Multi-institutional outcome study on the efficacy of closed-suction drainage of the scrotum in three-piece inflatable penile prosthesis surgery.
Infection is a devastating complication of penile prosthesis surgery that occurs in approximately 2-5% of all primary inflatable penile primary implants in most series. Prevention of hematoma and swelling with closed-suction drains has been shown not to increase infection rate and yield an earlier recovery time. Despite the intuitive advantages of short-term closed-suction drainage in reducing the incidence of postoperative scrotal swelling and associated adverse effects, many urologists are reluctant to drain the scrotum because of a theoretical risk of introducing an infection. In conclusion, this study was undertaken to evaluate the incidence of infection in three-piece penile prosthesis surgery with scrotal closed-suction drainage. A retrospective review of 425 consecutive primary three-piece penile prosthesis implantations was performed at three institutions in New Jersey, Ohio, and Arkansas from 1998 to 2002. Following the prosthesis insertion, 10 French Round Blake (Johnson & Johnson) or, in a few cases, 10 French Jackson Pratt, closed-suction drains were placed in each patient for less than 24 h. All subjects received standard perioperative antibiotic coverage. Average age at implant was 62 y (range 24-92 y). Operative time (incision to skin closure) was less than 60 min in the vast majority of cases. There were a total of 14 (3.3%) infections and three hematomas (0.7%) during an average 18-month follow-up period. In conclusion, this investigation revealed that closed-suction drainage of the scrotum for approximately 12-24 h following three-piece inflatable penile prosthesis surgery does not result in increased infection rate and is associated with a very low incidence of postoperative hematoma formation, swelling, and ecchymosis.
Sadeghi-Nejad
H
H
Division of Urology, UMDNJ New Jersey Medical School, Newark, New Jersey 07103, USA. hossein@ix.netcom.com
Ilbeigi
P
P
Wilson
S K
SK
Delk
J R
JR
Siegel
A
A
Seftel
A D
AD
Shannon
L
L
Jung
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019935:Penile Implantation / Q000009:adverse effects / Q000379:methods*; D015917:Penile Prosthesis / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012611:Scrotum / Q000601:surgery*; D013396:Suction; D013997:Time Factors; D016896:Treatment Outcome