title: Penile prosthesis surgery in out-patient setting: Effectiveness and costs in the "spending review" era.
abstract: BACKGROUND
  Penile implant patients are required to remain in the hospital after the operation for monitoring, antibiotic and analgesia administration. Cost containment, however, has resulted in the increased use of ambulatory surgery settings for many surgical procedures. Few studies have studied the feasibility of performing penile prosthesis insertion in an outpatient setting. The results are controversial and nowadays, in the most of centers that deal with prosthetic surgery, patients are still hospitalized.
  
  
  OBJECTIVE
  The aim of our investigation was to compare the feasibility of the performance as well as the complication profiles of penile implant surgery performed in an in-patient and an outpatient setting at a single center by a single surgeon.
  
  
  METHODS
  From January 2009 to June 2014, 50 patients of the same uro-andrological unit underwent penile prosthesis implantation performed by a single surgeon (N.M.). Twenty implantations were performed in an ambulatory day surgery setting.
  
  
  METHODS
  Effectiveness and costs of outpatient setting versus the in-patient setting of the penile prosthesis surgery.
  
  
  RESULTS
  There were some differences between the two groups in the intra-operative parameters, such as, operating time. Time lost from work was similar in both groups approximating 14 days. The mean number of analgesic pills ingested by the patients post-operatively was similar in both groups, averaging just under 25 pills per patient. There weren't post-operative complications in the outpatient group. Cost were 17% less in outpatient clinic.
  
  
  CONCLUSIONS
  The outpatient setting for this surgery is safe and effective even in patients with comorbidities or in case of secondary procedures. Costs are reduced by 17%.
authors.affiliation: Urology Unit, Santa Maria Annunziata Hospital (IOT), Florence. info@nicolamondaini.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Mondaini
authors.forename: Enrico
authors.initials: E
authors.lastname: Sarti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Giubilei
authors.forename: Andrea
authors.initials: A
authors.lastname: Gavazzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Costanzi
authors.forename: Arben
authors.initials: A
authors.lastname: Belba
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti