National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation

Sherwin Zargaroff, Vidit Sharma, Daniel Berhanu, Jeff A. Pearl, Joshua J Meeks, James M. Dupree, Brian V. Le, John Cashy, Kevin T. Mcvary*

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Introduction: A penile prosthesis infection (PPI) is either treated with explantation of the prosthesis with a possible delayed reimplantation or a salvage procedure with an immediate reimplantation of the prosthesis. Aim: We used a large, all-payer national database to investigate the use of the salvage procedure in the setting of PPI. Methods: The study used years 2000-2009 of the Nationwide Inpatient Sample to identify PPIs treated with immediate salvage or explantation alone. Admissions were then stratified by various parameters to compare differences in the salvage rates. Main Outcome Measures: Salvage Rate of Penile Prosthesis infection. Results: A total of 1,557 patients were treated with an explantation only (82.7%) or salvage (17.3%) for PPI, a proportion that remained stable over the study period. The patients treated with salvage were younger (60.4 vs. 65.1 years), more likely to be discharged home (87.3% vs. 61.9%), and were less likely to have a severe presentation (7.2% vs. 31.6%) than those who were explanted only (P<0.001). These factors were confirmed on multivariate regression analysis. The regression also revealed that treatment at rural hospitals had lower odds of salvage than treatment at urban teaching hospitals. Race, comorbid diabetes, and insurance status did not independently affect the salvage rate. There was no significant difference in total hospital charges between groups. Conclusions: Salvage rates have remained low over the past decade. Our study elucidated several factors decreasing the chances of salvage after PPI including age, severity of presentation, and hospital setting. Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, Le BV, Cashy J, and McVary KT. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation.

Original languageEnglish (US)
Pages (from-to)1078-1085
Number of pages8
JournalJournal of Sexual Medicine
Volume11
Issue number4
DOIs
StatePublished - Jan 1 2014

Fingerprint

Penile Prosthesis
Replantation
Infection
Prostheses and Implants
Therapeutics
Hospital Charges
Rural Hospitals
Salvage Therapy
Insurance Coverage
Urban Hospitals
Teaching Hospitals
Inpatients
Multivariate Analysis
Regression Analysis
Outcome Assessment (Health Care)
Databases

Keywords

  • Erectile dysfunction
  • Infection penile prosthesis
  • Salvage procedure
  • Surgery

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology

Cite this

Zargaroff, Sherwin ; Sharma, Vidit ; Berhanu, Daniel ; Pearl, Jeff A. ; Meeks, Joshua J ; Dupree, James M. ; Le, Brian V. ; Cashy, John ; Mcvary, Kevin T. / National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation. In: Journal of Sexual Medicine. 2014 ; Vol. 11, No. 4. pp. 1078-1085.
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title = "National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation",
abstract = "Introduction: A penile prosthesis infection (PPI) is either treated with explantation of the prosthesis with a possible delayed reimplantation or a salvage procedure with an immediate reimplantation of the prosthesis. Aim: We used a large, all-payer national database to investigate the use of the salvage procedure in the setting of PPI. Methods: The study used years 2000-2009 of the Nationwide Inpatient Sample to identify PPIs treated with immediate salvage or explantation alone. Admissions were then stratified by various parameters to compare differences in the salvage rates. Main Outcome Measures: Salvage Rate of Penile Prosthesis infection. Results: A total of 1,557 patients were treated with an explantation only (82.7{\%}) or salvage (17.3{\%}) for PPI, a proportion that remained stable over the study period. The patients treated with salvage were younger (60.4 vs. 65.1 years), more likely to be discharged home (87.3{\%} vs. 61.9{\%}), and were less likely to have a severe presentation (7.2{\%} vs. 31.6{\%}) than those who were explanted only (P<0.001). These factors were confirmed on multivariate regression analysis. The regression also revealed that treatment at rural hospitals had lower odds of salvage than treatment at urban teaching hospitals. Race, comorbid diabetes, and insurance status did not independently affect the salvage rate. There was no significant difference in total hospital charges between groups. Conclusions: Salvage rates have remained low over the past decade. Our study elucidated several factors decreasing the chances of salvage after PPI including age, severity of presentation, and hospital setting. Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, Le BV, Cashy J, and McVary KT. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation.",
keywords = "Erectile dysfunction, Infection penile prosthesis, Salvage procedure, Surgery",
author = "Sherwin Zargaroff and Vidit Sharma and Daniel Berhanu and Pearl, {Jeff A.} and Meeks, {Joshua J} and Dupree, {James M.} and Le, {Brian V.} and John Cashy and Mcvary, {Kevin T.}",
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Zargaroff, S, Sharma, V, Berhanu, D, Pearl, JA, Meeks, JJ, Dupree, JM, Le, BV, Cashy, J & Mcvary, KT 2014, 'National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation', Journal of Sexual Medicine, vol. 11, no. 4, pp. 1078-1085. https://doi.org/10.1111/jsm.12446

