Abstract: PD22-06
Sources of Funding: None

Introduction

Inflatable penile prosthesis (IPP) placement is a commonly performed procedure in the treatment of erectile dysfunction (ED). Although many patients do not experience postoperative complications, some require revision surgery. Anecdotally, some have challenged the use of rear tip extenders (RTE) during surgery under the assumption that their presence decreases axial rigidity. The objective of this study is to measure the utilization patterns of RTEs over time, and determine if their use is associated with the need for IPP surgical revision.

Methods

A retrospective review was conducted involving 65,448 cases of IPP placement between 2000 and 2015. Cases were stratified into 2 groups based on the presence (Group A) or absence (Group B) of rear-tip extender use during IPP replacement. Collected variables include the need for revision surgery, whether or not RTEs were used, and the date of revision surgery. Primary endpoints included prevalence of RTE usage from 2000 to 2015, as well as comparison of revision rates between Group A and Group B.

Results

There were 35,046 (53.5%) patients in Group A and 30,402 (46.5%) patients in Group B. Between 2000 and 2015 there was a statistically significant increase in the percentage of IPP placements utilizing RTEs from 6-8% of IPP procedures in 2000 to 82% and 93% of IPP placements in 2014 and 2015, respectively (P < 0.0001, see figure 1). Revision rates for both Group A and Group B changed in a parabolic fashion between 2000 and 2015. Group A revision rates increased from less than 1% in 2000 to a peak of 3.7% in 2011, followed by a decrease to 2.4% in 2015. Similarly, Group B revision rates increased from less than 1% in 2000 to a peak of 3% in 2012, followed by a decrease to 0.5% in 2015 (see figure 2). Comparing the revision rate of the two groups over the 15-year period demonstrated a two-fold increase in the rate of revision with the use of RTE (Group A 1.34%, Group B 2.65, P < 0.0001)

Conclusions

The use of RTEs has increased over the last 15 years, however there appears to be a higher rate of revision surgery if the implant utilizes RTE. Given the frequent use of RTE in IPP surgery, further studies to understand this association are needed.

Funding

None