To assess the difference in outcomes between single dilation (SingD) and sequential dilation (SeqD) in primary penile implantation, hypothesizing that patients who undergo sequential dilation had higher rates of non-infectious complications.
We performed a multicenter, retrospective study of men undergoing primary IPP placement. Intraoperative complications and postoperative noninfectious outcomes were assessed between the two groups. Multivariable analysis was performed to identify predictors of complications.
A total of 3293 patients met inclusion criteria. After matching, there were 379 patients who underwent SingD and 379 patients who underwent SeqD. There was no significant difference in intraoperative complications between patients who underwent SingD versus SeqD, nor was there any difference in cylinder length (20 cm with IQR 18-21 cm vs. 20 cm with IQR 18-20 cm respectively, p=0.4). On multivariable analysis, SeqD (OR 5.23 with IQR 2.74-10, p<0.001) and older age (OR 1.04 with IQR 1.01-1.06, p=0.007) were predictive of postoperative non-infectious complications. There was no significant difference in intraoperative complications between patients who underwent SingD versus SeqD, nor was there any difference in cylinder length. SeqD and older age were predictive of postoperative non-infectious complications.
During inflatable penile prosthesis placement in the uncomplicated patient without fibrosis, single dilation is a safe technique to utilize during implantation that will minimize postoperative adverse events, and promote device longevity without loss of cylinder length.
Urology. 2023 Aug 11 [Epub ahead of print]
Chrystal Chang, David W Barham, Zafardjan Dalimov, Daniel Swerdloff, Hossein Sadeghi-Nejad, Robert Andrianne, Maxime Sempels, Tung-Chin Hsieh, Georgios Hatzichristodoulou, Muhammed Hammad, Jake Miller, Daniar Osmonov, Aaron Lentz, Paul Perito, Alfredo Suarez-Sarmiento, James Hotaling, Kelli Gross, James M Jones, Koenraad van Renterghem, Sung Hun Park, J Nicholas Warner, Matthew Ziegelmann, Vaibhav Modgil, Adam Jones, Ian Pearce, Martin S Gross, Faysal A Yafi, Jay Simhan
Department of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania., Department of Urology, University of California, Irvine, Orange, California., NYU Langone - NYU Grossman School of Medicine, New York, New York., Service d'urologie, Centre Hospitalier Universitaire de Liege, Liege, Belgium., Department of Urology, University of California, San Diego, La Jolla, California., Department of Urology, 'Martha-Maria' Hospital Nuremberg, Nuremberg, Germany., Department of Urology, University Hospital Schleswig Holstein, Kiel, Germany., Department of Urology, Duke University, Durham, North Carolina., Perito Urology, Coral Gables, Florida., Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah., Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Department of Urology, Jessa Hospital, Hasselt, Belgium., Sewum Prosthetic Urology Center of Excellence, Seoul, South Korea., Department of Urology, Mayo Clinic, Rochester, Minnesota., Manchester Andrology Centre, Manchester University NHS Foundation Trust, Manchester, UK., Department of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. Electronic address: .