(232) Infrapubic Approach for Revision of Three-Component Inflatable Penile Prosthesis: A Longitudinal Analysis of Patient Satisfaction and Functional Outcomes

Introduction Revision surgery for inflatable penile prosthesis (IPP) is frequently required due to mechanical failure, infection, or other complications. The infrapubic approach has never been formally described for three-component IPP revision in the literature. Objective We aimed to evaluate patient satisfaction, functional outcomes, and complications in a cohort of men undergoing revision of three-component IPP using the infrapubic approach at a single center. Methods Data from 30 men consecutively undergoing three-component IPP revision via infrapubic approach were analyzed. Sociodemographic and clinical characteristics, comorbidities using the age-adjusted Charlson Comorbidity Index (CCI), reason for revision, postoperative complications, and quality of life were collected. Quality of life was evaluated at follow-up using the Short Personal Questionnaire of Satisfaction with IPP (QoLSPP), including subscales for personal (QoLSPP-P), social (QoLSPP-S), relational (QoLSPP-R), and functional (QoLSPP-F) domains. Descriptive statistics were used to characterize the cohort. Continuous variables were reported as median (interquartile range, IQR) and categorical variables as n (%). Spearman correlation analysis was performed to assess the association between follow-up length and quality of life scores, given the non-normal data distribution. Results Overall, median (IQR) age at revision was 66 (57-71) years, with median follow-up of 33.3 (21-57.2) months. Median BMI was 25.5 (23.9-28.3) kg/m⊃2;, and median CCI was 2 (1-3). The most common reason for revision was malfunction (n=18, 60%), followed by mechanical failure of components (n=7, 23.3%), and other causes (n=5, 16.7%). Postoperative complications at revision were rare, with 1 patient (3.3%) experiencing penile ulcer and 1 patient (3.3%) with penile edema. At follow-up, median total QoLSPP score was 94 (83-99), reflecting high overall satisfaction. Subscale analysis showed high satisfaction across all dimensions: QoLSPP-P 5 (4-5), QoLSPP-S 5 (4-5), QoLSPP-R 5 (4-5), and QoLSPP-F 5 (4-5). Spearman correlation analysis showed no significant association between follow-up length and total QoLSPP score (rho = -0.12, p = 0.53), indicating that patient satisfaction remained stable regardless of time elapsed since revision surgery. Conclusions This is the first descriptive series evaluating the infrapubic approach for revision of three-component IPP. The infrapubic approach appears safe and effective for revision procedures, with low morbidity and high patient satisfaction. These findings support its role as a viable option for IPP revision surgery and warrant further investigation in larger comparative studies. Disclosure No