina hospitals, the total number of penile prosthetic surgeries performed decreased significantly over the 6‐year time period.…”

Section: Discussionsupporting

confidence: 89%

Hospital-Based Trends in Penile Prosthetic Surgery

Mirheydar

Palazzi²,

Parsons

et al. 2015

The Journal of Sexual Medicine

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Introduction We examined national and regional trends in hospital-based penile prosthetic surgery and identified patient-specific factors predicting receipt of inflatable vs. semi-rigid penile prostheses. Aims To improve our understanding of the surgical treatment for erectile dysfunction (ED). Methods We utilized the Nationwide Inpatient Sample (NIS) from 1998 to 2010 in the United States and the California Office of Statewide Health Planning and Development (OSHPD) database from 1995 to 2010. Total number of penile implants performed and proportions of inflatable vs. semi-rigid prosthesis were examined. Multivariate analysis (MVA) was performed to identify factors associated with selection of inflatable vs. semi-rigid prostheses. Main Outcome Measures Primary outcome measure is the total number of hospital-based penile prosthetic surgeries performed in the United States over a 12-year period (1998–2010). Secondary outcome measures include proportion of inflatable and semi-rigid prosthesis implantations and factors influencing receipt of different prostheses. Results We identified 53,967 penile prosthetic surgeries in the NIS; annual number implanted decreased from 4,703 to 2,338. Inflatable prostheses incurred higher costs but had a similar length of stay (LOS). In MVA, Caucasian race, Peyronie's disease, and private insurance were independently associated with receipt of an inflatable prosthesis. We identified 7,054 penile prostheses in OSHPD; annual number implanted decreased from 760 to 318. The proportion of inflatable prostheses increased significantly from 78.4% to 88.4% between 2001 and 2010. Inflatable prostheses incurred higher costs but had similar median LOS. In MVA, Caucasians and men without spinal cord injury were more likely to receive inflatable prosthesis. Conclusion Hospital-based penile prosthetic surgery has decreased substantially both nationwide and in California. In the United States, Caucasian race, Peyronie's disease, and private insurance were independently associated with receipt of an inflatable penile prosthesis. California population data correlated with national trends and can be utilized to further study surgical management of ED.

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Section: Discussionsupporting

confidence: 89%

Hospital-Based Trends in Penile Prosthetic Surgery

Mirheydar

Palazzi²,

Parsons

et al. 2015

The Journal of Sexual Medicine

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“…In the last three decades, mechanical and material design changes have resulted in marked improvements in the function, reliability and safety of penile implants [4]. Currently, the most frequently implanted penile prostheses are the multicomponent inflatable type [5].…”

Section: Introductionmentioning

confidence: 99%

Should being aged over 70 years hinder penile prosthesis implantation?

Al-Najar¹,

Naumann²,

Kaufmann³

et al. 2009

BJU International

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OBJECTIVE To assess the satisfaction profiles following penile prosthesis surgery in patients with erectile dysfunction (ED) in their seventh decade of life. PATIENTS AND METHODS In all, 174 patients received, for the first time, a penile prosthesis between 1990 and 2007 in our department. Among these, 35 patients were aged ≥70 years at prosthesis implantation. Of these, 18 patients were still alive at the time of follow‐up. Using a telephone survey, patients were asked to answer the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) as well as the International Index of Erectile Dysfunction (IIEF). Another question in the survey was developed by the authors based on a comprehensive review of the literature, which assessed the usefulness of the device for the patient and the degree of their usage. This was formulated as follows: How many times per 2 weeks do you have a sexual intercourse? RESULTS In all, 15 of 18 patients were either very or somewhat satisfied (83%). At follow‐up 11 out of 15 (73%) patients were using their prosthesis regularly. The mean IIEF and EDITS scores were 21.80 and 75.20, respectively. CONCLUSION A penile prosthesis remains a highly promising treatment in older patients with a similar satisfaction rate to those published for younger patients. Thus, the motivation of the patient and not the age of the patient should be the main determinant factor in this surgical procedure.

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“…These devices began with the development of newer synthetic materials by NASA in the 1960s, which advanced human prosthetic devices to include the treatment of ED. The era of modern penile prosthetic surgery began in 1973 [1,2]. Investigators developed the two current classes of penile prosthetic devices.…”

mentioning

confidence: 99%

Penile prostheses: are they still relevant?

Carson¹

2003

BJU International

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and 270 VIPs. Currently our operating time is 2-2.5 h, depending on whether a pelvic lymphadenectomy is performed or not; the robotic RP time is 45 min less. Allowing for a theatre turn-over of 1-1.5 h, we can undertake three operations during a normal working day. Over 95% of the patients are discharged within 24 h; over the last month, half have gone home within 6 h of surgery.No patient has required an intraoperative transfusion. Six patients have had major complications, five requiring secondary surgical procedures (two port-site hernias, two pelvic haematomas and one repair of a small bowel injury). After 2 months, 90% of the patients are continent, and 60% of initially potent patients have had unassisted intercourse by the 6 month follow-up. Table 1 compares the operative variables during radical, laparoscopic RP and VIP.There appear to be two unresolved issues about robotic surgery, i.e. the cost of the procedure and the intensity of training. The da Vinci surgical system (Intuitive Surgical™, France) costs US $1.2 million, with a maintenance fee of $100 000/year after the first year. The average cost of disposables is $1500 per patient. These extra costs are balanced by the cost savings of decreased hospitalization, fewer blood transfusions, decreased theatre time and a lower complication rate. While it is notoriously difficult to calculate precise hospital costs in the USA, the best we can determine is that the robotic procedure still costs an average of $150 more than the open procedure. This has changed over the last few months, with costs actually favouring robotic surgery, as the operating times for VIP have become shorter than for open RP.

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Penile prosthesis implantation surgery: a statewide population based analysis of 2354 patients

Cited by 28 publications

References 8 publications

Hospital-Based Trends in Penile Prosthetic Surgery

Hospital-Based Trends in Penile Prosthetic Surgery

Should being aged over 70 years hinder penile prosthesis implantation?

Penile prostheses: are they still relevant?

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