Login to Access Video or Poster Abstract: MP25-11
Sources of Funding: none

Introduction

With rising healthcare cost, there is an effort by providers to adopt strategies that decrease cost of care and optimize utilization of available resources. One approach is to decrease post-operative hospitalization. There is a paucity of data on penile prosthetic surgeries in the outpatient setting. The purpose of this study is to analyze national trends in inflatable penile prosthesis (IPP) surgery, examining factors that impact selection of surgery setting.

Methods

Using Boston Scientific Corporation database, we analyzed data for AMS 700 surgeries performed in the US over a 10-year period. IPP surgeries analyzed included virgin implantation, revision or removal. The surgical and available patient information were utilized to examine potential factors associated with surgical setting. Standard statistical analysis was performed and p-value < 0.05 was deemed statistically significant.

Results

40,488 IPP surgeries were examined from 2005 to 2015. 75.0% were virgin implants, 22.2% revisions and 2.8% were removal of devices (1.7% for malfunction, 1.1% for infection). The most common etiologies of erectile dysfunction (ED) were organic (30.2%), prostatectomy (23.1%), Diabetes mellitus (17.0%) and vascular disease (15.2%). The Southeast region performed the highest proportion of IPP surgeries (46.7%) followed by Midwest (21.5%), Southwest (12.7%), West (11.9%) and Northeast (7.1%) regions. The overwhelming surgical approach was penoscrotal (75.9%). Over the 10-year period, there was significant increase in the proportion of IPP surgeries performed in the outpatient setting compared to in-patient (from 54.3% in 2005 to 83.2% in 2015, p<0.001, Fig.1). There was no difference in choice of surgery setting for revision or virgin IPP placement or removal for malfunction (p=0.60). However, surgery for infection occurred more frequently in the inpatient setting (1.5% vs 0.9%, p<0.001).

Conclusions

Outpatient IPP surgeries have increased significantly over the 10-year period. With the exception of surgery for infections, both complexity of surgery and patient comorbidities did not lead to differences in surgical setting. Outpatient IPP surgeries have the potential to decrease the cost of surgical management of ED. Future studies are needed to examine the outcomes of surgeries performed in both setting.

Funding

none