You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (PD44)1 Apr 2019PD44-06 POSTOPERATIVE PENILE PROSTHESIS PAIN: IS IT WORSE IN DIABETIC PATIENTS? Michel Apoj*, Mark Biebel, Archana Rajender, Didi Theva, Dayron Rodriguez, Martin Gross, and Ricardo Munarriz Michel Apoj*Michel Apoj* More articles by this author , Mark BiebelMark Biebel More articles by this author , Archana RajenderArchana Rajender More articles by this author , Didi ThevaDidi Theva More articles by this author , Dayron RodriguezDayron Rodriguez More articles by this author , Martin GrossMartin Gross More articles by this author , and Ricardo MunarrizRicardo Munarriz More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556610.48740.8eAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Inflatable penile prosthesis (IPP) surgery is an effective, safe and satisfactory treatment option for medication-refractory erectile dysfunction. Postoperative complications include infection, mechanical failure, erosion, and pain. Current literature suggests the need for a better approach to postoperative pain management after IPP surgery. Furthermore, targeted pain management strategies for diabetic patients have been suggested in the non-urologic literature, as several clinical studies have demonstrated that postoperative pain is different in diabetic and non-diabetic patients. The purpose of this study is to determine if there is a difference in postoperative pain after IPP placement in diabetics. METHODS: This is a single-institution retrospective review of 173 primary three-piece IPP prosthesis cases performed between 2014 and 2017. The main outcome measure was the number of 30-day postoperative emergency room and unplanned clinic visits specifically for significant pain. T-test was used for mean assessment and chi-square analysis was used for proportion assessment. P values <0.05 were considered statistically significant. The top HgbA1C quartile (with values greater than or equal to 8) was compared to the other quartiles, for a total of 30 (23%) and 98 (77%) patients, respectively. RESULTS: Diabetes was present in 92 (54.4%) patients and 96% of these were in the top HgbA1C quartile. Significant postoperative pain was more common in these patients (41% versus 13%, p = 0.047) and resulted in more unplanned 30-day post-operative visits (27% versus 11%, p = 0.042). These patients were more likely to be managed with a combination of opiates and gabapentin (30% versus 14%, p = 0.05). There were no statistical differences in age in diabetics and non-diabetics (mean 59 versus 61, p= 0.193). Hispanic and African-American patients represented 87% of the poorly controlled diabetics compared to only 13% of white patients (p <0.001). Poorly controlled diabetics had more medical comorbidities (p < 0.001). There were no differences in intra- or postoperative surgical complications in either group. CONCLUSIONS: Significant pain after IPP surgery was statistically higher in diabetics in the top HgbA1C quartile, which resulted in more unplanned 30-day post-operative visits. Approximately 90% of diabetics with HgbA1C greater than 8 were African-American and Hispanic patients. Patients with significant postoperative pain were managed with a combination of opioids and gabapentin. Future studies are required to optimize pain management in diabetics following IPP placement. Source of Funding: none Boston, MA; Dartmouth, NH; Boston, MA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e823-e823 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michel Apoj* More articles by this author Mark Biebel More articles by this author Archana Rajender More articles by this author Didi Theva More articles by this author Dayron Rodriguez More articles by this author Martin Gross More articles by this author Ricardo Munarriz More articles by this author Expand All Advertisement PDF downloadLoading ...
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