Sax-Bolder, Anessa

Abstract Introduction Surgical treatment options for Peyronie’s disease (PD) include penile plication, plaque excision with grafting, and penile prosthesis placement with straightening maneuvers. Choice of surgical incision depends on location and severity of curve, concomitant procedures, and surgeon preference. Objective To assess risk of wound complications after PD surgery stratified by ventral versus subcoronal incision type. Methods A single surgeon retrospective chart review was conducted for all patients undergoing PD tunica albuginea plication (TA) or plaque excision with grafting (PEG) from Aug 2019 to June 2023. Wound complication was classified as any dehiscence or physical examination finding suspicious for infection within 30d of surgery. A Mann–Whitney U Test was used to compare demographic variables and wound complication rate based on ventral and subcoronal approaches. Results Of the 161 patients included, 105 underwent TAP and 56 underwent PEG. All patients who underwent PEG had at least one plication suture performed to correct mild residual curvature after grafting. A ventral midline penile incision was used in 81 patients (50%) and subcoronal in 80 patients (50%). Wound complications within 30d of surgery were found in 10 patients (6%), including 8 (10%) with ventral incisions versus only 2 (3%) subcoronal (OR 4.27; 95% CI 0.87-20.79; p = 0.09). There was no significant difference in wound complications between TAP and PEG cohorts. Wound complications included dehiscence requiring repeat closure (n = 1) and superficial wound infection necessitating antibiotic therapy (n = 9). In a subgroup analysis of patients who underwent TAP only, 8 patients (7.6%) with a ventral approach experienced a 30d wound complication compared with 1 patient (3.4%) with a subcoronal approach. Conclusions Penile straightening surgeries are associated with a low rate of significant wound infections. While not statistically significant, a ventral incision may have a slightly higher risk than subcoronal for wound complications within the first 30d of surgery. Both ventral and subcoronal incisions can offer excellent exposure and may be considered for patients requiring plication and/or grafting approaches. Disclosure No.

Abstract Introduction Inflatable penile prostheses have favorable short-term results for men with refractory erectile dysfunction, but few studies have evaluated the long-term outcomes, including in a VA population. Objective This study aims to evaluate the outcomes and satisfaction rates using the novel validated survey, the Satisfaction Survey for Inflatable Penile Implant (SSIPI) of a long-term single-center VA practice. Methods Chart reviews were completed as a Quality Improvement project. All patients who underwent a primary inflatable penile prosthesis implantation from 1993-2021 were included. Demographics and data were collected; SSIPI was administered to men who could be reached. Statistical analyses were performed. Results 114 men were identified, 82 alive and 32 deceased. In the cohort we contacted, mean age at time of surgery was 62.6 years old and mean follow-up 78.2 months (5-234 months). Average SSIPI scores were 64.5/80 (26-80). Smokers were less satisfied with length of penis vs. non-smokers (SSIPI#8 = 2.89 vs 3.93, p=0.032). Men with diabetes were more likely to express regret about undergoing IPP surgery compared to men without (SSIPI#4 = 4.05 vs 4.38, p=0.0029). Men with an ASA score of 2 or less had higher total SSIPI scores compared to ASA score of 3+ (70.36 vs. 61.13, p=0.046). Conclusions Long-term satisfaction with IPP in a veteran population appears favorable. However, a significant number of these men still score poorly on SSIPI and/or have complications. The utility of this novel assessment instrument appears excellent. Men with smoking, diabetes, and higher overall comorbidities may find fewer positive results. Disclosure No