Mp76-09 Outcomes of Transurethral Surgery After Ipp

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (MP76)1 May 2024MP76-09 OUTCOMES OF TRANSURETHRAL SURGERY AFTER IPP Valerie Vasylieva, Gerard Henry, Ryan Griggs, and Edward Karpman Valerie VasylievaValerie Vasylieva , Gerard HenryGerard Henry , Ryan GriggsRyan Griggs , and Edward KarpmanEdward Karpman View All Author Informationhttps://doi.org/10.1097/01.JU.0001009484.98400.42.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Inflatable penile prosthesis (IPP) effectively restores erectile function with very high patient satisfaction rates. However, some patients may require subsequent treatments for urethral stricture, enlarged prostate and bladder tumors. These underlying conditions oftentimes coexist with erectile dysfunction (ED). Transurethral surgery (TUS) treatment of coexisting conditions in patients with IPP can be challenging and associated with a theoretical risk of mechanical injury and infection of the implant. There is a lack of literature reporting on IPP issues after TUS. Objective: The aim of this study was to evaluate postoperative outcomes in patients who underwent TUS following IPP placement. METHODS: After IRB approval, we reviewed the medical records of all patients who underwent Greenlight laser enucleation of the prostate (GLEP)(Wolf© 26 Fr cystoscope), Rezum© vaporization (21 Fr delivery device), transurethral bladder tumor resection (TURBT) (21 and 22 Fr cystoscopes), Holmium laser cystolitholapaxy (21 Fr cystoscope) and Optilume balloon dilation surgeries(19 Fr cystoscope and 24 Fr balloon) after IPP placement at our institution from 2014 to 2023. We excluded patients who underwent TUS prior to IPP placement and only included patients who had an in situ IPP at the time of the TUS procedure. Parameters such as IPSS score, PSA, postvoid residual volume (PVR) and transrectal ultrasound were used for assessment before and after surgery. All surgeries were performed by a single surgeon. Postoperative progress was assessed at multiple follow-up visits. RESULTS: Eight patients with IPP underwent 14 TUS. Six patients (43%) received surgical BPH treatment, one patient developed a bladder neck contracture (BNC) after GLEP and required a second TUS, one patient required four litholapaxies for recurrent bladder/prostate stones. Two patients developed a pendulous stricture. One patient developed a stricture after erosion from an IPP cylinder placed by a different surgeon 23 years prior. The patient underwent IPP removal and replacement at our facility 63 months prior to Optilume® balloon dilation. Another case of stricture was recorded in patient who underwent TURBT 5 month prior in our clinic. The mean time between IPP placement and TUS was 31.6±30.1 months. The average prostate volume was 61.9±40.6 mL, and the mean parameters of PVR, Maximum flow rate (Q max), IPSS, and PSA before surgery were 138.3±93.6 mL, 8.4±6.6 ml/s, 14.4±6.4, and 2.7±2.7 ng/ml, respectively. An average of 35.3±25.5 grams of prostate tissue was resected during GLEP. Postoperative parameters of PVR, Q max and PSA were 35.5±31.3 ml, 19.2±8.9 ml/s and 0.73±0.6 ng/dl, respectively. There were no cases of postoperative infections or IPP malfunctions reported during a mean follow-up of 40.5±35.6 months. CONCLUSIONS: Our experience shows that TUS performed after IPP placement is effective and safe in addressing underlying conditions such as BPH, bladder tumors and urethral strictures. Our findings indicate favorable postoperative outcomes in terms of PVR and PSA levels, without any reported infections or malfunctions of the IPP. However, it is important to consider the limitations of this study, including the small sample size. Further research with larger sample sizes would be beneficial to validate these findings and provide more comprehensive insights into the outcomes of TUS following IPP placement. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1246 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Valerie Vasylieva More articles by this author Gerard Henry More articles by this author Ryan Griggs More articles by this author Edward Karpman More articles by this author Expand All Advertisement PDF downloadLoading ...