National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation. / Zargaroff, Sherwin; Sharma, Vidit; Berhanu, Daniel; Pearl, Jeff A.; Meeks, Joshua J; Dupree, James M.; Le, Brian V.; Cashy, John; Mcvary, Kevin T.

In: Journal of Sexual Medicine, Vol. 11, No. 4, 01.01.2014, p. 1078-1085.

Research output: Contribution to journalArticle

TY - JOUR

T1 - National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation

AU - Zargaroff, Sherwin

AU - Sharma, Vidit

AU - Berhanu, Daniel

AU - Pearl, Jeff A.

AU - Meeks, Joshua J

AU - Dupree, James M.

AU - Le, Brian V.

AU - Cashy, John

AU - Mcvary, Kevin T.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Introduction: A penile prosthesis infection (PPI) is either treated with explantation of the prosthesis with a possible delayed reimplantation or a salvage procedure with an immediate reimplantation of the prosthesis. Aim: We used a large, all-payer national database to investigate the use of the salvage procedure in the setting of PPI. Methods: The study used years 2000-2009 of the Nationwide Inpatient Sample to identify PPIs treated with immediate salvage or explantation alone. Admissions were then stratified by various parameters to compare differences in the salvage rates. Main Outcome Measures: Salvage Rate of Penile Prosthesis infection. Results: A total of 1,557 patients were treated with an explantation only (82.7%) or salvage (17.3%) for PPI, a proportion that remained stable over the study period. The patients treated with salvage were younger (60.4 vs. 65.1 years), more likely to be discharged home (87.3% vs. 61.9%), and were less likely to have a severe presentation (7.2% vs. 31.6%) than those who were explanted only (P<0.001). These factors were confirmed on multivariate regression analysis. The regression also revealed that treatment at rural hospitals had lower odds of salvage than treatment at urban teaching hospitals. Race, comorbid diabetes, and insurance status did not independently affect the salvage rate. There was no significant difference in total hospital charges between groups. Conclusions: Salvage rates have remained low over the past decade. Our study elucidated several factors decreasing the chances of salvage after PPI including age, severity of presentation, and hospital setting. Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, Le BV, Cashy J, and McVary KT. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation.

AB - Introduction: A penile prosthesis infection (PPI) is either treated with explantation of the prosthesis with a possible delayed reimplantation or a salvage procedure with an immediate reimplantation of the prosthesis. Aim: We used a large, all-payer national database to investigate the use of the salvage procedure in the setting of PPI. Methods: The study used years 2000-2009 of the Nationwide Inpatient Sample to identify PPIs treated with immediate salvage or explantation alone. Admissions were then stratified by various parameters to compare differences in the salvage rates. Main Outcome Measures: Salvage Rate of Penile Prosthesis infection. Results: A total of 1,557 patients were treated with an explantation only (82.7%) or salvage (17.3%) for PPI, a proportion that remained stable over the study period. The patients treated with salvage were younger (60.4 vs. 65.1 years), more likely to be discharged home (87.3% vs. 61.9%), and were less likely to have a severe presentation (7.2% vs. 31.6%) than those who were explanted only (P<0.001). These factors were confirmed on multivariate regression analysis. The regression also revealed that treatment at rural hospitals had lower odds of salvage than treatment at urban teaching hospitals. Race, comorbid diabetes, and insurance status did not independently affect the salvage rate. There was no significant difference in total hospital charges between groups. Conclusions: Salvage rates have remained low over the past decade. Our study elucidated several factors decreasing the chances of salvage after PPI including age, severity of presentation, and hospital setting. Zargaroff S, Sharma V, Berhanu D, Pearl JA, Meeks JJ, Dupree JM, Le BV, Cashy J, and McVary KT. National trends in the treatment of penile prosthesis infections by explantation alone vs. immediate salvage and reimplantation.

KW - Erectile dysfunction

KW - Infection penile prosthesis

KW - Salvage procedure

KW - Surgery

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