Introduction & Objective :
Urethral surgery for stricture disease or urethral trauma sustained at the time of inflatable penile prosthesis (IPP) implantation is thought to significantly increase rates of device infection. The classic teaching requires procedure abortion, urethral repair and a future, delayed IPP implantation.
We report our experience with patients who had urethral surgery at the time of IPP implantation in order to further elucidate potential risk factors associated with device complications.
Consecutive records of patients who underwent IPP implantation at our institution between May 2007 and March 2017 were queried retrospectively. Medical records of patients with a history of urethral surgery at the time of IPP implantation were evaluated. Patient demographics, pre-operative workup, intra-operative maneuvers and post-operative follow-up data were analyzed with use of standard statistics.
Records of thirteen men were identified. Average patient age was 63.9 years (range: 40-81yo), and 11 of men (84.6%) were Caucasian. Two men who sustained intra-operative urethral injuries underwent complex repairs with suprapubic tube (SPT) placement. The remaining eleven men had stricture disease and required either stricture dilation, incision or urethroplasty. IPP revision (explantation/ implantation) was performed in two of the men undergoing urethral dilation for stricture disease. There were no device infections or erosions. (Table 1)
Urethral surgery required to address either stricture disease or intra-operative urethral injury appears to be safe, when performed at the time of IPP implantation. SPT should be strongly considered during repairs of more significant urethral injuries, especially when graft material is utilized.