A population-based analysis of contemporary rates of reoperation for penile prosthesis procedures.
OBJECTIVE
To perform a population-based comparison of inflatable vs semirigid penile prostheses and to determine contemporary rates of reoperation and identify factors impacting the type of prosthetic implanted.


METHODS
Patient-level discharge data and revisit files from the Agency for Healthcare Research and Quality for semirigid and inflatable prosthesis procedures performed for erectile dysfunction from 2006 to 2009 in the state of California were examined. Regression analysis was performed to determine differences between the procedures in terms of infectious and noninfectious failure. Regression analysis was performed to identify factors associated with revision and to identify associations between potential risk factors and the type of implant performed.


RESULTS
A total of 2263 cases were included in the study (1824 inflatable and 439 semirigid). The overall reoperation rate was 7.42%. There was no difference in the overall revision rate between the 2 groups (7.52% semirigid and 7.40% inflatable; P=.94). The reoperation rate secondary to infectious complications was 3.6% (4.5% semirigid vs 3.23% inflatable; P=.18). The revision rate secondary to noninfectious failure was 2.96% in the semirigid vs 4.17% in the inflatable group (P=.25). Medicaid insurance (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.41-3.61), African American race (OR, 1.7; 95% CI, 1.20-2.49), age>80 (P=.046), and diabetes (OR, 1.67; 95% CI, 1.07-2.59) were associated with receiving a semirigid implant.


CONCLUSIONS
Reoperation rates for infectious and noninfectious failure are equivalent between the semirigid and inflatable penile prostheses. Sociodemographic factors appear to significantly influence the type of prosthesis a patient receives.
Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO. Electronic address: sgrewal@okuso.com.
Shaun
S
Grewal
Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO.
Joel
J
Vetter
Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO.
Steven B
SB
Brandes
Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, MO.
Seth A
SA
Strope
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D019935:Penile Implantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D015917:Penile Prosthesis / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011474:Prosthesis Design; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies