(488) Predictive Factors of Drain Output in Penile Prosthesis Surgery

Introduction The use of vacuum drains in penile prosthesis implantation aims to reduce the incidence of postoperative hematomas, thereby lowering the prosthesis-related infection rate and facilitating faster patient recovery. Objective To determine if patient characteristics, intraoperative factors, and postoperative outcomes can predict increased drain output, thus indicating a higher risk of postoperative scrotal hematoma. The secondary objective of the study is to identify which patients are eligible for drain removal 6 hours after the procedure (and prior to hospital discharge in those undergoing outpatient surgery) Methods This was a single-center prospective observational study involving 100 patients who underwent implantation of a 3-piece penile prosthesis between April 2023 and July 2024. Of these, 82% were treated in an outpatient setting. An 8 Ch Redon drain (DrenoFast®) was placed and secured to the skin. Drain output was recorded at 2, 4, 6, 12, and 24 hours post-surgery. Baseline characteristics collected included age, body mass index, and the etiology of erectile dysfunction. Perioperative variables included approach type (scrotal, infrapubic, subcoronal), prosthesis type (AMS700, Titan, Infla10), operative time, prosthesis length, dilation, cavernotomes, curvature, curvature correction, and use of compressive bandage ("mummy wrap"). Complications were recorded, such as hematomas, reoperation, and prosthetic infection. Initial descriptive analysis of the population was performed, followed by a division into two groups: patients with drain output < 100 cc and those with output ≥ 100 cc. Of the 100 patients, 4 were excluded due to accidental drain dislodgement. Differences in baseline and intraoperative characteristics between the two groups were analyzed using t-tests for continuous variables and Chi-square tests for categorical variables Results The mean age of the patients was 61.91 years (95% CI 60.29 – 63.53), with a mean body mass index (BMI) of 27.76 kg/m2 (95% CI 26.94 – 28.57). The average surgical time was 47.80 minutes (95% CI 44.60 – 50.99). Regarding complications, 8 patients (8%) developed postoperative hematoma, with no cases of prosthesis infection or reoperation. Among all variables analyzed, the use of anticoagulants (RR 3,604 IC 95% 1,522 – 8,535) and the drainage output at 6 hours >65cc (p-valor 0,000102) were associated with an increased risk of exceeding 100 cc of drainage output within the first 24 hours Conclusions Our results suggest that early drain removal at 6 hours is feasible for most patients, allowing discharge on the same day in outpatient procedures. However, for patients on anticoagulation therapy or with a drainage output exceeding 65 cc within the first 6 hours, extending drainage to 24 hours may reduce the risk of scrotal hematoma Disclosure No