Abstract: PD22-10
Sources of Funding: none

Introduction

Solid organ transplantation, with its associated immunosuppression, has generally been considered a relative contraindication to penile prosthesis (PP) placement due to a perceived increased risk of complications. However, there are limited data to support this belief. We compared re-operation rates after PP in solid organ transplant patients to age-matched controls.

Methods

A retrospective analysis of all patients with a history of solid organ transplant that also underwent PP placement by one of three surgeons at a large, tertiary, academic center was performed. Data extracted from the medical record included age and comorbidities at implantation, device type, organ transplanted, and need for any PP reoperation (due to infection, malfunction, etc). A cohort of age-matched controls was identified for comparison. Descriptive statistics are presented as mean ± standard deviation and comparative statistics include student t-test and chi-squared test or Fisher exact test, as appropriate.

Results

We identified 26 patients who had undergone both solid organ transplant and PP between 1999-2015, along with an age matched group of patients who underwent PP alone. Transplants consisted of heart (N=3), liver (N=2), and kidney (N=21), with 4 kidney patients simultaneously receiving a pancreas. Mean follow up time was 29.5 months in the transplant group and 13.5 months in the PP alone group. Age at PP did not significantly differ between patients with versus without transplant (53.7±8.1 v 56.4±9.0, p 0.26), nor did BMI (30.3±5.5 v 30.2±4.7, p 0.92), history of prostate surgery (7.7% v 15.4%, p 0.39), rectal surgery (3.9% v 3.9%, p 1.00), hyperlipidemia (69.2% v 69.2%, p 1.00), hypertension (92.3% v 76.9%, p 0.25), or heart disease (57.7% v 30.8%, p 0.093). Peripheral vascular disease was more common in patients with versus without transplant (26.9% v 3.9%, p 0.021), as was stroke (19.2% v 0.0%, p 0.05) and diabetes (84.6% v 53.6%, p 0.016). No significant differences in reoperation rates existed between patients with versus without transplant (7.7% v 11.5%, p 1.00), nor between the type of organ transplanted (p 1.00). No differences in reoperation rate by implant model (2-piece versus 3-piece) were noted (p 0.47).

Conclusions

This study shows that outcomes of penile prosthesis placement in solid organ transplantation patients do not differ from those in non-transplant patients. Additionally both 2-piece and 3-piece implants had similar outcomes. Penile prostheses appear to be a safe option for treating erectile dysfunction in solid organ transplant recipients.

Funding

none