(36) DRAINED VERSUS NON-DRAINED INFLATABLE PENILE PROSTHESIS IMPLANTATION: A MULTICENTER PROSPECTIVE NONRANDOMIZED PILOT STUDY

Abstract Objectives Our goal was to understand the risks and benefits of post-inflatable penile prosthesis (IPP) implanation drainage and optimal duration. Methods Patients underwent IPP implantation for the first time by four European high volume surgeons. They were divided into 3 groups based on the presence and duration of drainage. Group 1 (n=114) had no drain placed, Group 2 had a drain placed for 24 hours (n=114) and Group 3 had a drain placed for 72 hours (n=117). The presence or absence of postoperative (PO) scrotal hematoma and prosthesis infection were evaluated and compared between the groups via scrotal ultrasound (US) examination carried out 24 hours then 3 and 10 days PO. All patients were followed up postoperatively for a minimum of 80 days. Results The exact distribution of hematoma prevalence was greatest on the 3rd PO day with the highest rate in Group 1: (n=13, 11.4%) followed by Group 2: (n=7, 6.1%) and the least in Group 3: (n=1, 0.9%). The patients from Group 3 demonstrated a statistically significant lower incidence of hematoma on the 10th PO day: (n=1, 0.9%) compared to Group 2: (n= 11, 9.6%) and Group 1: (n=8, 7%, p=0.013). However, on the 3rd PO day, there was a statistically significant lower incidence of hematoma in Groups 3 and 2: (1% and 7%, respectively) versus Group 1: (11.4%, p=0.004). Hematoma rates followed the same group order after the first day of surgery: 8.8% (n=10), 5.3% (n=6), and 1.7% (n=2), respectively. (p=0.054). Five patients (4.4%) in Group 1 and four patients (3.5%) in Group 2 developed an IPP associated infection, opposed to only a single patient (0.85%) in Group 3. Conclusions Prolonged scrotal drainage for 72 hours after virgin IPP implantation significantly reduces hematoma and infection rates. It is likely that hematoma formation is per se a predisposing factor for IPP infection. Conflicts of Interest The authors of no conflict of interest.